Quality of Life and Tryptophan Degradation

  • D. Fuchs
  • K. Schroecksnadel
  • G. Neurauter
  • R. Bellmann-Weiler
  • M. Ledochowski
  • G. Weiss
Reference work entry


Patients suffering from autoimmune disease, cancer or chronic inflammatory diseases mostly suffer from severe “complications” of their underlying illness, like weight loss, physical inefficiency, immunodeficiency, anemia, chronic fatigue, mood disorders or even depression. All these symptoms can severely impair the quality of life of patients. The percentage of patients with chronic diseases complaining about poor quality of life is high, irrespective of their underlying disease.

Interestingly, most patients suffering from chronic inflammatory disease have a strongly disturbed  tryptophan metabolism. Within cellular immune response the essential amino acid tryptophan is degraded by the enzyme  indoleamine-2,3-dioxygenase (IDO), leading to lowered tryptophan serum/plasma concentrations and increased levels of tryptophan catabolites like kynurenine. Tryptophan is not only necessary for the growth and proliferation of various cells as well as pathogens, it is also the precursor of the important neurotransmitters serotonin (5-hydroxytryptamin) and nicotinamide adenine dinucleotide (NAD). Increased  tryptophan degradation within chronic inflammatory cascades thus leads to a diminished tryptophan availability, which might not only decrease the immunoresponsiveness of patients, but may also influence their mood, physical strength and haematopoiesis.

In fact, immune-mediated tryptophan degradation is supposed to contribute importantly to the development of fatigue, weight loss, and neuropsychiatric disorders. This review provides an overview, how enhanced IDO-activation might contribute to the development of various symptoms impairing the quality of life of patients with chronic disease.


Quinolinic Acid Neuropsychiatric Symptom Nicotinamide Adenine Dinucleotide Acute Tryptophan Depletion Tryptophan Depletion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:


aminocarboxymuconic semialdehyde


adenosine triphosphate


guanine triphosphate cylohydrolase I


human immunodeficiency virus infection


indoleamine 2,3-dioxygenase




indoleamine-pyrrole 2,3-dioxygenase-like 1


kynurenine to tryptophan ratio




nicotinamide adenine dinucleotide


tryptophan pyrrolase

Th1 type immune response

T-helper cell type 1 immune response


tumor necrosis factor-α


5-hydroxytryptamin (= serotonin)




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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • D. Fuchs
    • 1
  • K. Schroecksnadel
    • 2
  • G. Neurauter
    • 1
  • R. Bellmann-Weiler
    • 2
  • M. Ledochowski
    • 3
  • G. Weiss
    • 2
  1. 1.Division of Biological Chemistry, BiocenterInnsbruck Medical UniversityInnsbruckAustria
  2. 2.Department of Internal MedicineInnsbruck Medical UniversityInnsbruckAustria
  3. 3.Division of Nutrition MedicineInnsbruck Medical UniversityInnsbruckAustria

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