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Indeed, in a model of graft-versus-host disease (GVHD), T-cell-depleted bone marrow transplants fed with TMAO-rich diet exhibited a significant increase in the frequency of F4/80 + CD11b + CD16/32 + inflammatory macrophages relative to the F4/80 + CD11b + whole population, worsening disease severity, and increasing mortality ( Figure 3 Beyond the inflammatory response, choline metabolism is also implicated in IL-4-induced macrophage polarization, critical for immunity against intestinal helminth infection, resolution of inflammation, and tissue repair

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Schrier L, Ferns SP, Barnes KM, Emons JA, Nilsson O, et al

This is off-label use currently, but the data is compelling enough that it deserves consideration for appropriate patients