In a large variety of apparently unrelated diseases, the major pathway of tryptophan metabolism, that which proceeds through kynurenine, has been observed to be abnormal. The deviation is a quantitative one: the urinary excretion of one or more normal metabolites is high. Attempts to explain this phenomenon have largely been restricted to hypotheses that assume a "metabolic block" in the catabolism of these metabolites, as exemplified by pyridoxine deficiency. However, it seems unlikely that the variety of conditions associated with the increased excretion of these tryptophan metabolites, e.g., Hodgkin's disease, rheumatoid arthritis, schizophrenia, porphyria, renal tuberculosis, and aplastic anemia, to mention only a few that are included in a recent review (1), would all be coupled specifically with pyridoxine deficiency. Being inducible by its specific substrate (6) and, through a different mechanism involving RNA synthesis (7), by glucocorticoids (8, 9), it has served as the model of mammalian adaptive enzymes and has drawn attention to the important physiological regulation of metabolism mediated by changes in the amounts of enzymes (10, 4). The quantitative study of tryptophan pyrrolase in human liver appeared to be necessary for approaching the causes that underlie the abnormal tryptophan metabolism in various diseases.
MethodsThe hospitalized subjects with various diseases were all ambulatory and in no acute distress, with the indicated exception of those who were undergoing abdominal surgery. They were kept on a regular hospital diet and received no medications for at least 1 week before, and during, these studies. Unless otherwise indicated, no pa--tient was included who had been taking corticosteroids, sedatives, tranquilizers, or vitamin preparations for a prolonged period of time. The urinary excretion of kynurenine during the 24 hours after an oral dose of 2 g L-tryptophan was determined by the method of Tompsett (11).Specimens of human liver were obtained by Menghini needle biopsy by the standard percutaneous aspiration technique. When indicated, larger liver samples were obtained by excision from surgical patients during laparotomy. With these larger samples, a microassay suitable 1527