The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overview
AbstractBackgroundThe balance between neurotoxic and neuroprotective effects of kynurenine pathway (KP) components has been recently proposed as a key element in the pathophysiology of bipolar disorder (BD) and related mood episodes. This comprehensive overview explored the link of KP with symptom s...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-01-01
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| Series: | European Psychiatry |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822023409/type/journal_article |
| _version_ | 1811156302509899776 |
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| author | Francesco Bartoli Riccardo M. Cioni Daniele Cavaleri Tommaso Callovini Cristina Crocamo Błażej Misiak Jonathan B. Savitz Giuseppe Carrà |
| author_facet | Francesco Bartoli Riccardo M. Cioni Daniele Cavaleri Tommaso Callovini Cristina Crocamo Błażej Misiak Jonathan B. Savitz Giuseppe Carrà |
| author_sort | Francesco Bartoli |
| collection | DOAJ |
| description | AbstractBackgroundThe balance between neurotoxic and neuroprotective effects of kynurenine pathway (KP) components has been recently proposed as a key element in the pathophysiology of bipolar disorder (BD) and related mood episodes. This comprehensive overview explored the link of KP with symptom severity and other clinical features of BD.MethodsWe searched Medline, Embase, and PsycInfo electronic databases for studies assessing the association of peripheral and/or central concentrations of KP metabolites with putative clinical features, including symptom severity and other clinical domains in BD.ResultsWe included the findings of 13 observational studies investigating the possible variations of KP metabolites according to symptom severity, psychotic features, suicidal behaviors, and sleep disturbances in BD. Studies testing the relationship between KP metabolites and depression severity generated mixed and inconsistent findings. No statistically significant correlations with manic symptoms were found. Moreover, heterogeneous variations of the KP across different clinical domains were shown. Few available studies found (a) higher levels of cerebrospinal fluid kynurenic acid and lower of plasma quinolinic acid in BD with psychotic features, (b) lower central and peripheral picolinic acid levels in BD with suicide attempts, and (c) no significant correlations between KP metabolites and BD-related sleep disturbances.ConclusionsAn imbalance of KP metabolism toward the neurotoxic branches is likely to occur in people with BD, though evidence on variations according to specific clinical features of BD is less clear. Additional research is needed to clarify the role of KP in the etiopathogenesis of BD and related clinical features. |
| first_indexed | 2024-04-10T04:49:17Z |
| format | Article |
| id | doaj.art-590a887ec4de453880ec69fa9154d532 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-04-10T04:49:17Z |
| publishDate | 2022-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-590a887ec4de453880ec69fa9154d5322023-03-09T12:33:56ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-01-016510.1192/j.eurpsy.2022.2340The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overviewFrancesco Bartoli0https://orcid.org/0000-0003-2612-4119Riccardo M. Cioni1https://orcid.org/0000-0001-5718-9930Daniele Cavaleri2https://orcid.org/0000-0001-5342-9394Tommaso Callovini3https://orcid.org/0000-0001-6489-5331Cristina Crocamo4https://orcid.org/0000-0002-2979-2107Błażej Misiak5https://orcid.org/0000-0002-5392-6398Jonathan B. Savitz6https://orcid.org/0000-0001-8143-182XGiuseppe Carrà7https://orcid.org/0000-0002-6877-6169Department of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDepartment of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDepartment of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDepartment of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDepartment of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDepartment of Psychiatry, Wrocław Medical University, Wrocław, PolandLaureate Institute for Brain Research, Tulsa, Oklahoma, USA Oxley College of Health Sciences, The University of Tulsa, Tulsa, Oklahoma, USADepartment of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy Division of Psychiatry, University College London, London, United KingdomAbstractBackgroundThe balance between neurotoxic and neuroprotective effects of kynurenine pathway (KP) components has been recently proposed as a key element in the pathophysiology of bipolar disorder (BD) and related mood episodes. This comprehensive overview explored the link of KP with symptom severity and other clinical features of BD.MethodsWe searched Medline, Embase, and PsycInfo electronic databases for studies assessing the association of peripheral and/or central concentrations of KP metabolites with putative clinical features, including symptom severity and other clinical domains in BD.ResultsWe included the findings of 13 observational studies investigating the possible variations of KP metabolites according to symptom severity, psychotic features, suicidal behaviors, and sleep disturbances in BD. Studies testing the relationship between KP metabolites and depression severity generated mixed and inconsistent findings. No statistically significant correlations with manic symptoms were found. Moreover, heterogeneous variations of the KP across different clinical domains were shown. Few available studies found (a) higher levels of cerebrospinal fluid kynurenic acid and lower of plasma quinolinic acid in BD with psychotic features, (b) lower central and peripheral picolinic acid levels in BD with suicide attempts, and (c) no significant correlations between KP metabolites and BD-related sleep disturbances.ConclusionsAn imbalance of KP metabolism toward the neurotoxic branches is likely to occur in people with BD, though evidence on variations according to specific clinical features of BD is less clear. Additional research is needed to clarify the role of KP in the etiopathogenesis of BD and related clinical features.https://www.cambridge.org/core/product/identifier/S0924933822023409/type/journal_articleBipolar disorderclinical featureskynurenine pathwaytryptophan |
| spellingShingle | Francesco Bartoli Riccardo M. Cioni Daniele Cavaleri Tommaso Callovini Cristina Crocamo Błażej Misiak Jonathan B. Savitz Giuseppe Carrà The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overview European Psychiatry Bipolar disorder clinical features kynurenine pathway tryptophan |
| title | The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overview |
| title_full | The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overview |
| title_fullStr | The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overview |
| title_full_unstemmed | The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overview |
| title_short | The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overview |
| title_sort | association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder an overview |
| topic | Bipolar disorder clinical features kynurenine pathway tryptophan |
| url | https://www.cambridge.org/core/product/identifier/S0924933822023409/type/journal_article |
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