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Harris DMM, Szymczak S, Schuchardt S, Labrenz J, Tran F, Welz L, Graßhoff H, Zirpel H, Sümbül M, Oumari M, Engelbogen N, Junker R, Conrad C, Thaçi D, Frey N, Franke A, Weidinger S, Hoyer B, Rosenstiel P, Waschina S, Schreiber S, Aden K. Tryptophan degradation as a systems phenomenon in inflammation - an analysis across 13 chronic inflammatory diseases. EBioMedicine 2024; 102:105056. [PMID: 38471395 PMCID: PMC10943670 DOI: 10.1016/j.ebiom.2024.105056] [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: 10/23/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Chronic inflammatory diseases (CIDs) are systems disorders that affect diverse organs including the intestine, joints and skin. The essential amino acid tryptophan (Trp) can be broken down to various bioactive derivatives important for immune regulation. Increased Trp catabolism has been observed in some CIDs, so we aimed to characterise the specificity and extent of Trp degradation as a systems phenomenon across CIDs. METHODS We used high performance liquid chromatography and targeted mass spectrometry to assess the serum and stool levels of Trp and Trp derivatives. Our retrospective study incorporates both cross-sectional and longitudinal components, as we have included a healthy population as a reference and there are also multiple observations per patient over time. FINDINGS We found reduced serum Trp levels across the majority of CIDs, and a prevailing negative relationship between Trp and systemic inflammatory marker C-reactive protein (CRP). Notably, serum Trp was low in several CIDs even in the absence of measurable systemic inflammation. Increases in the kynurenine-to-Trp ratio (Kyn:Trp) suggest that these changes result from increased degradation along the kynurenine pathway. INTERPRETATION Increases in Kyn:Trp indicate the kynurenine pathway as a major route for CID-related Trp metabolism disruption and the specificity of the network changes indicates excessive Trp degradation relative to other proteogenic amino acids. Our results suggest that increased Trp catabolism is a common metabolic occurrence in CIDs that may directly affect systemic immunity. FUNDING This work was supported by the DFG Cluster of Excellence 2167 "Precision medicine in chronic inflammation" (KA, SSchr, PR, BH, SWa), the BMBF (e:Med Juniorverbund "Try-IBD" 01ZX1915A and 01ZX2215, the e:Med Network iTREAT 01ZX2202A, and GUIDE-IBD 031L0188A), EKFS (2020_EKCS.11, KA), DFG RU5042 (PR, KA), and Innovative Medicines Initiative 2 Joint Undertakings ("Taxonomy, Treatments, Targets and Remission", 831434, "ImmUniverse", 853995, "BIOMAP", 821511).
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Affiliation(s)
- Danielle M M Harris
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany; Institute for Human Nutrition and Food Science, Division Nutriinformatics, Kiel University, Kiel, Germany
| | - Silke Szymczak
- Institute of Medical Biometry and Statistics, University of Lübeck, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Sven Schuchardt
- Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hanover, Germany
| | - Johannes Labrenz
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Florian Tran
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany; Department of Internal Medicine I, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Lina Welz
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany; Institute for Human Nutrition and Food Science, Division Nutriinformatics, Kiel University, Kiel, Germany
| | - Hanna Graßhoff
- Department of Rheumatology University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Henner Zirpel
- Comprehensive Center for Inflammation Medicine, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Melike Sümbül
- Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Mhmd Oumari
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Nils Engelbogen
- Institute of Clinical Chemistry, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ralf Junker
- Institute of Clinical Chemistry, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Claudio Conrad
- Department of Internal Medicine I, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Diamant Thaçi
- Comprehensive Center for Inflammation Medicine, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Norbert Frey
- Department of Medicine III: Cardiology, Angiology, and Pneumology, Heidelberg University, Heidelberg, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Stephan Weidinger
- Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Bimba Hoyer
- Department of Internal Medicine I, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Philip Rosenstiel
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Silvio Waschina
- Institute for Human Nutrition and Food Science, Division Nutriinformatics, Kiel University, Kiel, Germany
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany; Department of Internal Medicine I, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Konrad Aden
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany; Department of Internal Medicine I, Kiel University and University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany.
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2
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Brivio P, Audano M, Gallo MT, Miceli E, Gruca P, Lason M, Litwa E, Fumagalli F, Papp M, Mitro N, Calabrese F. Venlafaxine's effect on resilience to stress is associated with a shift in the balance between glucose and fatty acid utilization. Neuropsychopharmacology 2023; 48:1475-1483. [PMID: 37380799 PMCID: PMC10425382 DOI: 10.1038/s41386-023-01633-0] [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: 04/14/2023] [Revised: 05/29/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023]
Abstract
Brain metabolism is a fundamental process involved in the proper development of the central nervous system and in the maintenance of the main higher functions in humans. As consequence, energy metabolism imbalance has been commonly associated to several mental disorders, including depression. Here, by employing a metabolomic approach, we aimed to establish if differences in energy metabolite concentration may underlie the vulnerability and resilience in an animal model of mood disorder named chronic mild stress (CMS) paradigm. In addition, we have investigated the possibility that modulation of metabolite concentration may represent a pharmacological target for depression by testing whether repeated treatment with the antidepressant venlafaxine may normalize the pathological phenotype by acting at metabolic level. The analyses were conducted in the ventral hippocampus (vHip) for its key role in the modulation of anhedonia, a core symptom of patients affected by depression. Interestingly, we showed that a shift from glycolysis to beta oxidation seems to be responsible for the vulnerability to chronic stress and that vHip metabolism contributes to the ability of the antidepressant venlafaxine to normalize the pathological phenotype, as shown by the reversal of the changes observed in specific metabolites. These findings may provide novel perspectives on metabolic changes that could serve as diagnostic markers and preventive strategies for the early detection and treatment of depression as well as for the identification of potential drug targets.
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Affiliation(s)
- Paola Brivio
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Milan, Italy
| | - Matteo Audano
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Milan, Italy
| | - Maria Teresa Gallo
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Milan, Italy
| | - Eleonora Miceli
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Milan, Italy
| | - Piotr Gruca
- Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Magdalena Lason
- Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Ewa Litwa
- Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Fabio Fumagalli
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Milan, Italy
| | - Mariusz Papp
- Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Nico Mitro
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Milan, Italy
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesca Calabrese
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, Milan, Italy.
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Bichler CS, Niedermeier M, Hüfner K, Gálffy M, Gostner JM, Nelles P, Schöttl SE, Sperner-Unterweger B, Kopp M. Climbing as an Add-On Treatment Option for Patients with Severe Anxiety Disorders and PTSD: Feasibility Analysis and First Results of a Randomized Controlled Longitudinal Clinical Pilot Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11622. [PMID: 36141895 PMCID: PMC9517148 DOI: 10.3390/ijerph191811622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Exercise has considerable effects on physical and psychological health. Anxiolytic effects of climbing exercise have been found in people suffering from depression. However, there are no studies on patients with severe anxiety disorders or post-traumatic stress disorder (PTSD) practicing climbing as add-on treatment. Additionally, many studies on physical therapy fail to use adequate active control groups. Therefore, this study aimed to investigate the feasibility of a four-week climbing exercise program for patients with anxiety disorders or PTSD in comparison to a standard exercise treatment and a social control group. METHODS Outpatients diagnosed with anxiety disorders or PTSD (F 40, F 41, F 43.1 according to ICD-10) were randomly assigned to (a) climbing exercise (n = 27), (b) Nordic walking exercise (n = 23), or (c) control condition (n = 23) providing the same amount of social contact for eight sessions of 90 minutes each. Psychological parameters (symptom severity, worry symptoms, self-efficacy, quality of life) and biological parameters were assessed at the beginning and at the end of the four-week program. Additionally, follow-up assessments were conducted three and six months after the program ended. RESULTS Sixty outpatients (75% female) aged 18-65 years with a longstanding history of a mental disorder (>10 years) and classified as treatment-resistant (95%) and with averaging 3.8 psychiatric comorbidities completed the pilot trial. After participation, symptoms of anxiety disorders were significantly reduced (p = 0.003), and health-related characteristics significantly improved (depression symptoms: p < 0.001, worry symptoms: p < 0.001, self-efficacy: p < 0.001, quality of life-physical health: p = 0.002, quality of life-psychological health: p = 0.006) in all groups. The feasibility of conducting climbing exercises for the patient groups could be demonstrated, and a general acceptance in the groups was recorded. No significant time-by-group interactions were found. At the completion of the program, psychological parameters improved, while biological parameters remained the same in all three groups. CONCLUSIONS Participation in the climbing group as well as in Nordic walking and social contact groups demonstrated beneficial results in patients with anxiety disorders and PTSD with severe mental burden. Nevertheless, climbing did not show any additional clinically relevant benefits compared to Nordic walking or social contact. Studies with larger sample sizes and qualitative insights are needed to further evaluate the possible benefits of climbing in this population.
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Affiliation(s)
- Carina S. Bichler
- Department of Sport Science, University of Innsbruck, Fuerstenweg 185, 6020 Innsbruck, Austria
| | - Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Fuerstenweg 185, 6020 Innsbruck, Austria
| | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Mátyás Gálffy
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Johanna M. Gostner
- Institute of Medical Biochemistry, Biocenter, Medical University of Innsbruck, Innrain 80-82, 6020 Innsbruck, Austria
| | - Philipp Nelles
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Stefanie E. Schöttl
- Department of Sport Science, University of Innsbruck, Fuerstenweg 185, 6020 Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Fuerstenweg 185, 6020 Innsbruck, Austria
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Mechtcheriakov S, Gleissenthall GV, Geisler S, Arnhard K, Oberacher H, Schurr T, Kemmler G, Unterberger C, Fuchs D. Tryptophan-kynurenine metabolism during acute alcohol withdrawal in patients with alcohol use disorder: The role of immune activation. Alcohol Clin Exp Res 2022; 46:1648-1656. [PMID: 35938556 PMCID: PMC9804431 DOI: 10.1111/acer.14920] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Recent research has suggested that excessive alcohol consumption in patients with alcohol use disorder (AUD) is associated with chronic immune activation, which affects the metabolism of the neurotransmitter precursor amino acid tryptophan (TRP) and contributes to the complex pathophysiology of AUD. Our study investigated possible immune-associated alterations of TRP to kynurenine (KYN) metabolism in patients with AUD during acute alcohol withdrawal. METHODS We measured serum concentrations of TRP, KYN, quinolinic (QUIN), kynurenic acid (KYNA), and the immune activation marker neopterin (NEO) at the first, fifth and 10th day of alcohol withdrawal in patients with AUD, who attended a standardized in-patient treatment program and underwent a detailed clinical assessment. RESULTS Data from these individuals were compared to data from a reference control group (RCG). The primary outcome measures were the differences in serum concentrations of metabolites between AUD patients and RCG and correlations between NEO and metabolites of the tryptophan-kynurenine pathway. r = 0.695, p < 0.001) in the AUD group. Mixed models analysis showed that NEO concentrations were positively associated with QUIN but not with KYNA concentrations. Several behavioral symptoms correlated positively with QUIN concentrations and negatively with the KYNA/QUIN ratio. CONCLUSIONS Our findings demonstrate that the changes in TRP catabolism in acute alcohol withdrawal resulting in increased KYN production could reflect the involvement of immune-associated activation of the enzyme indoleamine 2,3-dioxygenase, as NEO concentrations correlated with the KYN/TRP ratio. In addition, our data show that this low-grade immune activation may cause an imbalance in the production of neurotoxic and neuroprotective kynurenine metabolites in AUD.
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Affiliation(s)
- Sergei Mechtcheriakov
- University Clinic of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical PsychologyMedical University of InnsbruckInnsbruckAustria
| | - Gabriele V. Gleissenthall
- University Clinic of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical PsychologyMedical University of InnsbruckInnsbruckAustria
| | - Simon Geisler
- Institute of Biological Chemistry, BiocenterMedical University of InnsbruckInnsbruckAustria
| | - Kathrin Arnhard
- Institute of Legal Medicine and Core Facility MetabolomicsMedical University of InnsbruckInnsbruckAustria
| | - Herbert Oberacher
- Institute of Legal Medicine and Core Facility MetabolomicsMedical University of InnsbruckInnsbruckAustria
| | - Timo Schurr
- University Clinic of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical PsychologyMedical University of InnsbruckInnsbruckAustria
| | - Georg Kemmler
- University Clinic of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical PsychologyMedical University of InnsbruckInnsbruckAustria
| | - Christine Unterberger
- University Clinic of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical PsychologyMedical University of InnsbruckInnsbruckAustria
| | - Dietmar Fuchs
- Institute of Biological Chemistry, BiocenterMedical University of InnsbruckInnsbruckAustria
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5
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Umeda K, Shindo D, Somekawa S, Nishitani S, Sato W, Toyoda S, Karakawa S, Kawasaki M, Mine T, Suzuki K. Effects of Five Amino Acids (Serine, Alanine, Glutamate, Aspartate, and Tyrosine) on Mental Health in Healthy Office Workers: A Randomized, Double-Blind, Placebo-Controlled Exploratory Trial. Nutrients 2022; 14:nu14112357. [PMID: 35684157 PMCID: PMC9183184 DOI: 10.3390/nu14112357] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 12/04/2022] Open
Abstract
Background: The importance of maintaining good mental health with overall well-being has recently drawn attention from various spheres of academics and the working population. Amino acid intake has been reported to reduce depression symptoms and other mental health problems. However, the effectiveness of amino acid intake (i.e., single or combined) remains unknown. In this study, we assessed a combination of five amino acids (serine, alanine, glutamate, aspartate, and tyrosine; SAGAT) reported to regulate mental health. Methods: A randomized, double-blind, placebo-controlled exploratory trial was conducted. Participants, aged between 20 and 65 years with fatigue sensation, were randomized to receive either SAGAT or the placebo and ingested them for four weeks. A transient mental work was loaded at day 0 and after four weeks of intervention. As the primary outcomes, the fatigue sensation was assessed. The mood status, cognitive function, work efficiency, and blood marker were also measured as secondary outcomes. Results: The number of participants analyzed for the efficacy evaluation were 20 in SAGAT and 22 in the placebo. There were no significant differences in the primary outcomes. However, as the secondary outcomes, the SAGAT group showed a significant improvement in motivation and cognitive function in the recovery period after mental work loaded in a four-week intervention compared to the placebo. Conclusion: The current findings suggest that SAGAT contributes to maintaining proper motivation and cognitive function. Clinical Trial Registration: University Hospital Medical Information Network Clinical Trial Registry (ID: UMIN 000041221).
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Affiliation(s)
- Kentaro Umeda
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Kawasaki 210-8681, Japan; (D.S.); (S.S.); (S.N.)
- Correspondence: (K.U.); (K.S.)
| | - Daichi Shindo
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Kawasaki 210-8681, Japan; (D.S.); (S.S.); (S.N.)
| | - Shinji Somekawa
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Kawasaki 210-8681, Japan; (D.S.); (S.S.); (S.N.)
| | - Shinobu Nishitani
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Kawasaki 210-8681, Japan; (D.S.); (S.S.); (S.N.)
| | - Wataru Sato
- Research Institute for Bioscience Products & Fine Chemicals, Ajinomoto Co., Inc., Kawasaki 210-8681, Japan; (W.S.); (S.T.); (S.K.); (M.K.)
| | - Sakiko Toyoda
- Research Institute for Bioscience Products & Fine Chemicals, Ajinomoto Co., Inc., Kawasaki 210-8681, Japan; (W.S.); (S.T.); (S.K.); (M.K.)
| | - Sachise Karakawa
- Research Institute for Bioscience Products & Fine Chemicals, Ajinomoto Co., Inc., Kawasaki 210-8681, Japan; (W.S.); (S.T.); (S.K.); (M.K.)
| | - Mika Kawasaki
- Research Institute for Bioscience Products & Fine Chemicals, Ajinomoto Co., Inc., Kawasaki 210-8681, Japan; (W.S.); (S.T.); (S.K.); (M.K.)
| | - Tomoyuki Mine
- Research & Business Planning Department, Ajinomoto Co., Inc., Tokyo 104-8315, Japan;
| | - Katsuya Suzuki
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Kawasaki 210-8681, Japan; (D.S.); (S.S.); (S.N.)
- Correspondence: (K.U.); (K.S.)
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6
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Hüfner K, Giesinger JM, Gostner JM, Egeter J, Koudouovoh-Tripp P, Vill T, Fuchs D, Sperner-Unterweger B. Neurotransmitter Precursor Amino Acid Ratios Show Differential, Inverse Correlations with Depression Severity in the Low and High Depression Score Range. Int J Tryptophan Res 2021; 14:11786469211039220. [PMID: 34483668 PMCID: PMC8414612 DOI: 10.1177/11786469211039220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/20/2021] [Indexed: 12/28/2022] Open
Abstract
The immunomodulatory capacity of mental stress is one of the basic concepts of
psychoneuroimmunology. The current prospective longitudinal study was designed
to evaluate the effect of acute mental stress on neurotransmitter precursor
amino acid levels in individuals with depression at 2 time points. Ten
physically healthy patients with a diagnosis of major depressive episode and
Montgomery–Åsberg Depression Rating Scale scores (MADRAS) ⩾20 points at
inclusion were assessed on 2 study days (once with higher MADRAS scores, once
with lower MADRAS scores; median 34.5 days apart) and subjected to a
standardized acute mental stress test on each study day. Blood was collected at
4 time points: once prior to and at 3 time points (0, 30 minutes, 60 minutes)
following mental stress. Neurotransmitter precursor amino acid levels, that is
kynurenine/tryptophan (KYN/TRP) and phenylalanine/tyrosine (PHE/TYR), as well as
neopterin and nitrite were analyzed in a total of 80 individual blood samples.
Regression and correlation analyses were performed. Regression analyses of
PHE/TYR (R2 = .547) and KYN/TRP
(R2 = .440) in relation to MADRAS depression
severity showed a quadratic curve fit. This was reflected by a negative linear
correlation between MADRAS scores and PHE/TYR as well as KYN/TRP in the lower
score range (r = −.805, P < .001 and
r = −.586, P < .001 respectively) and a
positive correlation in the higher MADRAS score range
(r = .713, P < .001 and
r = .379, P = .016 respectively). No effect of
acute mental stress was found. This analysis exemplifies the implications of
sampling as well as data distributions on results. The crosstalk of biological
mechanisms that orchestrate metabolic and immunological signaling may vary
depending on depression severity resulting in non-linear associations that may
explain the heterogeneity of results found in the literature.
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Affiliation(s)
- Katharina Hüfner
- University Clinic for Psychiatry II,
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of
Innsbruck, Austria
- Katharina Hüfner, University Clinic for
Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics,
Medical University of Innsbruck, Anichstr. 35, Innsbruck 6020, Austria.
| | - Johannes M Giesinger
- University Clinic for Psychiatry II,
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of
Innsbruck, Austria
| | - Johanna M Gostner
- Institute of Medical Biochemistry,
Biocenter, Medical University of Innsbruck, Austria
| | - Jonas Egeter
- University Clinic for Psychiatry II,
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of
Innsbruck, Austria
| | - Pia Koudouovoh-Tripp
- University Clinic for Psychiatry II,
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of
Innsbruck, Austria
- Division of Psychiatry and
Psychotherapeutic Medicine, Hospital St. Vinzenz Zams, Austria
| | - Theresa Vill
- University Clinic for Psychiatry II,
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of
Innsbruck, Austria
| | - Dietmar Fuchs
- Institute of Biological Chemistry,
Biocenter, Medical University of Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- University Clinic for Psychiatry II,
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of
Innsbruck, Austria
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7
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Effects of stress associated with academic examination on the kynurenine pathway profile in healthy students. PLoS One 2021; 16:e0252668. [PMID: 34081742 PMCID: PMC8174692 DOI: 10.1371/journal.pone.0252668] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 05/20/2021] [Indexed: 12/16/2022] Open
Abstract
The effects of stress on the neuroendocrine, central nervous and immune systems are extremely complex. The kynurenine pathway (KP) of the tryptophan metabolism is recognised as a cross-link between the neuroendocrine- and immune systems. However, the effects of acute stress from everyday life on KP activation have not yet been studied. This study aims to investigate changes in the levels of the KP neuroactive metabolites and cytokines in response to stress triggered by academic examinations. Ninety-two healthy first year medical students benevolently participated in the study. Parameters were measured pre- examination, which is considered to be a high-stress period, and post-examination, as a low-stress period. Stress induced by academic examinations significantly increases the perceived stress scores (p<0.001), serum cortisol levels (p<0.001) and brain-derived neurotrophic factor (BDNF) levels (p<0.01). It decreased IL-10 levels (p<0.05) but had no effect on IL-6 and TNF-alpha levels. Only the KP neuroactive metabolite, 3-hydroxykynurenine (3-HK) significantly increased (p<0.01) in the post-examination period. In addition, the stress scores positively correlated with the levels of cortisol (r2 = 0.297, p<0.01) at post examination. Acute stress triggered by academic examinations increases cortisol and BDNF production and suppresses the anti-inflammatory cytokine, IL-10, but did not increase significantly the levels of other pro-inflammatory cytokines, tryptophan, kynurenine and downstream KP metabolites. The concomitant increased levels of BDNF under the duress of acute examination stress appear to limit the levels pro-inflammatory markers, which may attenuate the action of cortisol and the neuroinflammatory branch of the KP.
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