The gut microbiome-derived TMAO can also affect our immune system by activating TXNIP-NLRP3 inflammasomes [138], leading to the expression of inflammatory markers such as TNF-α, IL-6 [100, 139], IL-18, and IL-1B [138] that can boost plaque development in arteries by generating cholesterol-packed foamy macrophages, ultimately resulting in CAD [140] (Fig. 2). Here, TNF is linked to coronary artery disorder.