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The process of TMA production through the choline TMA-lyase complex, namely, CutC and CutD (often collectively referred to as CUTC), represents the primary pathway by which gut microbiota convert dietary choline into TMA ( L-carnitine is present in red meat and dairy products ( Serratia bacteria and Acinetobacter calcoaceticus that found in the human gut can cleave the 3-hydroxybutyryloxy group of L-carnitine to directly produce TMA ( in vitro , thereby generating TMA (Zhu et al., 2014)