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Also, Apo M/S1P may activate PI3K/Akt pathway by S1PR1 and S1PR3 to irritate eNOS expression and NO generation, lessening monocytes adhesion to ECs 95,96

Butyrobetaine is a pro-atherogenic intermediate in gut microbial metabolism of L-carnitine to TMAO

Endothelial cells produce nitric oxide (NO), a free radical that acts as a vasodilator and inhibits platelet aggregation and adhesion [66]

These peptide hormones mediate their biological actions through five different but closely related G-protein coupled melanocortin receptors (MC1-R to MC5-R) that are distributed in many tissues and involved in the regulation of important physiological functions including skin pigmentation, steroidogenesis, energy homeostasis, sexual function, and exocrine secretion (Yang, 2011)