Akademik Veri Yönetim Sistemi
XXXIII. WASPaLM World Congress, Antalya, Türkiye, 16 Eylül 2024
Aim: Generalized Anxiety Disorder is one of the most prevalent anxiety disorders among children and
adolescents. Imbalances in the tryptophan/kynurenine pathway, particularly an excess or change in the
metabolites ratio of specific neuroactive features, can be linked to some neurological and psychiatric conditions.
To our knowledge, this study is the first investigation of the relationship between the tryptophan/kynurenine
pathway and generalized anxiety disorder in children and adolescents. This study aims to investigate the
potential impact of serum levels of tryptophan, kynurenine, kynurenic acid, and quinolinic acid levels, known as
tryptophan/kynurenine pathway markers, on the etiology and clinical course of Generalized Anxiety Disorder.
Methods: This study was conducted between May 2022 and October 2023 at the Gazi University Faculty of
Medicine Hospital. Participants were selected from Child and Adolescent Psychiatry Outpatient Clinic and
samples were analyzed at the Department of Medical Biochemistry of the hospital. A total of 26 treatment-naive
children with Generalized Anxiety Disorder and 38 healthy controls were included in the present study. All
participants were interviewed with Schedule for Affective Disorders and Schizophrenia for School-Age Children
by certified psychiatrists to confirm Generalized Anxiety Disorder diagnosis and exclude comorbid psychiatric
disorders. The severity of Generalized Anxiety Disorder symptoms was assessed by revised Child Anxiety and
Depression Scales. Venous blood samples were collected and centrifuged at 1.300g for 10 minutes to obtain
the separated serum. The serum tryptophan, kynurenine, kynurenic acid, and quinolinic acid levels were
measured using original commercial ELISA kits.
Results: 26 patients with Generalized Anxiety Disorder (7 male, 19 female; median (IQR 25-75) of age 170
(138-190) months) and 38 healthy controls (18 male, 20 female; age 154 (123-180) months) presented
comparable age and gender. Serum Tryptophan and Quinolinic acid levels of the Generalized Anxiety Disorder
group were significantly lower than the control group. Tryptophan (median [IQR], 62.8 (19.7- 82.3) vs. 210 (58-
264) mg/L, p = 0.001) and Quinolinic acid (median [IQR], 9.9 (7.8-11.4) vs. 11.9 (10-17) ng/mL, p = 0.004). The
groups had no significant difference regarding kynurenine and kynurenic acid levels (p > 0.05). Serum levels of
of tryptophan, kynurenic acid, and quinolinic acid levels were negatively significantly correlated with
Generalized Anxiety Disordersymptom severity (p=0,008, p=0,047, p=0,002 respectively).
Conclusions: The present research explored whether the kynurenine pathway imbalances can be the underlying
cause of Generalized Anxiety Disorder in childhood. It is thought that the kynurenine pathway has been
proposed to play an essential role in neuronal inflammation and alterations in the central nervous system.
Imbalances in kynurenine pathway cause an excess or change in the proportion of metabolites with neuroactive
compounds. The findings suggested that children with Generalized Anxiety Disorder had lower serum
tryptophan and quinolinic acid levels than controls. There were also significant correlations between serum
tryptophan and quinolinic acid levels with Generalized Anxiety Disorder symptom severity. These findings point
that serum ryptophan oxidation pathway marker levels may be related to Generalized Anxiety Disorder
etiopathogenesis, depending on Generalized Anxiety Disorder symptom severity.
2.10.2024 11:59 Online Abstract
https://burkonturizm.com/bildiri/TKBD2024EN/en/index.asp 1/2
Keywords : Generalized Anxiety Disorder, tryptophan/kynurenine pathway, tryptophan, kynurenine, kynurenic
acid, quinolinic acid