Metabolism of 14C-labelled L-tryptophan, L-kynurenine and hydroxy-L-kynurenine in miners with scleroderma.

Six South African White miners were studied with the 2-g L-tryptophan load test and tracer doses of L-tryptophan-7a-14C, L-kynurenine-keto-14C and hydroxy-L-kynurenine-keto-14C. The breath 14CO2 and 14 urinary metabolities were measured. When they were compared with a previous study of American women with scleroderma, similar 14CO2 and tryptophan metabolite excretion patterns were observed in the data from the miners. The labelled quinolinic acid excretion was more significantly elevated in the South African miners' urine than in the urine of the American women. The data from both studies suggest that some patients with scleroderma have an altered step in the tryptophan metabolic pathway after hydroxy-anthranilic acid. What relationship exists between the induction of pulmonary silicosis and the subsequent development of scleroderma, requires additional human studies.