1. The role of tryptophan degradation in the association between inflammatory markers and depressive symptoms in chronic dialysis patients
- Author
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Casper F. M. Franssen, Carl E.H. Siegert, Ido P. Kema, Adriaan Honig, Gertrud L. G. Haverkamp, Friedo W. Dekker, Merel van Diepen, Wim L. Loosman, Internal medicine, Psychiatry, APH - Mental Health, Groningen Kidney Center (GKC), Guided Treatment in Optimal Selected Cancer Patients (GUTS), and Lifestyle Medicine (LM)
- Subjects
Male ,CHRONIC KIDNEY-DISEASE ,INTERLEUKIN-6 ,medicine.medical_treatment ,Interleukin-1beta ,030232 urology & nephrology ,HEMODIALYSIS-PATIENTS ,ACTIVATION ,chemistry.chemical_compound ,0302 clinical medicine ,Glomerulonephritis ,depressive symptoms ,QUALITY-OF-LIFE ,Prospective Studies ,Prospective cohort study ,INDOLEAMINE 2 ,education.field_of_study ,biology ,Depression ,Incidence ,Tryptophan ,Interleukin ,Middle Aged ,inflammatory markers ,Interleukin-10 ,C-Reactive Protein ,Nephrology ,Female ,Hemodialysis ,Adult ,medicine.medical_specialty ,Population ,tryptophan degradation ,03 medical and health sciences ,Renal Dialysis ,Internal medicine ,KYNURENINE ,medicine ,Humans ,Interleukin 6 ,education ,Dialysis ,METAANALYSIS ,Aged ,Transplantation ,INTERFERON-GAMMA ,business.industry ,Tumor Necrosis Factor-alpha ,Beck Depression Inventory ,3-DIOXYGENASE ,chronic dialysis patients ,Endocrinology ,chemistry ,RENAL-DISEASE PATIENTS ,biology.protein ,business ,030217 neurology & neurosurgery ,Kynurenine ,INDOLEAMINE 2,3-DIOXYGENASE ,Biomarkers - Abstract
Background: Among chronic dialysis patients, associations have been found between inflammatory markers and depressive symptoms. In this population, no studies have examined the mechanism linking the association between inflammatory markers and depressive symptoms. We examined whether the association between inflammatory markers and depressive symptoms is mediated by tryptophan (TRP) degradation along the kynurenine (KYN) pathway.Methods: The data are part of an observational, prospective cohort study in five urban dialysis centres in The Netherlands. Depressive symptoms were determined with the Beck Depression Inventory. Peripheral blood was collected before dialysis to measure inflammatory markers [high sensitivity C-reactive protein (HsCRP), interleukin (IL)-1 beta, IL-6, IL-10 and tumour necrosis factor-alpha (TNF-alpha)], TRP, KYN and 3-hydroxykynurenine. The KYN/TRP ratio was used as a measure of TRP degradation. The association between inflammatory markers and depressive symptoms was determined using linear regression analysis and adjusted for the KYN/TRP ratio.Results: In total, 490 chronic dialysis patients were included. HsCRP [beta= 3.8; confidence interval (CI): 1.0-6.6], IL-6 (beta= 9.1; CI: 4.0-14.1) and TNF-alpha (beta= 1.3; CI: 0.9-1.7) were associated with the KYN/TRP ratio. We found significant associations between HsCRP (beta= 0.8; CI: 0.3-1.3) and IL-6 (beta= 1.2; CI: 0.3-2.2) levels and depressive symptoms. However, this association was not attenuated after adjustment for the KYN/TRP ratio. Also, no significant associations were found between the KYN/TRP ratio and depressive symptoms.Conclusion: The association between inflammatory markers and depressive symptoms in chronic dialysis patients was not mediated by TRP degradation along the KYN pathway.
- Published
- 2017
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