Bartoli, Francesco;
Cioni, Riccardo M;
Cavaleri, Daniele;
Callovini, Tommaso;
Crocamo, Cristina;
Misiak, Blazej;
Savitz, Jonathan B;
(2022)
The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overview.
European Psychiatry
, 65
(1)
, Article e82. 10.1192/j.eurpsy.2022.2340.
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Abstract
Background. The 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. Methods. We 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. Results. We 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. Conclusions. An 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.
| Type: | Article |
|---|---|
| Title: | The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overview |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1192/j.eurpsy.2022.2340 |
| Publisher version: | https://doi.org/10.1192/j.eurpsy.2022.2340 |
| Language: | English |
| Additional information: | © The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Psychiatry, Bipolar disorder, clinical features, kynurenine pathway, tryptophan, TRYPTOPHAN BREAKDOWN, QUINOLINIC ACID, BRAIN, SCHIZOPHRENIA, METAANALYSES, PREVALENCE, ADDICTION, VOLUME |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10167318 |
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