5-Hydroxytryptamine and tryptamine pathways in scleroderma

Stachow, A; Jabłońska, S.; Skiendzielewska, A

doi:10.1111/j.1365-2133.1977.tb15060.x

Cited by 52 publications

(13 citation statements)

References 16 publications

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“…It has been suggested that those affected might metabolize tryptophan along an alternative metabolic pathway, leading to accumulation of toxic metabolites such as kynurenine [75]. Disorders of amine metabolism have also been implicated in the pathophysiology of scleroderma [76].…”

Section: Toxic Oil Tryptophan and Sclerodermamentioning

confidence: 99%

Epidemics of vascular toxicity and pulmonary hypertension: what can be learned?

Egermayer¹

2000

Journal of Internal Medicine

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Abstract. Egermayer P (Canterbury RespiratoryResearchEpidemics of vascular disease caused by toxins and infectious agents affecting both humans and animals have been common in history. Examples of agents implicated include anorexients, ergotamine, mercury, arsenic, vinyl chloride, thorotrast, plant alkaloids, nitrites, toxic oil, tryptophan and bacterial, viral and parasitic infections. A major characteristic of these disorders is endothelial dysfunction, which may manifest itself in vasospastic disorders, sclerodermiform skin lesions, fibrosis, osteolytic lesions, polyneuropathy and portal and pulmonary hypertension. Angiosarcoma may also be a late outcome. These diseases are more common than is generally appreciated. The aetiology is usually multifactorial. This and other factors contribute to delayed recognition.

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Section: Toxic Oil Tryptophan and Sclerodermamentioning

confidence: 99%

Epidemics of vascular toxicity and pulmonary hypertension: what can be learned?

Egermayer¹

2000

Journal of Internal Medicine

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“…Serotonin has induced dermal fibrosis in rats 11 and can stimulate DNA synthesis in fibroblasts in vitro 12 . In one study, abnormal tryptophan and serotonin metabolism was demonstrated in patients with idiopathic scleroderma and systemic sclerosis 13 . Serotonin has recently been demonstrated to induce proliferation of cardiac valvular subendocardial cells in vitro , 14 suggesting that the fibrotic process affecting skin and cardiac tissue may have a shared mechanism.…”

Section: Discussionmentioning

confidence: 99%

“…12 In one study, abnormal tryptophan and serotonin metabolism was demonstrated in patients with idiopathic scleroderma and systemic sclerosis. 13 Serotonin has recently been demonstrated to induce proliferation of cardiac valvular subendocardial cells in vitro, 14 suggesting that the fibrotic process affecting skin and cardiac tissue may have a shared mechanism. However, serotonin is secreted by the majority of carcinoid tumours yet carcinoidrelated scleroderma is unusual, suggesting that other factors such as genetic predisposition or other neuroendocrine mediators must play a role.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous manifestations of the malignant carcinoid syndrome

Bell

Poston

Vora

et al. 2005

British Journal of Dermatology

121

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“…are also associated with sclerodermalike disease. Abnormalities in tryptophan metabolism have been described in patients with scleroderma and in family members of a patient with scleroderma (33,34). Perhaps, in a host with an occult enzyme deficiency, an iatrogenic excess of substrate for kyn-urenine and serotonin synthesis could have unmasked the scleroderma-like disease.…”

Section: Discussionmentioning

confidence: 99%

Association of l‐tryptophan and an illness resembling eosinophilic fasciitis: clinical and histopathologic findings in four patients with eosinophilia‐myalgia syndrome

Bulpitt

Verity

Clements

et al. 1990

Arthritis & Rheumatism

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The Centers for Disease Control has recently reported an association between the use of oral Ltryptophan preparations and a disease marked by severe myalgia, peripheral eosinophilia, and neuromuscular and cutaneous abnormalities. They have labeled the condition eosinophilia-myalgia syndrome. We report here the clinical and histopathologic findings in 4 patients who developed an illness resembling eosinophilic fasciitis following the initiation of oral L-tryptophan supplementation.L-tryptophan has gained popularity as an empiric therapy for a variety of pain and sleep disorders, including insomnia, premenstrual syndrome, fibromyalgia (11, and depression. and over the last decade, its recommendation by practitioners and use by the general public have become extensive. Recently. the Centers for Disease Control (CDC) has received numerous reports suggesting a possible relationship between the oral consumption of commercial preparations of I>-tryptophan and the development of a syndrome marked by eosinophilia. severe myalgia, fever, skin changes, and respiratory symptoms, with onset weeks to years after initiation of L-tryptophan use ( 2 4 ) . The CDC has issued a health alert advising consumers to discontinue the use of this dietary supplement. They provided a provisional case-definition of eosinophilia-myalgia syndrome (EMS), but they did not include definitive morphologic findings. The precise role of L-tryptophan (or a contaminant in the L-tryptophan preparation) in the development of the syndrome is unknown, but the temporal relationship between the use of these preparations and the onset of EMS was sufficient to warrant this immediate warning by the CDC.Eosinophilic fasciitis (EF) was originally described by Shulman in 1974 ( 5 ) and further characterized by Rodnan and coworkers the following year (6,7). Although recognizing a similarity between EF and idiopathic scleroderma, Rodnan and other investigators have postulated that EF is a clinically distinct entity, differentiated from scleroderma by the pattern and appearance of the skin involvement, the presence of eosinophilia, the absence of Raynaud's phenomenon, an elevation in the erythrocyte sedimentation rate (ESR) and gamma globulin level, the rapidity with which contractures develop, the responsiveness to corticosteroid treatment, and the characteristic biopsy findings of deep fasciitis with perivascular infiltrates sparing skin and muscle. Over 200 case reports have followed the original description; however, the etiology of EF has remained an enigma.In this report, we describe 4 patients whose clinical and laboratory findings fit the CDC's provisional criteria for the diagnosis of EMS and who developed an illness that clinically resembled eosinophilic fasciitis. In response to the CDC's health alert, their cases were retrospectively reviewed and it was discovered that all 4 were taking L-tryptophan before and during the disease course. This probable associa-

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5-Hydroxytryptamine and tryptamine pathways in scleroderma

Cited by 52 publications

References 16 publications

Epidemics of vascular toxicity and pulmonary hypertension: what can be learned?

Epidemics of vascular toxicity and pulmonary hypertension: what can be learned?

Cutaneous manifestations of the malignant carcinoid syndrome

Association of l‐tryptophan and an illness resembling eosinophilic fasciitis: clinical and histopathologic findings in four patients with eosinophilia‐myalgia syndrome

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