TLR4 and atherosclerosis: Upregulation of arginase activity has been associated with multiple cardiovascular dysfunctions, including atherosclerosis and hypertension.40,42 An alteration of hepatic arginase from direct microbiome modulation has not been reported previously; however, arginase has been proposed to be a potential target in the treatment of cardiovascular diseases.42 Greater expression of hepatic fetuin-A and colonic TLR4 was also observed in OVX-R mice compared to SHM-R mice, suggesting an interaction between the gut microbiome and fetuin-A expression associated with altered sex hormone status.