The role of the kynurenine pathway in suicidality in adolescent major depressive disorder

PSYCHIATRY RESEARCH

卷:227

Article

Bradley, Kailyn A. L.¹  Case, Julia Ac.¹  Khan, Omar¹  Ricart, Thomas¹  Hanna, Amira¹  Alonso, Carmen M.²  Gabbay, Vilma^1,3,4 

[1] Icahn Sch Med Mt Sinai, Dept Psychiat, New York, NY 10029 USA

[2] NYU, Sch Med, NYU Child Study Ctr, Child & Adolescent Psychiat, New York, NY 10016 USA

[3] Nathan S Kline Inst Psychiat Res, Orangeburg, NY 10962 USA

[4] Icahn Sch Med Mt Sinai, Dept Neurosci, New York, NY 10029 USA

关键词: Tryptophan;    3-hydroxyanthranilic acid;    Indoleamine 2;    3-dioxygenase;    Adolescence;    Depression;    Suicide;   

DOI  :  10.1016/j.psychres.2015.03.031

来源: Elsevier

【 摘 要 】

The neuroimmunological kynurenine pathway (KP) has been implicated in major depressive disorder (MDD) in adults and adolescents, most recently in suicidality in adults. The KP is initiated by the enzyme indoleamine 2,3-dioxygenase (IDO), which degrades tryptophan (TRP) into kynurenine (KYN) en route to neurotoxins. Here, we examined the KP in 20 suicidal depressed adolescents composed of past attempters and those who expressed active suicidal intent-30 non-suicidal depressed youth, and 22 healthy controls (HC). Plasma levels of TRP, KYN, 3-hydroxyanthranilic acid (3-HAA), and KYN/TRP (index of IDO) were assessed. Suicidal adolescents showed decreased TRP and elevated KYN/TRP compared to both non-suicidal depressed adolescents and HC. Findings became more significantly pronounced when excluding medicated participants, wherein there was also a significant positive correlation between KYN/TRP and suicidality. Finally, although depressed adolescents with a history of suicide attempt differed from acutely suicidal adolescents with respect to disease severity, anhedonia, and suicidality, the groups did not differ in KP measures. Our findings suggest a possible specific role of the KP in suicidality in depressed adolescents, while illustrating the clinical phenomenon that depressed adolescents with a history of suicide attempt are similar to acutely suicidal youth and are at increased risk for completion of suicide. Published by Elsevier Ireland Ltd.

【 授权许可】

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