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. 2017 Feb 13:8:16.
doi: 10.3389/fpsyt.2017.00016. eCollection 2017.

High Kynurenine (a Tryptophan Metabolite) Predicts Remission in Patients with Major Depression to Add-on Treatment with Celecoxib

Daniela Krause  1 , Aye-Mu Myint  1 , Christine Schuett  2 , Richard Musil  1 , Sandra Dehning  1 , Anja Cerovecki  1 , Michael Riedel  1 , Volker Arolt  3 , Markus J Schwarz  4 , Norbert Müller  1
Affiliations

High Kynurenine (a Tryptophan Metabolite) Predicts Remission in Patients with Major Depression to Add-on Treatment with Celecoxib

Daniela Krause et al. Front Psychiatry. .

Abstract

Background: Signs of an inflammatory process have been described in major depression.

Methods: In a double-blind, randomized study of celecoxib or placebo add-on to reboxetine in 40 depressed patients, celecoxib treatment has beneficial effects. In order to evaluate the tryptophan/kynurenine metabolism and to identify predictors for remission, tryptophan (TRP), kynurenine (KYN), kynurenic acid (KYNA), and quinolinic acid (QUIN) were estimated in the serum of 32 patients before and after treatment and in a group of 20 healthy controls.

Results: KYN levels were significantly lower in patients (p = 0.008), and the QUIN/KYN ratios were significantly higher (p = 0.028). At baseline, the higher KYN/TRP ratio was predictive for remission during celecoxib add-on treatment (p = 0.04) as well as for remission in the overall patient group (p = 0.01). In the placebo group, remitters showed a higher KYNA/QUIN ratio (p = 0.032). In the overall group, remitters showed lower KYNA/KYN (p = 0.035) and QUIN/KYN (p = 0.011) ratios. The lower the formation of downstream metabolites, especially QUIN, the better the treatment outcome.

Conclusion: The high KYN/TRP ratio predicted remission after treatment with celecoxib in this small sample of depressed patients. Eventually, the KYN/TRP ratio might be a marker for those patients, which benefit from an additional anti-inflammatory treatment.

Keywords: celecoxib; cyclooxygenase-2; depression; kynurenines; remission.

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Figures

Figure 1
Figure 1
Comparison of the KYN/TRP ratio at baseline (KYN/TRP V0) between remitters (n = 6) and non-remitters (n = 12) in the celecoxib add-on group.
Figure 2
Figure 2
Comparison of the KYNA/QUIN ratio at baseline (KYNA/QUIN V0) between remitters (n = 3) and non-remitters (n = 11) from the placebo group.
Figure 3
Figure 3
Comparison of QUIN/KYN ratio at baseline (QUIN/KYN V0) between remitters (n = 9) and non-remitters (n = 23) from the overall group of patients with major depression.
See this image and copyright information in PMC

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