Alp Hamit Hakan, Kurhan Faruk, Akbay Halil İbrahim
Department of Biochemistry, Faculty of Medicine, University of Van Yuzuncu Yil, Van, Turkey.
Department of Psychiatry, Faculty of Medicine, University of Van Yuzuncu Yil, Van, Turkey.
Psychiatry Clin Neurosci. 2025 Jul;79(7):378-388. doi: 10.1111/pcn.13819. Epub 2025 Apr 1.
Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by repetitive thoughts and behaviors. The kynurenine pathway has been increasingly implicated in psychiatric disorders. This study aimed to investigate the predictive value of kynurenine pathway metabolites, including serotonin and tryptophan, in patients with varying degrees of OCD.
One hundred fifty OCD patients and 30 healthy controls were included in this study. Patients were divided into mild-moderate, severe, and extremely severe OCD groups based on their Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores. Serum levels of serotonin, tryptophan, kynurenine, kynurenic acid, indolamine 2,3-dioxygenase (IDO), tryptophan 2,3-dioxygenase (TDO), 3-hydroxykynurenine, quinolinic acid and picolinic acid were measured using enzyme-linked immunosorbent assay. Logistic regression and receiver operating characteristic (ROC) analysis were performed to evaluate the predictive value of these analytes for OCD severity.
Serotonin and tryptophan levels were significantly decreased in OCD patients compared to healthy controls, while kynurenine pathway metabolites were significantly increased in patients with OCD. Serum levels of kynurenine pathway metabolites increased with severity in OCD patients. As a result of ROC analysis, serotonin, tryptophan and kynurenine pathway metabolites had higher AUC values in distinguishing OCD patients from healthy volunteers, while kynurenine and tryptophan had higher AUC values in distinguishing disease severity.
This study clarifies the role of the kynurenine pathway in the pathophysiology of OCD and suggests that kynurenine pathway metabolites, especially kynurenine, may serve as useful biomarkers to diagnose and differentiate OCD severity. Further research is needed to confirm these findings and explore therapeutic implications.
强迫症（OCD）是一种以反复出现的想法和行为为特征的精神疾病。犬尿氨酸途径越来越多地与精神疾病相关。本研究旨在探讨犬尿氨酸途径代谢产物，包括血清素和色氨酸，在不同程度强迫症患者中的预测价值。
本研究纳入了150例强迫症患者和30名健康对照。根据耶鲁-布朗强迫症量表（Y-BOCS）评分，将患者分为轻中度、重度和极重度强迫症组。采用酶联免疫吸附测定法测量血清素、色氨酸、犬尿氨酸、犬尿酸、吲哚胺2,3-双加氧酶（IDO）、色氨酸2,3-双加氧酶（TDO）、3-羟基犬尿氨酸、喹啉酸和吡啶酸的水平。进行逻辑回归和受试者工作特征（ROC）分析，以评估这些分析物对强迫症严重程度的预测价值。
与健康对照相比，强迫症患者的血清素和色氨酸水平显著降低，而强迫症患者的犬尿氨酸途径代谢产物显著增加。强迫症患者血清中犬尿氨酸途径代谢产物的水平随病情严重程度增加。ROC分析结果显示，血清素、色氨酸和犬尿氨酸途径代谢产物在区分强迫症患者和健康志愿者方面具有较高的AUC值，而犬尿氨酸和色氨酸在区分疾病严重程度方面具有较高的AUC值。
本研究阐明了犬尿氨酸途径在强迫症病理生理学中的作用，并表明犬尿氨酸途径代谢产物，尤其是犬尿氨酸，可能作为诊断和区分强迫症严重程度的有用生物标志物。需要进一步的研究来证实这些发现并探索其治疗意义。
