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Accumulation of butyryl-carnitine has been associated with abnormal mitochondrial lipid -oxidation in T2D 54 , suggesting a link between TMAO and mitochondrial dysfunction consistent with the finding that TMAO binds to protein kinase R-like endoplasmic reticulum kinase and increases mitochondrial stress 55

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The aforementioned cell wall and membrane targeting technologies can be harnessed in this context to enhance specificity