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Rensch P, Postolache TT, Dalkner N, Stross T, Constantine N, Dagdag A, Wadhawan A, Mohyuddin F, Lowry CA, Joseph J, Birner A, Fellendorf FT, Finner A, Lenger M, Maget A, Painold A, Queissner R, Schmiedhofer F, Smolle S, Tmava-Berisha A, Reininghaus EZ. Toxoplasma gondii IgG serointensity and cognitive function in bipolar disorder. Int J Bipolar Disord 2024; 12:31. [PMID: 39179937 PMCID: PMC11343948 DOI: 10.1186/s40345-024-00353-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 08/08/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND Alongside affective episodes, cognitive dysfunction is a core symptom of bipolar disorder. The intracellular parasite T. gondii has been positively associated with both, the diagnosis of bipolar disorder and poorer cognitive performance, across diagnostic boundaries. This study aims to investigate the association between T. gondii seropositivity, serointensity, and cognitive function in an euthymic sample of bipolar disorder. METHODS A total of 76 participants with bipolar disorder in remission were tested for T. gondii-specific IgG and IgM antibodies and for cognitive performance using neuropsychological test battery. Cognitive parameters were categorized into three cognitive domains (attention and processing speed, verbal memory, and executive function). Statistical analysis of associations between continuous indicators of cognitive function as dependent variables in relationship to T. gondii, included multivariate analyses of co-variance for seropositivity, and partial correlations with IgG serointensity in IgG seropositives. All analyses were controlled for age and premorbid IQ. RESULTS In seropositives (n = 27), verbal memory showed significant inverse partial correlations with IgG antibody levels (short delay free recall (r=-0.539, p = 0.005), long delay free recall (r=-0.423, p = 0.035), and immediate recall sum trial 1-5 (r=-0.399, p = 0.048)). Cognitive function did not differ between IgG seropositive and seronegative individuals in any of the cognitive domains (F (3,70) = 0.327, p = 0.806, n = 76). IgM positives (n = 7) were too few to be analyzed. CONCLUSIONS This investigation is the first to show an association between T. gondii IgG serointensity and memory function in a well-diagnosed bipolar disorder sample. It adds to the existing literature on associations between latent T. gondii infection and cognition in bipolar disorder, while further research is needed to confirm and expand our findings, eliminate potential sources of bias, and establish cause-effect relationships.
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Affiliation(s)
- Paul Rensch
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Teodor T Postolache
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Center for Research on Aging, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Aurora, CO, USA
- VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center (MIRECC), Baltimore, Maryland, USA
| | - Nina Dalkner
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria.
| | - Tatjana Stross
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Niel Constantine
- Institute of Human Virology, Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Aline Dagdag
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Abhishek Wadhawan
- Department of Psychiatry, Saint Elizabeths Hospital, Washington, DC, USA
| | - Farooq Mohyuddin
- Department of Psychiatry, Saint Elizabeths Hospital, Washington, DC, USA
| | - Christopher A Lowry
- Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Aurora, CO, USA
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Joshua Joseph
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Armin Birner
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Frederike T Fellendorf
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Alexander Finner
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Melanie Lenger
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Alexander Maget
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Annamaria Painold
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Robert Queissner
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Franziska Schmiedhofer
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Stefan Smolle
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Adelina Tmava-Berisha
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Eva Z Reininghaus
- Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
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Reininghaus EZ, Lenger M, Schönthaler EMD, Fellendorf FT, Stross T, Schwarz M, Moll N, Reininghaus B, Dalkner N. Changes in tryptophan breakdown associated with response to multimodal treatment in depression. Front Psychiatry 2024; 15:1380620. [PMID: 38974918 PMCID: PMC11224482 DOI: 10.3389/fpsyt.2024.1380620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/03/2024] [Indexed: 07/09/2024] Open
Abstract
Background Research on depression showed that dysregulations in tryptophan (TRP), kynurenine (KYN), and its KYN pathway metabolites are key aspects in the development and maintenance of depressive symptoms. In our previous reports, we described sex-specific changes in TRP breakdown as well as changes in KYN and KYN/TRP in association with treatment response and inflammatory and metabolic parameters. However, results of treatment effects on KYN pathway metabolites as well as how pathway changes are related to treatment response remain sparse. Objective We investigated potential changes of KYN and KYN pathway metabolites in association with therapeutic response of individuals with depression during a six-week multimodal psychiatric rehabilitation program. Methods 87 participants were divided into treatment responders and non-responders (48 responders, 39 non-responders; 38 male, 49 female; M age = 51.09; SD age = 7.70) using scores of psychological questionnaires. KYN pathway metabolites serum concentrations as well as their ratios were collected using high performance liquid chromatography. Changes over time (time of admission (t1) vs. time of discharge (t2)) were calculated using repeated measure analyses of (co)variance. Results Non-responders exhibited higher levels of 3-Hydroxyanthralinic acid (3-HAA), nicotinic acid (NA), and 3-HAA/KYN, independently of measurement time. NA levels decreased, while 3-HAA levels increased over time in both groups, independently of treatment response. 3-HK/KYN levels decreased, while KYN levels increased in non-responders, but not in responders over time. Discussion The results indicate that some compounds of the KYN pathway metabolites can be altered through multimodal long-term interventions in association with treatment response. Especially the pathway degrading KYN further down to 3-HAA and 3-HK/KYN might be decisive for treatment response in depression.
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Affiliation(s)
- Eva Z. Reininghaus
- Clinical Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Melanie Lenger
- Clinical Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Elena M. D. Schönthaler
- Clinical Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Frederike T. Fellendorf
- Clinical Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Tatjana Stross
- Clinical Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Markus Schwarz
- Institute of Laboratory Medicine, University Hospital, Ludwig-Maximilian University (LMU), Munich, Munich, Germany
| | - Natalie Moll
- Institute of Laboratory Medicine, University Hospital, Ludwig-Maximilian University (LMU), Munich, Munich, Germany
| | - Bernd Reininghaus
- Clinical Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Nina Dalkner
- Clinical Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
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Queissner R, Fellendorf FT, Dalkner N, Bengesser SA, Maget A, Birner A, Platzer M, Reininghaus B, Häussl A, Schönthaler E, Tmava-Berisha A, Lenger M, Reininghaus EZ. The influence of chronic inflammation on the illnesscourse of bipolar disorder: A longitudinal study. J Psychiatr Res 2024; 174:258-262. [PMID: 38670061 DOI: 10.1016/j.jpsychires.2024.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 04/02/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION C-reactive protein (CRP) is a systemic inflammatory marker, which indicates systemic inflammatory processes It is involved in different inflammatory processes of the body and is a reliable marker for the general inflammatory state of the body. High sensitive CRP seems to play a key role as a state and trait marker of bipolar disorder (BD). In the current study, we tried to determine the long-term effect of CRP levels on clinical symptoms and illness course of bipolar disorder. METHODS For the current study, we examined 106 patients with BD for a period of four years. Participants underwent a clinical screening for depressive and manic episodes with the Hamilton Depression Scale (HAMD) and the Young Mania Rating Score (YMRS) and a serological diagnostic for inflammatory parameters every six months, thus leading to 8 measurement times in total. Patients with the presence of severe medical or neurological comorbidities such as active cancer, chronic obstructive lung disease, rheumatoid arthritis, systemic lupus erythematosus, Alzheimer's disease, Parkinson's disease, Huntington's disease or multiple sclerosis and acute infections were not included in the study. RESULTS In our sample, 26% showed a mean hsCRP above 5 mg/dl. Those patients showed a significantly higher mean YMRS score than those with a mean hsCRP under 5 mg/dl during our observation period. Regarding HAMD there was no significant difference in hsCRP values. The existence of lithium treatment showed no significant influence on mean hsCRP levels between the start and endpoint. CONCLUSION Individuals who were exposed to a higher level of inflammation over time suffered from more manic symptoms in this period. These findings underline the hypothesis that inflammatory processes have an accumulative influence on the illness course of BD, especially concerning manic symptoms and episodes.
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Affiliation(s)
- Robert Queissner
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Frederike T Fellendorf
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria.
| | - Nina Dalkner
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Susanne A Bengesser
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Alexander Maget
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Armin Birner
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Martina Platzer
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Bernd Reininghaus
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Alfred Häussl
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Elena Schönthaler
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Adelina Tmava-Berisha
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Melanie Lenger
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
| | - Eva Z Reininghaus
- Medical University Graz, Department for Psychiatry and Psychotherapeutic Medicine, Auenbruggerplatz 31, 8036, Graz, Austria
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Sunon P, Ngokpho B, Kaewket K, Wannapaiboon S, Ngamchuea K. Copper(II) phthalocyanine as an electrocatalytic electrode for cathodic detection of urinary tryptophan. Analyst 2024; 149:3041-3051. [PMID: 38625079 DOI: 10.1039/d4an00418c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Herein, we introduce a novel method for tryptophan detection via a reduction reaction facilitated by its interaction with a copper(II) phthalocyanine (CuPc) electrocatalytic electrode. This method addresses challenges associated with the susceptibility of the oxidation response to interference from various species when measuring tryptophan in bodily fluids. The reduction currents exhibit a linear increase with tryptophan concentrations in two ranges: 0.0013-0.10 mM and 0.10-1.20 mM, with the sensitivities of 14.7 ± 0.5 μA mM-1 and 3.5 ± 0.1 μA mM-1, respectively. The limit of detection (LOD, 3SB/m) is determined to be 0.39 μM. The sensor exhibits excellent reproducibility, with the relative standard deviation of <5%. Application of the sensor to authentic urine samples yields a % recovery of 101 ± 4%.
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Affiliation(s)
- Pachanuporn Sunon
- School of Chemistry, Institute of Science, Suranaree University of Technology, 111 University Avenue, Suranaree, Muang, Nakhon Ratchasima 30000, Thailand.
- Institute of Research and Development, Suranaree University of Technology, 111 University Avenue, Suranaree, Muang, Nakhon Ratchasima, 30000, Thailand
| | - Busarakham Ngokpho
- School of Chemistry, Institute of Science, Suranaree University of Technology, 111 University Avenue, Suranaree, Muang, Nakhon Ratchasima 30000, Thailand.
| | - Keerakit Kaewket
- School of Chemistry, Institute of Science, Suranaree University of Technology, 111 University Avenue, Suranaree, Muang, Nakhon Ratchasima 30000, Thailand.
| | - Suttipong Wannapaiboon
- Synchrotron Light Research Institute, 111 University Avenue, Suranaree, Muang, Nakhon Ratchasima, 30000, Thailand
| | - Kamonwad Ngamchuea
- School of Chemistry, Institute of Science, Suranaree University of Technology, 111 University Avenue, Suranaree, Muang, Nakhon Ratchasima 30000, Thailand.
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Chen J, Amdanee N, Zuo X, Wang Y, Gong M, Yang Y, Li H, Zhang X, Zhang C. Biomarkers of bipolar disorder based on metabolomics: A systematic review. J Affect Disord 2024; 350:492-503. [PMID: 38218254 DOI: 10.1016/j.jad.2024.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 12/05/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024]
Abstract
Bipolar disorder (BD) is a severe affective disorder characterized by recurrent episodes of depression or mania/hypomania, which significantly impair cognitive function, life skills, and social abilities of patients. There is little understanding of the neurobiological mechanisms of BD. The diagnosis of BD is primarily based on clinical assessment and psychiatric examination, highlighting the urgent need for objective markers to facilitate the diagnosis of BD. Metabolomics can be used as a diagnostic tool for disease identification and evaluation. This study summarized the altered metabolites in BD and analyzed aberrant metabolic pathways, which might contribute to the diagnosis of BD. Search of PubMed and Web of science for human BD studies related to metabolism to identify articles published up to November 19, 2022 yielded 987 articles. After screening and applying the inclusion and exclusion criteria, 16 untargeted and 11 targeted metabolomics studies were included. Pathway analysis of the potential differential biometabolic markers was performed using the Kyoto encyclopedia of genes and genomes (KEGG). There were 72 upregulated and 134 downregulated biomarkers in the untargeted metabolomics studies using blood samples. Untargeted metabolomics studies utilizing urine specimens revealed the presence of 78 upregulated and 54 downregulated metabolites. The targeted metabolomics studies revealed abnormalities in the metabolism of glutamate and tryptophan. Enrichment analysis revealed that the differential metabolic pathways were mainly involved in the metabolism of glucose, amino acid and fatty acid. These findings suggested that certain metabolic biomarkers or metabolic biomarker panels might serve as a reference for the diagnosis of BD.
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Affiliation(s)
- Jin Chen
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China; Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu,210000, China
| | - Nousayhah Amdanee
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu,210000, China
| | - Xiaowei Zuo
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China
| | - Yu Wang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu,210000, China
| | - Muxin Gong
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China
| | - Yujing Yang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China
| | - Hao Li
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China
| | - Xiangrong Zhang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China; Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu,210000, China.
| | - Caiyi Zhang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu,221004, China.
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Queissner R, Buchmann A, Demjaha R, Tafrali C, Benkert P, Kuhle J, Jerkovic A, Dalkner N, Fellendorf F, Birner A, Platzer M, Tmava-Berisha A, Maget A, Stross T, Lenger M, Häussl A, Khalil M, Reininghaus E. Serum neurofilament light as a potential marker of illness duration in bipolar disorder. J Affect Disord 2024; 350:366-371. [PMID: 38215991 DOI: 10.1016/j.jad.2024.01.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/14/2024]
Abstract
INTRODUCTION Investigation on specific biomarkers for diagnostic or prognostic usage in mental diseases and especially bipolar disorder BD seems to be one outstanding field in current research. Serum neurofilament light (sNfL), a marker for neuro-axonal injury, is increased in various acute and chronic neurological disorders, but also neuro-psychiatric conditions, including affective disorders. The aim of our study was to determine a potential relation between a neuron-specific marker like sNfL and different clinical states of BD. METHODS In the current investigation, 51 patients with BD and 35 HC were included. Mood ratings with the Hamilton depression scale (HAMD) and the Young mania rating scale (YMRS) have been included. Illness duration was defined as the period from the time of diagnosis out of self-report and medical records. sNFL was quantified by a commercial ultrasensitive single molecule array (Simoa). RESULTS There was a significant positive correlation between the number of manic episodes in the past and sNfL, controlled for age and duration of illness. (R = 0.49, p = 0.03) Depressive episodes were not associated to sNfL values. (R = 0.311, p = n.s.) Patients with >3 years of illness duration showed significantly higher levels of sNfL (M18.59; SD 11.89) than patients with shorter illness duration (M = 12.38, p = 0.03) and HC (M = 11.35, p = 0.02). Patients with <3 years of illness and HC did not differ significantly in sNfL levels. DISCUSSION Interestingly, individuals with BD and HC did not differ in sNFL levels in general. Nevertheless, looking at the BD cohort more specifically, we found that individuals with BD with longer duration of illness (>3 years) had higher levels of sNfL than those with an illness duration below 3 years. Our results confirm previous reports on the relation of neuro-axonal injury as evidenced by sNfL and illness specific variables in bipolar disorder. Further studies are needed to clarify if sNfL may predict the disease course and/or indicated response to treatment regimes.
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Affiliation(s)
- R Queissner
- Medical University of Graz, Department for Psychiatry, Austria
| | - A Buchmann
- Medical University of Graz, Department for Neurology, Austria
| | - R Demjaha
- Medical University of Graz, Department for Neurology, Austria
| | - C Tafrali
- Medical University of Graz, Department for Neurology, Austria
| | - P Benkert
- Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Basel, Switzerland
| | - J Kuhle
- Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Basel, Switzerland
| | - A Jerkovic
- Institute of Molecular Biosciences, University of Graz, Austria
| | - N Dalkner
- Medical University of Graz, Department for Psychiatry, Austria
| | - F Fellendorf
- Medical University of Graz, Department for Psychiatry, Austria
| | - A Birner
- Medical University of Graz, Department for Psychiatry, Austria
| | - M Platzer
- Medical University of Graz, Department for Psychiatry, Austria
| | - A Tmava-Berisha
- Medical University of Graz, Department for Psychiatry, Austria
| | - A Maget
- Medical University of Graz, Department for Psychiatry, Austria
| | - T Stross
- Medical University of Graz, Department for Psychiatry, Austria
| | - M Lenger
- Medical University of Graz, Department for Psychiatry, Austria
| | - A Häussl
- Medical University of Graz, Department for Psychiatry, Austria
| | - M Khalil
- Medical University of Graz, Department for Neurology, Austria.
| | - E Reininghaus
- Medical University of Graz, Department for Psychiatry, Austria
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7
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Späth Z, Tmava-Berisha A, Fellendorf FT, Stross T, Maget A, Platzer M, Bengesser SA, Häussl A, Zwigl I, Birner A, Queissner R, Stix K, Wels L, Lenger M, Dalkner N, Zelzer S, Herrmann M, Reininghaus EZ. Vitamin D Status in Bipolar Disorder. Nutrients 2023; 15:4752. [PMID: 38004146 PMCID: PMC10674170 DOI: 10.3390/nu15224752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Vitamin D status may impact acute affective symptomatology and the severity of symptoms in patients with bipolar disorder (BD). Therefore, this cross-sectional study analyzed 25(OH)D, 24,25(OH)2D, and the vitamin D metabolite ratio (VMR) in BD and correlated the results with clinical affective symptomatology and functionality. The inactive precursor 25(OH)D, and its principal catabolite 24,25(OH)2D, were measured simultaneously with a validated liquid chromatography-tandem mass spectrometry method in 170 BD outpatients and 138 healthy controls. VMR was calculated as follows: VMR = 100×(24,25(OH)2D/25(OH)D). The psychometric assessment comprised: Beck Depression Inventory-II, Hamilton Depression Rating Scale, Young Mania Rating Scale, Global Assessment of Functioning, and number of suicide attempts. We did not find a significant difference between patients and controls in the concentrations of 25(OH)D and 24,25(OH)2D. Additionally, the VMR was comparable in both groups. The calculations for the clinical parameters showed a negative correlation between the Young Mania Rating Scale and 24,25(OH)2D (r = -0.154, p = 0.040), as well as the Young Mania Rating Scale and the VMR (r = -0.238, p = 0.015). Based on the small effect size and the predominantly euthymic sample, further exploration in individuals with manic symptoms would be needed to confirm this association. In addition, long-term clinical markers and an assessment in different phases of the disease may provide additional insights.
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Affiliation(s)
- Zita Späth
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Adelina Tmava-Berisha
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Frederike T. Fellendorf
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Tatjana Stross
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Alexander Maget
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Martina Platzer
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Susanne A. Bengesser
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Alfred Häussl
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Ina Zwigl
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Armin Birner
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Robert Queissner
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Katharina Stix
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Linda Wels
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Melanie Lenger
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Nina Dalkner
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
| | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria; (S.Z.); (M.H.)
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria; (S.Z.); (M.H.)
| | - Eva Z. Reininghaus
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria; (Z.S.); (F.T.F.); (T.S.); (A.M.); (M.P.); (S.A.B.); (A.H.); (I.Z.); (A.B.); (R.Q.); (K.S.); (L.W.); (M.L.); (N.D.); (E.Z.R.)
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8
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Ortega MA, Álvarez-Mon MA, García-Montero C, Fraile-Martínez Ó, Monserrat J, Martinez-Rozas L, Rodríguez-Jiménez R, Álvarez-Mon M, Lahera G. Microbiota-gut-brain axis mechanisms in the complex network of bipolar disorders: potential clinical implications and translational opportunities. Mol Psychiatry 2023; 28:2645-2673. [PMID: 36707651 PMCID: PMC10615769 DOI: 10.1038/s41380-023-01964-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/02/2023] [Accepted: 01/13/2023] [Indexed: 01/28/2023]
Abstract
Bipolar disorders (BD) represent a severe leading disabling mental condition worldwide characterized by episodic and often progressive mood fluctuations with manic and depressive stages. The biological mechanisms underlying the pathophysiology of BD remain incompletely understood, but it seems that there is a complex picture of genetic and environmental factors implicated. Nowadays, gut microbiota is in the spotlight of new research related to this kind of psychiatric disorder, as it can be consistently related to several pathophysiological events observed in BD. In the context of the so-called microbiota-gut-brain (MGB) axis, it is shown to have a strong influence on host neuromodulation and endocrine functions (i.e., controlling the synthesis of neurotransmitters like serotonin or mediating the activation of the hypothalamic-pituitary-adrenal axis), as well as in modulation of host immune responses, critically regulating intestinal, systemic and brain inflammation (neuroinflammation). The present review aims to elucidate pathophysiological mechanisms derived from the MGB axis disruption and possible therapeutic approaches mainly focusing on gut microbiota in the complex network of BD. Understanding the mechanisms of gut microbiota and its bidirectional communication with the immune and other systems can shed light on the discovery of new therapies for improving the clinical management of these patients. Besides, the effect of psychiatric drugs on gut microbiota currently used in BD patients, together with new therapeutical approaches targeting this ecosystem (dietary patterns, probiotics, prebiotics, and other novelties) will also be contemplated.
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Affiliation(s)
- Miguel A Ortega
- Department of Medicine and Medical Specialities, University of Alcala, Alcalá de Henares, Spain.
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain.
| | - Miguel Angel Álvarez-Mon
- Department of Medicine and Medical Specialities, University of Alcala, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Cielo García-Montero
- Department of Medicine and Medical Specialities, University of Alcala, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Óscar Fraile-Martínez
- Department of Medicine and Medical Specialities, University of Alcala, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Jorge Monserrat
- Department of Medicine and Medical Specialities, University of Alcala, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Lucia Martinez-Rozas
- Department of Medicine and Medical Specialities, University of Alcala, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
| | - Roberto Rodríguez-Jiménez
- Department of Legal Medicine and Psychiatry, Complutense University, Madrid, Spain
- Institute for Health Research 12 de Octubre Hospital, (Imas 12)/CIBERSAM (Biomedical Research Networking Centre in Mental Health), Madrid, Spain
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialities, University of Alcala, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Immune System Diseases-Rheumatology, Oncology Service an Internal Medicine, University Hospital Príncipe de Asturias (CIBEREHD), Alcalá de Henares, Spain
- Psychiatry Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, Alcalá de Henares, Spain
| | - Guillermo Lahera
- Department of Medicine and Medical Specialities, University of Alcala, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Psychiatry Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, Alcalá de Henares, Spain
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9
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Bartoli F, Cioni RM, Cavaleri D, Callovini T, Crocamo C, Misiak B, Savitz JB, Carrà G. The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overview. Eur Psychiatry 2022; 65:e82. [PMID: 36366795 PMCID: PMC9724221 DOI: 10.1192/j.eurpsy.2022.2340] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The balance between neurotoxic and neuroprotective effects of kynurenine pathway (KP) components has been recently proposed as a key element in the pathophysiology of bipolar disorder (BD) and related mood episodes. This comprehensive overview explored the link of KP with symptom severity and other clinical features of BD. METHODS We searched Medline, Embase, and PsycInfo electronic databases for studies assessing the association of peripheral and/or central concentrations of KP metabolites with putative clinical features, including symptom severity and other clinical domains in BD. RESULTS We included the findings of 13 observational studies investigating the possible variations of KP metabolites according to symptom severity, psychotic features, suicidal behaviors, and sleep disturbances in BD. Studies testing the relationship between KP metabolites and depression severity generated mixed and inconsistent findings. No statistically significant correlations with manic symptoms were found. Moreover, heterogeneous variations of the KP across different clinical domains were shown. Few available studies found (a) higher levels of cerebrospinal fluid kynurenic acid and lower of plasma quinolinic acid in BD with psychotic features, (b) lower central and peripheral picolinic acid levels in BD with suicide attempts, and (c) no significant correlations between KP metabolites and BD-related sleep disturbances. CONCLUSIONS An imbalance of KP metabolism toward the neurotoxic branches is likely to occur in people with BD, though evidence on variations according to specific clinical features of BD is less clear. Additional research is needed to clarify the role of KP in the etiopathogenesis of BD and related clinical features.
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Affiliation(s)
- Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Riccardo M Cioni
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Daniele Cavaleri
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Tommaso Callovini
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Błażej Misiak
- Department of Psychiatry, Wrocław Medical University, Wrocław, Poland
| | - Jonathan B Savitz
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA.,Oxley College of Health Sciences, The University of Tulsa, Tulsa, Oklahoma, USA
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Division of Psychiatry, University College London, London, United Kingdom
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10
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Li D, Yu S, Long Y, Shi A, Deng J, Ma Y, Wen J, Li X, Liu S, Zhang Y, Wan J, Li N, Ao R. Tryptophan metabolism: Mechanism-oriented therapy for neurological and psychiatric disorders. Front Immunol 2022; 13:985378. [PMID: 36159806 PMCID: PMC9496178 DOI: 10.3389/fimmu.2022.985378] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/11/2022] [Indexed: 12/04/2022] Open
Abstract
Neurological and psychiatric disorders are a category of chronic diseases that are widespread and pose serious mental and physical health problems for patients. The substrates, products, and enzymes of Tryptophan metabolism all contribute to the development of neurological and psychiatric disorders. This paper deals with three metabolic pathways of tryptophan that produce a series of metabolites called tryptophan Catabolics (TRYCATs). These metabolites are involved in pathological processes such as excitotoxicity, neuroinflammation, oxidative stress, and mitochondrial damage and are closely associated with neurological and psychiatric disorders such as Alzheimer's disease and depression. Here, we review the elements that affect how tryptophan metabolism is regulated, including inflammation and stress, exercise, vitamins, minerals, diet and gut microbes, glucocorticoids, and aging, as well as the downstream regulatory effects of tryptophan metabolism, including the regulation of glutamate (Glu), immunity, G-protein coupled receptor 35 (Gpr35), nicotinic acetylcholine receptor (nAChR), aryl hydrocarbon receptor (AhR), and dopamine (DA). In order to advance the general understanding of tryptophan metabolism in neurological and psychiatric disorders, this paper also summarizes the current situation and effective drugs of tryptophan metabolism in the treatment of neurological and psychiatric disorders and considers its future research prospects.
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Affiliation(s)
- Dan Li
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shuang Yu
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yu Long
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ai Shi
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jie Deng
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yin Ma
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Wen
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoqiu Li
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Songyu Liu
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yulu Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jinyan Wan
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Nan Li
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rui Ao
- Oncology Center, Sichuan Provincial People's Hospital, Chengdu, China
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11
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Davidson M, Rashidi N, Nurgali K, Apostolopoulos V. The Role of Tryptophan Metabolites in Neuropsychiatric Disorders. Int J Mol Sci 2022; 23:ijms23179968. [PMID: 36077360 PMCID: PMC9456464 DOI: 10.3390/ijms23179968] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/27/2022] [Accepted: 08/31/2022] [Indexed: 12/20/2022] Open
Abstract
In recent decades, neuropsychiatric disorders such as major depressive disorder, schizophrenia, bipolar, etc., have become a global health concern, causing various detrimental influences on patients. Tryptophan is an important amino acid that plays an indisputable role in several physiological processes, including neuronal function and immunity. Tryptophan’s metabolism process in the human body occurs using different pathways, including the kynurenine and serotonin pathways. Furthermore, other biologically active components, such as serotonin, melatonin, and niacin, are by-products of Tryptophan pathways. Current evidence suggests that a functional imbalance in the synthesis of Tryptophan metabolites causes the appearance of pathophysiologic mechanisms that leads to various neuropsychiatric diseases. This review summarizes the pharmacological influences of tryptophan and its metabolites on the development of neuropsychiatric disorders. In addition, tryptophan and its metabolites quantification following the neurotransmitters precursor are highlighted. Eventually, the efficiency of various biomarkers such as inflammatory, protein, electrophysiological, genetic, and proteomic biomarkers in the diagnosis/treatment of neuropsychiatric disorders was discussed to understand the biomarker application in the detection/treatment of various diseases.
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Affiliation(s)
- Majid Davidson
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia
- Regenerative Medicine and Stem Cells Program, Australian Institute of Musculoskeletal Science (AIMSS), Melbourne, VIC 3021, Australia
| | - Niloufar Rashidi
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia
- Regenerative Medicine and Stem Cells Program, Australian Institute of Musculoskeletal Science (AIMSS), Melbourne, VIC 3021, Australia
| | - Kulmira Nurgali
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia
- Regenerative Medicine and Stem Cells Program, Australian Institute of Musculoskeletal Science (AIMSS), Melbourne, VIC 3021, Australia
- Department of Medicine Western Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia
- Immunology Program, Australian Institute of Musculoskeletal Science (AIMSS), Melbourne, VIC 3021, Australia
- Correspondence:
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12
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Is Poor Lithium Response in Individuals with Bipolar Disorder Associated with Increased Degradation of Tryptophan along the Kynurenine Pathway? Results of an Exploratory Study. J Clin Med 2022; 11:jcm11092517. [PMID: 35566641 PMCID: PMC9103936 DOI: 10.3390/jcm11092517] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/15/2022] [Accepted: 04/27/2022] [Indexed: 11/17/2022] Open
Abstract
Bipolar disorder is associated with an inflammation-triggered elevated catabolism of tryptophan to the kynurenine pathway, which impacts psychiatric symptoms and outcomes. The data indicate that lithium exerts anti-inflammatory effects by inhibiting indoleamine-2,3-dioxygenase (IDO)-1 activity. This exploratory study aimed to investigate the tryptophan catabolism in individuals with bipolar disorder (n = 48) compared to healthy controls (n = 48), and the associations with the response to mood stabilizers such as lithium, valproate, or lamotrigine rated with the Retrospective Assessment of the Lithium Response Phenotype Scale (or the Alda scale). The results demonstrate an association of a poorer response to lithium with higher levels of kynurenine, kynurenine/tryptophan ratio as a proxy for IDO-1 activity, as well as quinolinic acid, which, overall, indicates a pro-inflammatory state with a higher degradation of tryptophan towards the neurotoxic branch. The treatment response to valproate and lamotrigine was not associated with the levels of the tryptophan metabolites. These findings support the anti-inflammatory properties of lithium. Furthermore, since quinolinic acid has neurotoxic features via the glutamatergic pathway, they also strengthen the assumption that the clinical drug response might be associated with biochemical processes. The relationship between the lithium response and the measurements of the tryptophan to the kynurenine pathway is of clinical relevance and may potentially bring advantages towards a personalized medicine approach to bipolar disorder that allows for the selection of the most effective mood-stabilizing drug.
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13
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Coppens V, Verkerk R, Morrens M. Tracking TRYCAT: A Critical Appraisal of Kynurenine Pathway Quantifications in Blood. Front Pharmacol 2022; 13:825948. [PMID: 35250576 PMCID: PMC8892384 DOI: 10.3389/fphar.2022.825948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/19/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Violette Coppens
- Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium.,Scientific Initiative of Neuropsychiatric and Psychopharmacological Studies (SINAPS), University Psychiatric Centre Duffel, Duffel, Belgium
| | - Robert Verkerk
- Laboratory of Medical Biochemistry, University of Antwerp, Antwerp, Belgium
| | - Manuel Morrens
- Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium.,Scientific Initiative of Neuropsychiatric and Psychopharmacological Studies (SINAPS), University Psychiatric Centre Duffel, Duffel, Belgium
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