Plasma tryptophan and kynurenine in females with temporomandibular disorders and fibromyalgia-An exploratory pilot study.
fibromyalgia
kynurenine pathway
pain
psychological symptoms
temporomandibular disorders
tryptophan metabolism
Journal
Journal of oral rehabilitation
ISSN: 1365-2842
Titre abrégé: J Oral Rehabil
Pays: England
ID NLM: 0433604
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
27
05
2019
revised:
30
08
2019
accepted:
11
09
2019
pubmed:
24
9
2019
medline:
21
1
2020
entrez:
24
9
2019
Statut:
ppublish
Résumé
Both temporomandibular disorders myalgia (TMDM) and fibromyalgia (FM) have been linked to central and peripheral changes in serotonin availability. The precursor of serotonin, tryptophan (TRP), is mainly catabolised via another pathway to produce kynurenine (KYN), but whether changes of this pathway are present in TMDM and FM are still unclear. The aim was to explore blood plasma concentrations of TRP and KYN in TMDM and FM in an attempt to identify novel associations for future research. Plasma of 113 female participants (17 TMDM, 40 FM and 56 healthy pain-free controls) were analysed for TRP and KYN concentrations. The degradation of TRP via the KYN pathway was indicated by the KYN to TRP ratio (KYN/TRP). Pain intensities were assessed with the Graded Chronic Pain Scale (GCPS) and Visual Analogue Scale (VAS). Psychological symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder scale (GAD-7). In TMDM there was a negative correlation between TRP and pain intensity (r The association between KYN/TRP and pain intensity as well as anxiety ratings in this small exploratory study may indicate that KYN/TRP could be a relevant indicator for symptom severity in TMDM and FM. Further investigations of the KYN pathway in chronic myalgia are warranted.
Sections du résumé
BACKGROUND
BACKGROUND
Both temporomandibular disorders myalgia (TMDM) and fibromyalgia (FM) have been linked to central and peripheral changes in serotonin availability. The precursor of serotonin, tryptophan (TRP), is mainly catabolised via another pathway to produce kynurenine (KYN), but whether changes of this pathway are present in TMDM and FM are still unclear.
OBJECTIVE
OBJECTIVE
The aim was to explore blood plasma concentrations of TRP and KYN in TMDM and FM in an attempt to identify novel associations for future research.
METHODS
METHODS
Plasma of 113 female participants (17 TMDM, 40 FM and 56 healthy pain-free controls) were analysed for TRP and KYN concentrations. The degradation of TRP via the KYN pathway was indicated by the KYN to TRP ratio (KYN/TRP). Pain intensities were assessed with the Graded Chronic Pain Scale (GCPS) and Visual Analogue Scale (VAS). Psychological symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder scale (GAD-7).
RESULTS
RESULTS
In TMDM there was a negative correlation between TRP and pain intensity (r
CONCLUSION
CONCLUSIONS
The association between KYN/TRP and pain intensity as well as anxiety ratings in this small exploratory study may indicate that KYN/TRP could be a relevant indicator for symptom severity in TMDM and FM. Further investigations of the KYN pathway in chronic myalgia are warranted.
Substances chimiques
Kynurenine
343-65-7
Tryptophan
8DUH1N11BX
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
150-157Subventions
Organisme : Swedish Rheumatism Association
ID : R861271
Organisme : Stockholm County Council
ID : SLL20180426
Organisme : Karolinska Institutet
ID : 2-281-2017
Informations de copyright
© 2019 John Wiley & Sons Ltd.
Références
Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287-333.
Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017;76(2):318-328.
Goldenberg DL. Diagnosis and differential diagnosis of fibromyalgia. Am J Med. 2009;122(12):S14-S21.
Fitzcharles M-A, Shir Y, Ablin JN, et al. Classification and clinical diagnosis of fibromyalgia syndrome: recommendations of recent evidence-based interdisciplinary guidelines. Evid Based Complement Alternat Med. 2013;2013:1-9.
Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache. 2014;28(1):6-27.
Balasubramaniam R, de Leeuw R, Zhu H, Nickerson RB, Okeson JP, Carlson CR. Prevalence of temporomandibular disorders in fibromyalgia and failed back syndrome patients: a blinded prospective comparison study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(2):204-216.
Moreno-Fernández AM, Jiménez-Castellanos E, Iglesias-Linares A, Bueso-Madrid D, Fernández-Rodríguez A, De Miguel M. Fibromyalgia syndrome and temporomandibular disorders with muscular pain. A review. Mod Rheumatol. 2017;27(2):210-216.
Hoffmann GR, Kotchen MJ, Kotchen AT, Cowley WT, Dasgupta WM, Cowley WA. Temporomandibular disorders and associated clinical comorbidities. Clin J Pain. 2011;27(3):268-274.
Strasser MB, Gostner MJ, Fuchs MD. Mood, food, and cognition: role of tryptophan and serotonin. Curr Opin Clin Nutr Metab Care. 2016;19(1):55-61.
Arreola R, Becerril-Villanueva E, Cruz-Fuentes C, et al. Immunomodulatory effects mediated by serotonin. J Immunol Res. 2015;2015:1-21.
Dantzer R, O'Connor JC, Lawson MA, Kelley KW. Inflammation-associated depression: from serotonin to kynurenine. Psychoneuroendocrinology. 2011;36(3):426-436.
Wolfe F, Russell IJ, Vipraio G, Ross K, Anderson J. Serotonin levels, pain threshold, and fibromyalgia symptoms in the general population. J Rheumatol. 1997;24(3):555-559.
Russell IJ, Vaeroy H, Javors M, Nyberg F. Cerebrospinal fluid biogenic amine metabolites in fibromyalgia/fibrositis syndrome and rheumatoid arthritis. Arthritis Rheum. 1992;35(5):550-556.
Ernberg M, Hedenberg-Magnusson B, Alstergren P, Lundeberg T, Kopp S. Pain, allodynia, and serum serotonin level in orofacial pain of muscular origin. J Orofac Pain. 1999;13(1):56.
Christidis N, Omrani S, Fredriksson L, et al. Repeated tender point injections of granisetron alleviate chronic myofascial pain--a randomized, controlled, double-blinded trial. J Headache Pain. 2015;16:104.
Gerdle B, Ghafouri B, Ernberg M, Larsson B. Chronic musculoskeletal pain: review of mechanisms and biochemical biomarkers as assessed by the microdialysis technique. J Pain Res. 2014;7:313.
Kennedy PJ, Cryan JF, Dinan TG, Clarke G. Kynurenine pathway metabolism and the microbiota- gut- brain axis. Neuropharmacology. 2017;112:399-412.
Schröcksnadel K, Wirleitner B, Winkler C, Fuchs D. Monitoring tryptophan metabolism in chronic immune activation. Clin Chim Acta. 2006;364(1):82-90.
Louca Jounger S, Christidis N, Svensson P, List T, Ernberg M. Increased levels of intramuscular cytokines in patients with jaw muscle pain. J Headache Pain. 2017;18(1):30.
Kadetoff D, Lampa J, Westman M, Andersson M, Kosek E. Evidence of central inflammation in fibromyalgia - Increased cerebrospinal fluid interleukin- 8 levels. J Neuroimmunol. 2012;242(1-2):33-38.
Walker AK, Kavelaars A, Heijnen CJ, Dantzer R. Neuroinflammation and comorbidity of pain and depression. Pharmacol Rev. 2014;66(1):80.
Maes M, Galecki P, Verkerk R, Rief W. Somatization, but not depression, is characterized by disorders in the tryptophan catabolite (TRYCAT) pathway, indicating increased indoleamine 2,3-dioxygenase and lowered kynurenine aminotransferase activity. Neuro Endocrinol Lett. 2011;32(3):264-273.
Alexander GM, Reichenberger E, Peterlin BL, Perreault MJ, Grothusen JR, Schwartzman RJ. Plasma amino acids changes in complex regional pain syndrome. Pain Res Treat. 2013;2013.
Curto M, Lionetto L, Negro A, et al. Altered kynurenine pathway metabolites in serum of chronic migraine patients. J Headache Pain. 2016;17(1):1-7.
Schroecksnadel K, Winkler C, Duftner C, Wirleitner B, Schirmer M, Fuchs D. Tryptophan degradation increases with stage in patients with rheumatoid arthritis. Clin Rheumatol. 2006;25(3):334-337.
Kim H, Chen L, Lim G, et al. Brain indoleamine 2,3-dioxygenase contributes to the comorbidity of pain and depression. J Clin Invest. 2012;122(8):2940-2954.
Russell IJ. Biochemical abnormalities in fibromyalgia syndrome. J Musculoskelet Pain. 1994;2(3):101-115.
Hackshaw KV, Rodriguez-saona L, Plans M, Bell LN, Buffington C. A bloodspot- based diagnostic test for fibromyalgia syndrome and related disorders. Analyst. 2013;138(16):4453-4462.
Schwarz MJ, Offenbaecher M, Neumeister A, et al. Evidence for an altered tryptophan metabolism in fibromyalgia. Neurobiol Dis. 2002;11(3):434-442.
Wolfe F, Smythe HA, Yunus MB, et al. The american college of rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis Rheum. 1990;33(2):160-172.
Bie J, Guest J, Guillemin GJ, Grant R. Central kynurenine pathway shift with age in women. J Neurochem. 2016;136(5):995-1003.
Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP. Arthritis Care Res. 2011;63(S11):S240-S252.
Badawy A. Plasma free tryptophan revisited: what you need to know and do before measuring it. J Psychopharmacol. 2010;24(6):809-815.
Yunus MB, Dailey JW, Aldag JC, Masi AT, Jobe PC. Plasma tryptophan and other amino acids in primary fibromyalgia: a controlled study. J Rheumatol. 1992;19(1):90-94.
Maes M, Verkerk R, Delmeire L, Van Gastel A, van Hunsel F, Scharpé S. Serotonergic markers and lowered plasma branched-chain-amino acid concentrations in fibromyalgia. Psychiatry Res. 2000;97(1):11-20.
Bazzichi L, Palego L, Giannaccini G, et al. Altered amino acid homeostasis in subjects affected by fibromyalgia. Clin Biochem. 2009;42(10-11):1064-1070.
Yunus MB. Role of central sensitization in symptoms beyond muscle pain, and the evaluation of a patient with widespread pain. Best Pract Res Clin Rheumatol. 2007;21(3):481-497.
Littlejohn G, Guymer E. Modulation of NMDA receptor activity in fibromyalgia. Biomedicines. 2017;5(4):15.
Fitzgerald P, Cassidy Eugene M, Clarke G, et al. Tryptophan catabolism in females with irritable bowel syndrome: relationship to interferon-gamma, severity of symptoms and psychiatric co-morbidity. Neurogastroenterol Motil. 2008;20(12):1291-1297.
Louca S, Christidis N, Ghafouri B, et al. Serotonin, glutamate and glycerol are released after the injection of hypertonic saline into human masseter muscles - a microdialysis study. J Headache Pain. 2014;15(1):1-11.
Kim YK, Jeon SW. Neuroinflammation and the immune-kynurenine pathway in anxiety disorders. Curr Neuropharmacol. 2018;16(5):574-582.
Konradsson Å. Modulation of Prefrontal Glutamatergic Transmission and "Atypicality" of Antipsychotic Drugs. Stockholm, Sweden: Department of Physiology and Pharmacology, Karolinska Institutet; 2010.