A Brief Historic Overview of Clinical Disorders Associated with Tryptophan: The Relevance to Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM).

Blankfield, Adele

doi:10.4137/ijtr.s10085

Cited by 19 publications

(31 citation statements)

References 65 publications

(136 reference statements)

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“…Its levels are reduced because of undernutrition,17 malabsorption,3,32 or any significant illness or injury which upregulates KP catabolism 1…”

Section: Protein Energy Malnutrition (Pem) Niacin and Cofactorsmentioning

confidence: 99%

“…CFS/FM is a complex autoimmune spectrum disorder which is frequently familial 2,3,41,47. The onset is either acute or insidious and has a variable and unpredictable course and outcome.…”

Section: Cfs/fm—the Metabolic Enigmamentioning

confidence: 99%

“…Tryptophan32 and Vitamin B-12 deficiencies are associated with malabsorption and contribute to the causes of nutritional demyelinating disorders 3. Both substances have juvenile forms of illnesses.…”

Section: Cfs/fm—the Metabolic Enigmamentioning

confidence: 99%

“…Aspects of some of the putative precipitating factors have been previously outlined 2,3. An analysis of the areas of metabolic dysfunction will focus on future directions for research and management.…”

mentioning

confidence: 99%

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Article Commentary: Kynurenine Pathway Pathologies: Do Nicotinamide and Other Pathway Co-Factors have a Therapeutic Role in Reduction of Symptom Severity, Including Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM)

Blankfield¹

2013

Int J�Tryptophan�Res

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The definition of dual tryptophan pathways has increased the understanding of the mind-body, body-mind dichotomy. The serotonergic pathway highlights the primary (endogenous) psychiatric disorders. The up-regulation of the kynurenine pathway by physical illnesses can cause neuropathic and immunological disorders1 associated with secondary neuropsychiatric symptoms.Tryptophan and nicotinamide deficiencies fall within the protein energy malnutrition (PEM) spectrum. They can arise if the kynurenine pathway is stressed by primary or secondary inflammatory conditions and the consequent imbalance of available catabolic/anabolic substrates may adversely influence convalescent phase efficiency. The replacement of depleted or reduced NAD+ levels and other cofactors can perhaps improve the clinical management of these disorders.Chronic fatigue syndrome (CFS) and fibromyalgia (FM) appear to meet the criteria of a tryptophan-kynurenine pathway disorder with potential neuroimmunological sequelae. Aspects of some of the putative precipitating factors have been previously outlined.2,3 An analysis of the areas of metabolic dysfunction will focus on future directions for research and management.

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“…Its levels are reduced because of undernutrition,17 malabsorption,3,32 or any significant illness or injury which upregulates KP catabolism 1…”

Section: Protein Energy Malnutrition (Pem) Niacin and Cofactorsmentioning

confidence: 99%

“…CFS/FM is a complex autoimmune spectrum disorder which is frequently familial 2,3,41,47. The onset is either acute or insidious and has a variable and unpredictable course and outcome.…”

Section: Cfs/fm—the Metabolic Enigmamentioning

confidence: 99%

Section: Cfs/fm—the Metabolic Enigmamentioning

confidence: 99%

mentioning

confidence: 99%

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Article Commentary: Kynurenine Pathway Pathologies: Do Nicotinamide and Other Pathway Co-Factors have a Therapeutic Role in Reduction of Symptom Severity, Including Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM)

Blankfield¹

2013

Int J�Tryptophan�Res

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“…In addition, there is strong evidence of lowering the threshold of pain sensitivity in patients with FM. At the same time, clinical application of diferent methods, such as neurosensory potential testing, revealed that the mechanical allodynia in patients with FM is not restricted to tender points and is prevalent [5].…”

Section: Introductionmentioning

confidence: 99%

Chronic Pain and Depression

Karapetyan¹,

Manvelyan²

2017

Depression

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Today, it is clear that chronic pain and depression are closely related. Depression can cause pain, and chronic pain can cause depression too. According to the American Pain Foundation, about 32 million people in the U.S. report have had pain lasting longer than 1 year. Statistical international data prove that more than half of the patients with pain are depressed or have mood swings, and on average, 65% of depressed people also complain of pain. Patients simultaneously sufering of chronic pain and limited independence are especially vulnerable. Fibromyalgia (FM) is one of the most common chronic pain syndromes, afecting 15 up to 5% of world population, is characterized as difuse widespread body pain, with deinite tender points and clinical features, and also triggers the development of depression. Depression severity in patients with FM worsens severity of pain. Depressive disorders are observed in approximately 90% of patients with FM. Pain triggers development of depressive conditions in patients with chronic character of pain, and time course of disease shows certain patern of increasing of severity of depression and worsens long term outcomes. Patients with chronic pain must be evaluated for depression, and successful management of pain must include treatment of depressive mood too.

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