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TMAVA, a metabolite of intestinal microbes, is increased in plasma from patients with liver steatosis, inhibits -Butyrobetaine hydroxylase, and exacerbates fatty liver in mice

That criticism is not the entire story

Including enhancement of nucleotide excision repair capacity in melanocytes and keratinocytes following MT-1 treatment, reduction of UV-induced cyclobutane pyrimidine dimer formation, activation of antioxidant defence pathways, and upregulation of DNA repair enzyme expression downstream of MC1R-cAMP signalling

In addition, it is now apparent that AD is multifactorial rather than a single disease (43)