An international group of scientists led by Professor Marc-Emmanuel Dumas at Imperial College London & CNRS, along with Prof. Patrice Cani (Imperial & University of Louvain, UCLouvain), Dr. Dominique Gauguier (Imperial & INSERM, Paris) and Prof. Peter Liu (University of Ottawa Heart Institute), has identified an unexpected natural compound that helps counter insulin resistance and type 2 diabetes. The compound, trimethylamine (TMA), is a metabolite created by gut microbes from dietary choline. According to a study in Nature Metabolism, TMA can interrupt a key immune pathway and contribute to healthier blood sugar levels.
The discovery builds on work that began 20 years ago. During his postdoctoral research, Patrice Cani found that high-fat diets allow bacterial components to pass into the body, prompting the immune system to activate and ignite inflammation. This immune response was shown to play a direct role in insulin resistance among people with diabetes. Although this idea faced skepticism in 2005, it is now widely recognized and scientifically accepted.
In 2025, researchers at the University of Louvain and Imperial College London clarified how this harmful chain reaction might be counteracted. They reported that TMA, formed by gut microbes from dietary choline present in several foods, can support improved blood-sugar control.
TMA Blocks a Critical Immune Protein
The key lies in the molecule’s interaction with IRAK4, a protein that helps regulate immune activity. Under a high-fat diet, IRAK4 responds by triggering inflammation to signal that the body is experiencing dietary imbalance.
However, when the body is exposed to elevated fat intake for extended periods (as in type 2 diabetes), IRAK4 becomes overstimulated. This constant activation drives chronic inflammation, which contributes directly to insulin resistance.
Using a combination of human cell cultures, animal studies, and molecular screening tools, the research team demonstrated that TMA can attach to IRAK4 and reduce its activity. This interaction lowers inflammation caused by fatty foods and restores the body’s ability to respond to insulin. The findings suggest that TMA may help recalibrate harmful metabolic responses triggered by poor dietary habits. The molecule also showed an impressive ability to protect mice from sepsis-related death by weakening overwhelming inflammatory responses.
IRAK4 Targeting Offers New Therapeutic Possibilities
Further experiments confirmed that removing the IRAK4 gene or inhibiting it with drugs produced the same beneficial effects seen with TMA. Because IRAK4 is already a well-established target in drug development, the results point toward promising treatment strategies for diabetes.
“This flips the narrative,” said Prof. Dumas. “We’ve shown that a molecule from our gut microbes can actually protect against the harmful effects of a poor diet through a new mechanism. It’s a new way of thinking about how the microbiome influences our health.”
“This shows how nutrition and our gut microbes can work together by producing molecules that fight inflammation and improve metabolic health!” said Prof. Patrice Cani, co-senior author, University of Louvain, Belgium and visiting professor at Imperial College London.
Global Impact and Future Directions
With more than 500 million people worldwide living with diabetes, the identification of TMA as a microbial signal that shapes immune responses introduces a potential new avenue for treatment. Approaches that enhance TMA production, whether through diet or medication, could help reduce insulin resistance and improve long-term health outcomes.
“What we eat shapes our microbes and some of their molecules can protect us from diabetes. That’s nutrition in action!” said University of Louvain, Prof. Cani.
This work was supported by an extensive network of collaborators across Europe and North America, involving teams in Belgium, Canada, Australia, France, Italy, and Spain. Funding came from numerous European (ERC, FEDER) and national (MRC, Wellcome Trust, ANR, FNRS, EOS, WELRi, ARC) sources, highlighting the large-scale effort behind this breakthrough.
