Enhanced degradation of tryptophan in patients on hemodialysis

P. Koenig, C. Nagl, G. Neurauter, H. Schennach, Gerald Brandacher, D. Fuchs

Research output: Contribution to journalArticle

Abstract

Background: Hemodialysis patients often present with increased concentrations of tryptophan catabolites perhaps related to an enhanced activity of tryptophandegrading enzyme indoleamine 2,3-dioxygenase (IDO) that is inducible by pro-inflammatory stimuli. The often chronic inflammation and immune activation status in dialysis patients may accelerate tryptophan degradation, which could influence patients' psychological performance. Patients and methods: In this study, plasma concentrations of kynurenine and tryptophan were determined by HPLC in 75 dialysis patients, aged 65.3 ± 15.0 years. Forty patients were female, 35 male; 21 (28%) had diabetesmellitus Type 1 or 2 and 32 (43%) suffered from sleep disturbances and/or depression. Their dialysis vintage was 4.26 ± 4.72 years. HPLC results were compared to concentrations obtained from 40 healthy blood donors, to immune activation marker neopterin, and to psychological test results based on INTERMED scores. Results: Compared to those in healthy controls, tryptophan concentrations were decreased in patients. Neopterin, kynurenine and the kynurenine to tryptophan ratio (kyn/trp, an index of tryptophan degradation) were increased in patients (all p <0.01). Kyn/trp correlated with neopterin concentrations (rs = 0.393, p <0.01). INTERMED scores were 21.0 + 8.4 and slightly higher in females (U = -1.831, p <0.07); they correlated with tryptophan concentrations (rs = -0.227, p <0.05) but with no other parameter studied. Data point to a possible relationship between tryptophan metabolic disturbances and psychologic presentation of patients, although only a rather weak relationship was found. Conclusion: We conclude that tryptophan degradation is increased in dialysis patients. The association with increased neopterin concentrations indicates activated IDO.

Original languageEnglish (US)
Pages (from-to)465-470
Number of pages6
JournalClinical Nephrology
Volume74
Issue number6
StatePublished - Dec 2010
Externally publishedYes

Fingerprint

Tryptophan
Renal Dialysis
Neopterin
Kynurenine
Dialysis
Indoleamine-Pyrrole 2,3,-Dioxygenase
High Pressure Liquid Chromatography
Psychological Tests
Blood Donors
Sleep
Biomarkers
Depression
Psychology
Inflammation
Enzymes

Keywords

  • Chronic hemodialysis
  • Indoleamine 2,3-dioxygenase
  • INTERMED-score
  • Neopterin
  • Tryptophan

ASJC Scopus subject areas

  • Nephrology

Cite this

Koenig, P., Nagl, C., Neurauter, G., Schennach, H., Brandacher, G., & Fuchs, D. (2010). Enhanced degradation of tryptophan in patients on hemodialysis. Clinical Nephrology, 74(6), 465-470.

Enhanced degradation of tryptophan in patients on hemodialysis. / Koenig, P.; Nagl, C.; Neurauter, G.; Schennach, H.; Brandacher, Gerald; Fuchs, D.

In: Clinical Nephrology, Vol. 74, No. 6, 12.2010, p. 465-470.

Research output: Contribution to journalArticle

Koenig, P, Nagl, C, Neurauter, G, Schennach, H, Brandacher, G & Fuchs, D 2010, 'Enhanced degradation of tryptophan in patients on hemodialysis', Clinical Nephrology, vol. 74, no. 6, pp. 465-470.
Koenig P, Nagl C, Neurauter G, Schennach H, Brandacher G, Fuchs D. Enhanced degradation of tryptophan in patients on hemodialysis. Clinical Nephrology. 2010 Dec;74(6):465-470.
Koenig, P. ; Nagl, C. ; Neurauter, G. ; Schennach, H. ; Brandacher, Gerald ; Fuchs, D. / Enhanced degradation of tryptophan in patients on hemodialysis. In: Clinical Nephrology. 2010 ; Vol. 74, No. 6. pp. 465-470.
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abstract = "Background: Hemodialysis patients often present with increased concentrations of tryptophan catabolites perhaps related to an enhanced activity of tryptophandegrading enzyme indoleamine 2,3-dioxygenase (IDO) that is inducible by pro-inflammatory stimuli. The often chronic inflammation and immune activation status in dialysis patients may accelerate tryptophan degradation, which could influence patients' psychological performance. Patients and methods: In this study, plasma concentrations of kynurenine and tryptophan were determined by HPLC in 75 dialysis patients, aged 65.3 ± 15.0 years. Forty patients were female, 35 male; 21 (28{\%}) had diabetesmellitus Type 1 or 2 and 32 (43{\%}) suffered from sleep disturbances and/or depression. Their dialysis vintage was 4.26 ± 4.72 years. HPLC results were compared to concentrations obtained from 40 healthy blood donors, to immune activation marker neopterin, and to psychological test results based on INTERMED scores. Results: Compared to those in healthy controls, tryptophan concentrations were decreased in patients. Neopterin, kynurenine and the kynurenine to tryptophan ratio (kyn/trp, an index of tryptophan degradation) were increased in patients (all p <0.01). Kyn/trp correlated with neopterin concentrations (rs = 0.393, p <0.01). INTERMED scores were 21.0 + 8.4 and slightly higher in females (U = -1.831, p <0.07); they correlated with tryptophan concentrations (rs = -0.227, p <0.05) but with no other parameter studied. Data point to a possible relationship between tryptophan metabolic disturbances and psychologic presentation of patients, although only a rather weak relationship was found. Conclusion: We conclude that tryptophan degradation is increased in dialysis patients. The association with increased neopterin concentrations indicates activated IDO.",
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AB - Background: Hemodialysis patients often present with increased concentrations of tryptophan catabolites perhaps related to an enhanced activity of tryptophandegrading enzyme indoleamine 2,3-dioxygenase (IDO) that is inducible by pro-inflammatory stimuli. The often chronic inflammation and immune activation status in dialysis patients may accelerate tryptophan degradation, which could influence patients' psychological performance. Patients and methods: In this study, plasma concentrations of kynurenine and tryptophan were determined by HPLC in 75 dialysis patients, aged 65.3 ± 15.0 years. Forty patients were female, 35 male; 21 (28%) had diabetesmellitus Type 1 or 2 and 32 (43%) suffered from sleep disturbances and/or depression. Their dialysis vintage was 4.26 ± 4.72 years. HPLC results were compared to concentrations obtained from 40 healthy blood donors, to immune activation marker neopterin, and to psychological test results based on INTERMED scores. Results: Compared to those in healthy controls, tryptophan concentrations were decreased in patients. Neopterin, kynurenine and the kynurenine to tryptophan ratio (kyn/trp, an index of tryptophan degradation) were increased in patients (all p <0.01). Kyn/trp correlated with neopterin concentrations (rs = 0.393, p <0.01). INTERMED scores were 21.0 + 8.4 and slightly higher in females (U = -1.831, p <0.07); they correlated with tryptophan concentrations (rs = -0.227, p <0.05) but with no other parameter studied. Data point to a possible relationship between tryptophan metabolic disturbances and psychologic presentation of patients, although only a rather weak relationship was found. Conclusion: We conclude that tryptophan degradation is increased in dialysis patients. The association with increased neopterin concentrations indicates activated IDO.

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