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The evaluation of serum tryptophan and kynurenine levels in patients with obstructive sleep apnea syndrome

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

The kynurenine (Kyn) pathway may play a role in certain physiological functions such as behavior, sleep, thermoregulation, and pregnancy. Tryptophan (Trp) is oxidized with tryptophan 2,3-dioxygenase and indolamine 2,3-dioxygenase (IDO). Under normal conditions, hepatic kynurenine is a transcription factor and IDO expression in healthy tissues is very low. The ratio of Kyn to Trp can be used as an indicator to assess IDO activity. This study aimed to determine the relationship between Kyn/Trp ratio and obstructive sleep apnea syndrome (OSAS) disease activity.

Methods

Study participants were categorized in 3 groups: Group 1 included patients with mild OSAS, Group 2, patients with moderate to severe OSAS, and Group 3, individuals considered normal to serve as controls. The demographic characteristics of the patients were recorded. Apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) measurements were performed by diagnostic polysomnography (PSG). Trp and Kyn levels were determined by HPLC-UV method.

Results

Group 1 included 30 patients (18 men) with mild OSAS; Group 2 included 42 patients (31 men) with moderate to severe OSAS; and Group 3 included 25 controls (13 men). While there was no statistically significant difference between the levels of tryptophan and kynurenine in the groups, a significant difference was found between the Kyn/Trp ratios. A significant correlation was observed in individuals with a body mass index less than 25 with the Kyn/Trp ratio. In individuals with mild OSAS, a significant correlation was observed between ODI and BMI. In individuals with moderate to severe OSAS, there was a significant correlation between ODI, AHI, and BMI.

Conclusion

In this study, there was no relationship between OSAS disease severity and IDO activity as assessed by immunoreactivity via the Kyn/Trp pathway.

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Authors and Affiliations

  1. Department of Otorhinolaryngology (Ear-Nose-Throat), Gazi University Faculty of Medicine, Ankara, Turkey

    Ayşe İriz

  2. Department of Medical Biochemistry, Gazi University Faculty of Medicine, Ankara, Turkey

    Rabia Şemsi, Burcu Eser, Burak Arslan & Aylin Sepici Dinçel

  3. Gülhane Institute of Health Sciences, R&D Centre, Chromatography Laboratory, The University of Health Sciences, Ankara, Turkey

    Burcu Eser

  4. Department of Medical Biochemistry, Ercis State Hospital, Van, Turkey

    Burak Arslan

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  1. Ayşe İriz
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Correspondence to Rabia Şemsi.

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The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Ethical conduct of research

Our study was performed with the approval of the ethics review board of the Gazi University Faculty of Medicine Ethics Committee and all the participants gave written informed consent. The number of the ethical approval is 573-10.09.2018.

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İriz, A., Şemsi, R., Eser, B. et al. The evaluation of serum tryptophan and kynurenine levels in patients with obstructive sleep apnea syndrome. Sleep Breath 25, 1389–1398 (2021). https://doi.org/10.1007/s11325-020-02250-7

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  • DOI: https://doi.org/10.1007/s11325-020-02250-7

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