Mechanistically, TMAO could be directly linked to the anti-tumor immune response, since the metabolite induced pyroptosis (a form of inflammatory cell death capable of evoking an anti-tumor immune response) of BC cells through activation of the endoplasmic reticulum stress kinase, EIF2AK3 (eukaryotic translation initiation factor 2 alpha kinase 3, a.k.a. PERK) [359]. Here, EIF2AK3 is linked to breast cancer.