The evaluation of serum tryptophan and kynurenine levels in patients with obstructive sleep apnea syndrome
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SLEEP BREATHING PHYSIOLOGY AND DISORDERS • ORIGINAL ARTICLE
The evaluation of serum tryptophan and kynurenine levels in patients with obstructive sleep apnea syndrome Ayşe İriz 1 & Rabia Şemsi 2
&
Burcu Eser 2,3 & Burak Arslan 2,4 & Aylin Sepici Dinçel 2
Received: 20 August 2020 / Revised: 2 November 2020 / Accepted: 12 November 2020 # Springer Nature Switzerland AG 2020
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. Keywords Tryptophan . Kynurenine . IDO . OSAS
Introduction Obstructive sleep apnea syndrome (OSAS) has gained importance in terms of public health and a prevalence varying
* Rabia Şemsi [email protected] 1
Department of Otorhinolaryngology (Ear-Nose-Throat), Gazi University Faculty of Medicine, Ankara, Turkey
2
Department of Medical Biochemistry, Gazi University Faculty of Medicine, Ankara, Turkey
3
Gülhane Institute of Health Sciences, R&D Centre, Chromatography Laboratory, The University of Health Sciences, Ankara, Turkey
4
Department of Medical Biochemistry, Ercis State Hospital, Van, Turkey
among population of different societies. It is influenced by many environmental and hereditary factors [1]. Obstructive sleep apnea syndrome is a disease characterized by recurrent obstructions of upper airway
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