The Peripheral Kynurenine Pathway and Psychosomatic Comorbidity in Subjects with Morbid Obesity Undergoing Bariatric Surgery

Farup, Per G.; Hestad, Knut

doi:10.3390/app12052648

Cited by 4 publications

(4 citation statements)

References 39 publications

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“…Clinical evaluation of this approach requires several years of follow-up, however, and such a preventive treatment must be initiated before severe motor or cognitive symptoms have developed—in the early stages of Parkinson’s disease [ 69 ], for example. In a recent review, Tanaka and co-workers (2022) discussed the concept of neurodevelopmental disorders that may precede such diseases as schizophrenia and Parkinson’s disease, for which early intervention with kynurenine analogues may have neuroprotective effects [ 5 ] Notably, downregulation of the peripheral kynurenine pathway, as achieved by bariatric surgery in obese subjects, was found to be accompanied by reduced peripheral inflammation, as monitored by C-reactive protein, whereas neuroinflammation was not monitored in the obese subjects [ 111 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of Tryptophan Dysmetabolism and Quinolinic Acid in Depressive and Neurodegenerative Diseases

et al. 2022

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Emerging evidence suggests that neuroinflammation is involved in both depression and neurodegenerative diseases. The kynurenine pathway, generating metabolites which may play a role in pathogenesis, is one of several competing pathways of tryptophan metabolism. The present article is a narrative review of tryptophan metabolism, neuroinflammation, depression, and neurodegeneration. A disturbed tryptophan metabolism with increased activity of the kynurenine pathway and production of quinolinic acid may result in deficiencies in tryptophan and derived neurotransmitters. Quinolinic acid is an N-methyl-D-aspartate receptor agonist, and raised levels in CSF, together with increased levels of inflammatory cytokines, have been reported in mood disorders. Increased quinolinic acid has also been observed in neurodegenerative diseases, including Parkinson’s disease, Alzheimer’s disease, amyotrophic lateral sclerosis, and HIV-related cognitive decline. Oxidative stress in connection with increased indole-dioxygenase (IDO) activity and kynurenine formation may contribute to inflammatory responses and the production of cytokines. Increased formation of quinolinic acid may occur at the expense of kynurenic acid and neuroprotective picolinic acid. While awaiting ongoing research on potential pharmacological interventions on tryptophan metabolism, adequate protein intake with appropriate amounts of tryptophan and antioxidants may offer protection against oxidative stress and provide a balanced set of physiological receptor ligands.

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Section: Discussionmentioning

confidence: 99%

The Role of Tryptophan Dysmetabolism and Quinolinic Acid in Depressive and Neurodegenerative Diseases

et al. 2022

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“…Blood samples from immediately before surgery and 6 and 12 months after surgery were used in this study. More information about the participants and the design is given in previous publications 8 , 11 .…”

Section: Participants and Methodsmentioning

confidence: 99%

Changes in bone turnover markers 6–12 months after bariatric surgery

Farup

2024

Sci Rep

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A rise in bone turnover markers (BTM) after bariatric surgery predicts poor bone health years later. This study explored factors associated with BTM and changes in BTM after bariatric surgery. Inclusion criteria were subjects 18 to 65 years of age with morbid obesity undergoing bariatric surgery. All data were measured before and 6 and 12 months after surgery. The study included 104 subjects: women/men: 83/21; mean age 43.1 (SD 8.4) years; BMI: 38.8 kg/m2 (SD 3.8). Surgery with Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) was performed in 84 (81%) and 20 (19%) subjects, respectively. From before to 6–12 months after surgery, procollagen type 1 N-terminal propeptid (P1NP) increased by 45.6 µg/L (95% CI 41.5–50.0, p < 0.001), and alkaline phosphatase (ALP) by 10 U/L (95% CI 7–14, p < 0.001). The increases were significantly larger after RYGB than after SG. The APOE- Ɛ3 allele was associated with low levels of BTM and high levels of leptin. There was an unfavourable increase in BTM after bariatric surgery. SG compared to RYGB and the presence of the APOE-Ɛ3 allele were associated with less unfavourable effects. The study emphasises the importance of optimal prophylactic interventions after bariatric surgery to prevent osteoporosis.

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“…The Obesity group: Subjects aged 18–65 years old with morbid obesity (defined as BMI > 40 kg/m 2 or >35 kg/m 2 with obesity-related complications) without severe not-obesity-related comorbidity referred to the obesity unit at Innlandet Hospital Trust, Gjøvik, Norway for evaluation of bariatric surgery were included in the “Morbid Obesity—Bio-Psycho-Social disorders” study (MO-BiPS study) [ 11 ]. Data from the first visit were used.…”

Section: Methodsmentioning

confidence: 99%

The Kynurenine Pathway in Healthy Subjects and Subjects with Obesity, Depression and Chronic Obstructive Pulmonary Disease

et al. 2023

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Background: Changes in tryptophan metabolism through the kynurenine pathway (KP) canis observed in several disorders and coupled with pathophysiological deviations. Methods: This study retrospectively compared the KP in serum in healthy subjects (108) with subjects with obesity (141), depression (49), and chronic obstructive pulmonary disease (COPD) (22) participating in four clinical studies and explored predictors of the changes in the KP metabolites. Results: Compared with the healthy group, the KP was upregulated in the disease groups with high kynurenine, quinolinic acid (QA), kynurenine/tryptophan-ratio and QA/xanthurenic acid-ratio and low kynurenic acid/QA-ratio. Tryptophan and xanthurenic acid were upregulated in the depressed group compared with the groups with obesity and COPD. The covariates BMI, smoking, diabetes, and C-reactive protein explained the significant differences between the healthy group and the group with obesity but not between the healthy group and the groups with depression and COPD, indicating that different pathophysiological conditions result in the same changes in the KP. Conclusions: The KP was significantly upregulated in the disease groups compared with the healthy group, and there were significant differences between the disease groups. Different pathophysiological abnormalities seemed to result in the same deviations in the KP.

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The Peripheral Kynurenine Pathway and Psychosomatic Comorbidity in Subjects with Morbid Obesity Undergoing Bariatric Surgery

Cited by 4 publications

References 39 publications

The Role of Tryptophan Dysmetabolism and Quinolinic Acid in Depressive and Neurodegenerative Diseases

The Role of Tryptophan Dysmetabolism and Quinolinic Acid in Depressive and Neurodegenerative Diseases

Changes in bone turnover markers 6–12 months after bariatric surgery

The Kynurenine Pathway in Healthy Subjects and Subjects with Obesity, Depression and Chronic Obstructive Pulmonary Disease

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