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In animal models, use of the choline TMA lyase inhibitor iodomethyl choline (IMC) increases bacterial cholesterol metabolite loss and decreases intestinal sterol transport protein Niemann-Pick C1-Like 1 (NPC1L1) expression, reshaping gut microbiota and reducing hepatic cholesterol accumulation, while upregulating CYP7A1 and other bile acid-related genes (Pathak et al., 2020)