Back to Journals » Neuropsychiatric Disease and Treatment » Volume 10

Kynurenine and depressive symptoms in a poststroke population

Authors Bensimon K, Herrmann N, Swardfager W, Yi H, Black S, Gao F, Snaiderman A, Lanctôt KL

Received 8 April 2014

Accepted for publication 11 June 2014

Published 22 September 2014 Volume 2014:10 Pages 1827—1835


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Kira Bensimon,1,2 Nathan Herrmann,1,2,4 Walter Swardfager,1–4 Hao Yi,1 Sandra E Black,1–4 Fu-Qiang Gao,1,4 Abraham Snaiderman,2,3 Krista L Lanctôt1–4

1Sunnybrook Research Institute, Toronto, ON, Canada; 2Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 3Toronto Rehabilitations Institute,Toronto, ON, Canada; 4Canadian Partnership for Stroke Recovery, Heart and Stroke Foundation, Ottawa, ON Canada

Background and purpose: Depression is a commonly occurring and persistent sequel of stroke affecting approximately 29% of patients. An immunological hypothesis has been put forward, and synthesis of kynurenine from tryptophan has been proposed to link inflammatory activity with neurotoxicity and neurotransmitter dysfunction. This study assessed the relationship between peripheral blood kynurenine and poststroke depressive symptoms.
Patients and methods: This was a multisite cross-sectional observational cohort study of patients with ischemic stroke. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression (CES-D) scale and divided into high, medium, and low depressive symptom tertiles. Concentrations of kynurenine and tryptophan were assayed from fasting serum samples, and the kynurenine/tryptophan ratio was compared between tertiles. Serum cytokine concentrations were assayed in a subgroup of patients, and the ratio of proinflammatory (IL-6, IL-18, IFNγ, TNF, IL-1β) to anti-inflammatory (IL-10) cytokines compared.
NLM identifier: NCT00254020.
Results: In these patients (n=86, 52.3% male, mean age 71.7±14.2 years), there were no differences in kynurenine/tryptophan ratios between CES-D scale tertiles (F2,76=0.04, P=0.96) controlling for relevant covariates. For cytokines (n=53), serum IL-1β concentrations (F2,52=3.55, P=0.037) and serum ratios of IL-18/IL-10 (F2,52=3.30, P=0.046), IFNγ/IL-10 (F2,52=4.02, P=0.025), and IL-1ß/IL-10 (F2,52=4.34, P=0.019) were elevated in the middle CES-D tertile. Post hoc analyses suggested that serum ratios of IL-18/IL-10 (ρ=0.28, P=0.04), and IL-1ß/IL-10 (ρ=0.43, P=0.001), as well as IL-1ß (ρ=0.29, P=0.04), were significantly associated with fatigue.
Conclusion: Peripheral kynurenine/tryptophan ratios were not associated with depressive symptoms in a poststroke population. However, in exploratory analyses a proinflammatory bias was identified specifically in patients with mild depressive symptoms and associated with poststroke fatigue, suggesting an avenue for future research.

Keywords: kynurenine, tryptophan, cytokine, inflammation, stroke, depression

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]


Other articles by this author:

Serum low-density lipoprotein levels, statin use, and cognition in patients with coronary artery disease

Rej S, Saleem M, Herrmann N, Stefatos A, Rau A, Lanctôt KL

Neuropsychiatric Disease and Treatment 2016, 12:2913-2920

Published Date: 10 November 2016

A meta-analysis of lipid peroxidation markers in major depression

Mazereeuw G, Herrmann N, Andreazza AC, Khan MM, Lanctôt KL

Neuropsychiatric Disease and Treatment 2015, 11:2479-2491

Published Date: 29 September 2015

Platelet activating factors are associated with depressive symptoms in coronary artery disease patients: a hypothesis-generating study

Mazereeuw G, Herrmann N, Xu H, Blanchard AP, Figeys D, Oh PI, Bennett SAL, Lanctôt KL

Neuropsychiatric Disease and Treatment 2015, 11:2309-2314

Published Date: 4 September 2015

Relationship between hair cortisol concentrations and depressive symptoms in patients with coronary artery disease

Yekta Dowlati, Nathan Herrmann, Walter Swardfager, et al

Neuropsychiatric Disease and Treatment 2010, 6:393-400

Published Date: 24 June 2010

Readers of this article also read:

Green synthesis of water-soluble nontoxic polymeric nanocomposites containing silver nanoparticles

Prozorova GF, Pozdnyakov AS, Kuznetsova NP, Korzhova SA, Emel’yanov AI, Ermakova TG, Fadeeva TV, Sosedova LM

International Journal of Nanomedicine 2014, 9:1883-1889

Published Date: 16 April 2014

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

A novel preparation method for silicone oil nanoemulsions and its application for coating hair with silicone

Hu Z, Liao M, Chen Y, Cai Y, Meng L, Liu Y, Lv N, Liu Z, Yuan W

International Journal of Nanomedicine 2012, 7:5719-5724

Published Date: 12 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010