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The kynurenine pathway and bipolar disorder: intersection of the monoaminergic and glutamatergic systems and immune response.

Publication ,  Journal Article
Kadriu, B; Farmer, CA; Yuan, P; Park, LT; Deng, Z-D; Moaddel, R; Henter, ID; Shovestul, B; Ballard, ED; Kraus, C; Gold, PW; Machado-Vieira, R ...
Published in: Molecular psychiatry
August 2021

Dysfunction in a wide array of systems-including the immune, monoaminergic, and glutamatergic systems-is implicated in the pathophysiology of depression. One potential intersection point for these three systems is the kynurenine (KYN) pathway. This study explored the impact of the prototypic glutamatergic modulator ketamine on the endogenous KYN pathway in individuals with bipolar depression (BD), as well as the relationship between response to ketamine and depression-related behavioral and peripheral inflammatory markers. Thirty-nine participants with treatment-resistant BD (23 F, ages 18-65) received a single ketamine infusion (0.5 mg/kg) over 40 min. KYN pathway analytes-including plasma concentrations of indoleamine 2,3-dioxygenase (IDO), KYN, kynurenic acid (KynA), and quinolinic acid (QA)-were assessed at baseline (pre-infusion), 230 min, day 1, and day 3 post-ketamine. General linear models with restricted maximum likelihood estimation and robust sandwich variance estimators were implemented. A repeated effect of time was used to model the covariance of the residuals with an unstructured matrix. After controlling for age, sex, and body mass index (BMI), post-ketamine IDO levels were significantly lower than baseline at all three time points. Conversely, ketamine treatment significantly increased KYN and KynA levels at days 1 and 3 versus baseline. No change in QA levels was observed post-ketamine. A lower post-ketamine ratio of QA/KYN was observed at day 1. In addition, baseline levels of proinflammatory cytokines and behavioral measures predicted KYN pathway changes post ketamine. The results suggest that, in addition to having rapid and sustained antidepressant effects in BD participants, ketamine also impacts key components of the KYN pathway.

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Published In

Molecular psychiatry

DOI

EISSN

1476-5578

ISSN

1359-4184

Publication Date

August 2021

Volume

26

Issue

8

Start / End Page

4085 / 4095

Related Subject Headings

  • Young Adult
  • Tryptophan
  • Psychiatry
  • Middle Aged
  • Kynurenine
  • Kynurenic Acid
  • Immunity
  • Humans
  • Bipolar Disorder
  • Aged
 

Citation

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Kadriu, B., Farmer, C. A., Yuan, P., Park, L. T., Deng, Z.-D., Moaddel, R., … Zarate, C. A. (2021). The kynurenine pathway and bipolar disorder: intersection of the monoaminergic and glutamatergic systems and immune response. Molecular Psychiatry, 26(8), 4085–4095. https://doi.org/10.1038/s41380-019-0589-8
Kadriu, Bashkim, Cristan A. Farmer, Peixiong Yuan, Lawrence T. Park, Zhi-De Deng, Ruin Moaddel, Ioline D. Henter, et al. “The kynurenine pathway and bipolar disorder: intersection of the monoaminergic and glutamatergic systems and immune response.Molecular Psychiatry 26, no. 8 (August 2021): 4085–95. https://doi.org/10.1038/s41380-019-0589-8.
Kadriu B, Farmer CA, Yuan P, Park LT, Deng Z-D, Moaddel R, et al. The kynurenine pathway and bipolar disorder: intersection of the monoaminergic and glutamatergic systems and immune response. Molecular psychiatry. 2021 Aug;26(8):4085–95.
Kadriu, Bashkim, et al. “The kynurenine pathway and bipolar disorder: intersection of the monoaminergic and glutamatergic systems and immune response.Molecular Psychiatry, vol. 26, no. 8, Aug. 2021, pp. 4085–95. Epmc, doi:10.1038/s41380-019-0589-8.
Kadriu B, Farmer CA, Yuan P, Park LT, Deng Z-D, Moaddel R, Henter ID, Shovestul B, Ballard ED, Kraus C, Gold PW, Machado-Vieira R, Zarate CA. The kynurenine pathway and bipolar disorder: intersection of the monoaminergic and glutamatergic systems and immune response. Molecular psychiatry. 2021 Aug;26(8):4085–4095.

Published In

Molecular psychiatry

DOI

EISSN

1476-5578

ISSN

1359-4184

Publication Date

August 2021

Volume

26

Issue

8

Start / End Page

4085 / 4095

Related Subject Headings

  • Young Adult
  • Tryptophan
  • Psychiatry
  • Middle Aged
  • Kynurenine
  • Kynurenic Acid
  • Immunity
  • Humans
  • Bipolar Disorder
  • Aged