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Translational Psychiatry
Article . 2017 . Peer-reviewed
License: CC BY NC ND
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Translational Psychiatry
Article
License: CC BY
Data sources: UnpayWall
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PubMed Central
Other literature type . 2017
License: CC BY NC ND
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Serum kynurenic acid is reduced in affective psychosis

Authors: Wurfel, B. E.; Drevets, W. C.; Bliss, S. A.; McMillin, J. R.; Suzuki, H.; Ford, B. N.; Morris, H. M.; +3 Authors

Serum kynurenic acid is reduced in affective psychosis

Abstract

A subgroup of individuals with mood and psychotic disorders shows evidence of inflammation that leads to activation of the kynurenine pathway and the increased production of neuroactive kynurenine metabolites. Depression is hypothesized to be causally associated with an imbalance in the kynurenine pathway, with an increased metabolism down the 3-hydroxykynurenine (3HK) branch of the pathway leading to increased levels of the neurotoxic metabolite, quinolinic acid (QA), which is a putative N-methyl-d-aspartate (NMDA) receptor agonist. In contrast, schizophrenia and psychosis are hypothesized to arise from increased metabolism of the NMDA receptor antagonist, kynurenic acid (KynA), leading to hypofunction of GABAergic interneurons, the disinhibition of pyramidal neurons and striatal hyperdopaminergia. Here we present results that challenge the model of excess KynA production in affective psychosis. After rigorous control of potential confounders and multiple testing we find significant reductions in serum KynA and/or KynA/QA in acutely ill inpatients with major depressive disorder (N=35), bipolar disorder (N=53) and schizoaffective disorder (N=40) versus healthy controls (N=92). No significant difference was found between acutely ill inpatients with schizophrenia (n=21) and healthy controls. Further, a post hoc comparison of patients divided into the categories of non-psychotic affective disorder, affective psychosis and psychotic disorder (non-affective) showed that the greatest decrease in KynA was in the affective psychosis group relative to the other diagnostic groups. Our results are consistent with reports of elevations in proinflammatory cytokines in psychosis, and preclinical work showing that inflammation upregulates the enzyme, kynurenine mono-oxygenase (KMO), which converts kynurenine into 3-hydroxykynurenine and quinolinic acid.

Country
United States
Keywords

Adult, Affective Disorders, Psychotic, Male, Bipolar Disorder, 610, Kynurenic Acid, Receptors, N-Methyl-D-Aspartate, Kynurenine 3-Monooxygenase, Psychology, Humans, Child Psychology, GABAergic Neurons, Kynurenine, Inflammation, Depressive Disorder, Major, Depression, Cognitive Psychology, Middle Aged, Quinolinic Acid, Corpus Striatum, School Psychology, Psychotic Disorders, Developmental Psychology, Schizophrenia, Cytokines, Original Article, Female

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
82
Top 1%
Top 10%
Top 1%
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