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FMO3 antisense oligonucleotide is a preclinical research tool developed by Ionis Pharmaceuticals to selectively knock down the expression of flavin-containing monooxygenase 3 (FMO3) in the liver. FMO3 is the primary enzyme responsible for converting gut-microbiota-derived trimethylamine (TMA) into trimethylamine N-oxide (TMAO), a metabolite strongly associated with cardiovascular and metabolic diseases. These oligonucleotides are typically second-generation phosphorothioate ASOs containing 2'-O-methoxyethyl (MOE) modifications. In animal models, FMO3 knockdown has been shown to reduce systemic TMAO levels, thereby preventing the development of atherosclerosis, hyperglycemia, hyperlipidemia, and obesity. It also appears to modulate FoxO1 expression, a central node for metabolic control. While highly effective in preclinical studies for metabolic and cardiovascular research, it is currently utilized as a research reagent rather than a clinical-stage drug candidate.
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