This effect results in the amplification of tumor invasiveness via the CCL17/CCR4/mammalian target of rapamycin complex 1 (mTORC1) axis.78 Additionally, Mirji et al. found that trimethylamine N-oxide (TMAO), which is produced by intestinal microbes during the breakdown of dietary choline, can trigger the production of pro-inflammatory mediators like TNFα and ROS. This evidence concerns the gene TNF and neoplasm.