IMR Press / FBL / Volume 29 / Issue 5 / DOI: 10.31083/j.fbl2905182
Open Access Review
Roles and Mechanisms of Choline Metabolism in Nonalcoholic Fatty Liver Disease and Cancers
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1 College of Life Science and Technology, Huazhong Agricultural University, 430070 Wuhan, Hubei, China
2 College of Biomedicine and Health, Huazhong Agricultural University, 430070 Wuhan, Hubei, China
3 Department of Medical Oncology, Huazhong University of Science and Technology, Tongji Medical College, Hubei Cancer Hospital, 430079 Wuhan, Hubei, China
*Correspondence: (Chang Xue); (Runzhi Chen)
These authors contributed equally.
Front. Biosci. (Landmark Ed) 2024, 29(5), 182;
Submitted: 11 December 2023 | Revised: 14 March 2024 | Accepted: 20 March 2024 | Published: 11 May 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Choline participates in three major metabolic pathways: oxidation, phosphorylation, and acetylation. Through oxidation, choline is converted to betaine and contributes to methyl metabolism and epigenetic regulation. Through phosphorylation, choline participates in phospholipid metabolism, and serves as the precursor of phosphocholine, phosphatidylcholine, glycerophosphocholine, and other essential compounds, thereby modulating lipid metabolism and transport. Through acetylation, choline is transformed into acetylcholine in cholinergic neurons, playing a vital role in neurotransmission. Moreover, gut microbiota can metabolize choline into trimethylamine-N-oxide, and be involved in the pathogenesis of various diseases such as nonalcoholic fatty liver disease (NAFLD), cancer, cardiovascular disease, etc. Since choline metabolism is implicated in the development of NAFLD and diverse cancers, including liver cancer, it may serve as a therapeutic target for these diseases in the future. Currently, there are numerous therapeutic agents targeting choline metabolism to treat NAFLD and cancers, but most of them are ineffective and some even have adverse effects that lead to a series of complications. Therefore, further research and clinical validation are required to obtain safe and efficacious drugs. This review comprehensively summarizes the choline metabolic pathway and its regulatory mechanisms, elucidates the roles and mechanisms of choline metabolism in the aforementioned diseases, and provides a discussion of the current advances and immense potential of this field.

nonalcoholic fatty liver disease
Fig. 1.
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