The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overview

Bibliographic Details
Title: The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overview
Authors: Francesco Bartoli, Riccardo M. Cioni, Daniele Cavaleri, Tommaso Callovini, Cristina Crocamo, Błażej Misiak, Jonathan B. Savitz, Giuseppe Carrà
Source: European Psychiatry, Vol 65 (2022)
Publisher Information: Cambridge University Press, 2022.
Publication Year: 2022
Collection: LCC:Psychiatry
Subject Terms: Bipolar disorder, clinical features, kynurenine pathway, tryptophan, Psychiatry, RC435-571
More Details: 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.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 0924-9338
1778-3585
Relation: https://www.cambridge.org/core/product/identifier/S0924933822023409/type/journal_article; https://doaj.org/toc/0924-9338; https://doaj.org/toc/1778-3585
DOI: 10.1192/j.eurpsy.2022.2340
Access URL: https://doaj.org/article/590a887ec4de453880ec69fa9154d532
Accession Number: edsdoj.590a887ec4de453880ec69fa9154d532
Database: Directory of Open Access Journals
More Details
ISSN:09249338
17783585
DOI:10.1192/j.eurpsy.2022.2340
Published in:European Psychiatry
Language:English