IntroductionIn recent years, the general view of the pathophysiology of schizophrenia (i.e., disturbances in dopamine [DA] transmission) has been expanded to also involve a glutamatergic dysfunction of the brain. Thus, clinical observations show that systemic administration of N-methyl-D-aspartate (NMDA) receptor antagonists (e.g., phencyclidine [PCP] and ketamine) evokes schizophrenia-like symptoms in healthy individuals and provokes symptoms in patients with schizophrenia. [1][2][3] Furthermore, the glutamate deficiency theory has gained some support from genetic findings. 4 A hypoglutamatergic state of the brain can also be achieved by elevation of the endogenous NMDA receptor antagonist kynurenic acid (KYNA).5 Indeed, increased concentrations of KYNA have been found in the cerebrospinal fluid (CSF) and in the postmortem brains of patients with schizophrenia.6-8 Kynurenic acid is a metabolite of tryptophan ( Fig. 1) and acts as an antagonist at the glycine coagonist site and the glutamate recognition site of the NMDA receptor.9-12 Additionally, KYNA blocks the α7* nicotinic receptor at low concentrations.13 Elevated levels of KYNA in the rat brain are associated with . This compound is an end-metabolite of the kynurenine pathway, and its formation indirectly depends on the activity of kynurenine 3-monooxygenase (KMO), the enzyme converting kynurenine to 3-hydroxykynurenine. Methods: We analyzed the association between KMO gene polymorphisms and CSF concentrations of KYNA in patients with schizophrenia and healthy controls. Fifteen single nucleotide polymorphisms (SNPs) were selected covering KMO and were analyzed in UNPHASED. Results: We included 17 patients with schizophrenia and 33 controls in our study. We found an association between a KMO SNP (rs1053230), encoding an amino acid change of potential importance for substrate interaction, and CSF concentrations of KYNA. Limitations: Given the limited sample size, the results are tentative until replication. Conclusion: Our results suggest that the nonsynonymous KMO SNP rs1053230 influences CSF concentrations of KYNA.