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In mice plasma TMAO has been shown to be higher in female and TMA lower compared to males as Flavin-Containing Monooxygenase 3 (the main TMAO producing enzyme) expression is drastically downregulated by testosterone (and mildly upregulated by estrogen

However, translating these strategies into clinical practice remains challenging due to potential off-target effects and limitations in crossing the BBB

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Crucially, experimental interventions targeting FAO modulate this injury: Enhancing FAO with L-carnitine reduced hyperoxia-induced impairments in alveolarization and vascularization, whereas inhibiting FAO exacerbated these injuries

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