Inflammation-Induced Tryptophan Breakdown is Related With Anemia, Fatigue, and Depression in Cancer.

Frontiers in Immunology
Lukas LanserKatharina Kurz

Abstract

Many patients with cancer suffer from anemia, depression, and an impaired quality of life (QoL). These patients often also show decreased plasma tryptophan levels and increased kynurenine concentrations in parallel with elevated concentrations of Th1 type immune activation marker neopterin. In the course of anti-tumor immune response, the pro-inflammatory cytokine interferon gamma (IFN-γ) induces both, the enzyme indoleamine 2,3-dioxygenase (IDO) to degrade tryptophan and the enzyme GTP-cyclohydrolase I to form neopterin. High neopterin concentrations as well as an increased kynurenine to tryptophan ratio (Kyn/Trp) in the blood of cancer patients are predictive for a worse outcome. Inflammation-mediated tryptophan catabolism along the kynurenine pathway is related to fatigue and anemia as well as to depression and a decreased QoL in patients with solid tumors. In fact, enhanced tryptophan breakdown might greatly contribute to the development of anemia, fatigue, and depression in cancer patients. IDO activation and stimulation of the kynurenine pathway exert immune regulatory mechanisms, which may impair anti-tumor immune responses. In addition, tumor cells can degrade tryptophan to weaken immune responses directed against them....Continue Reading

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Citations

Aug 22, 2020·Journal of Clinical Laboratory Analysis·Guang-Zhang LiZhi-Xin Liu
Oct 14, 2020·Scientific Reports·Sinem GürcüTerken Baydar
Mar 2, 2021·British Journal of Nursing : BJN·Mohammed Al Maqbali
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Jul 3, 2021·International Journal of Molecular Sciences·Christopher L McGinityDavid A Wink
Jul 7, 2021·Alimentary Pharmacology & Therapeutics·Jordan J McGingGordon W Moran
Aug 31, 2021·Frontiers in Cardiovascular Medicine·Lukas LanserKatharina Kurz
Oct 29, 2021·Experimental Dermatology·Maryana Stephany Ferreira BranquinhoAna Campa

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