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Tryptophan: A Unique Role in the Critically Ill.
Kanova, Marcela; Kohout, Pavel.
  • Kanova M; Department of Anaesthesiology and Intensive Care Medicine, University Hospital Ostrava, 708 52 Ostrava, Czech Republic.
  • Kohout P; Institute of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic.
Int J Mol Sci ; 22(21)2021 Oct 28.
Article in English | MEDLINE | ID: covidwho-1512377
ABSTRACT
Tryptophan is an essential amino acid whose metabolites play key roles in diverse physiological processes. Due to low reserves in the body, especially under various catabolic conditions, tryptophan deficiency manifests itself rapidly, and both the serotonin and kynurenine pathways of metabolism are clinically significant in critically ill patients. In this review, we highlight these pathways as sources of serotonin and melatonin, which then regulate neurotransmission, influence circadian rhythm, cognitive functions, and the development of delirium. Kynurenines serve important signaling functions in inter-organ communication and modulate endogenous inflammation. Increased plasma kynurenine levels and kynurenine-tryptophan ratios are early indicators for the development of sepsis. They also influence the regulation of skeletal muscle mass and thereby the development of polyneuromyopathy in critically ill patients. The modulation of tryptophan metabolism could help prevent and treat age-related disease with low grade chronic inflammation as well as post intensive care syndrome in all its varied manifestations cognitive decline (including delirium or dementia), physical impairment (catabolism, protein breakdown, loss of muscle mass and tone), and mental impairment (depression, anxiety or post-traumatic stress disorder).
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Tryptophan / Critical Illness / Kynurenine Type of study: Prognostic study Topics: Long Covid Limits: Humans Language: English Year: 2021 Document Type: Article Affiliation country: Ijms222111714

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Tryptophan / Critical Illness / Kynurenine Type of study: Prognostic study Topics: Long Covid Limits: Humans Language: English Year: 2021 Document Type: Article Affiliation country: Ijms222111714