Reduced Intake of Dietary Tryptophan Improves Beneficial Action of Budesonide in Patients with Lymphocytic Colitis and Mood Disorders

Abstract

Lymphocytic colitis (LC) is a gastrointestinal (GI) tract disease with poorly known pathogenesis, but some environmental and lifestyle factors, including certain dietary components, may play a role. Tryptophan is an essential amino acid, which plays important structural and functional roles as a component of many proteins. It is important in the development and maintenance of the body, in which it is metabolized in two main pathways: kynurenine (KYN) and serotonin. In this work, we explored the effect of reducing of TRP in the diet of patients with LC with mood disorders. We enrolled 40 LC patients who had a normal diet, 40 LC patients with the 8-week diet with TRP content reduced by 25% and 40 controls. All LC patients received budesonide at 9 mg per day, and the severity of their GI symptoms was evaluated by the Gastrointestinal Symptoms Rating Scale. Mood disorders were evaluated by the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale (HAM-D). The concentration of TRP and its metabolites, 5-hydroxyindoleacetic acid (5-HIAA), kynurenine (KYN), kynurenic acid (KYNA) and quinolinic acid (QA), in urine were determined. Budesonide improved the GI and mental states of LC patients, and the diet with reduced TRP content further amended these symptoms. Dietary intervention decreased the concentration of 5-HIAA by about 50% (3.4 vs. 6.3) and QA by about 45% (3.97 vs. 7.20). These changes were correlated with a significant improvement in the profitable action of budesonide on gastrointestinal and mental health of LC patients as they displayed significantly lower GSRS, HAM-A and HAM-B scores after than before the intervention—10.5 vs. 32, 11.0 vs. 21 and 12 vs. 18, respectively. In conclusion, a reduction in TRP intake in diet may improve GI and mental symptoms in LC patients treated with budesonide and these changes may be mediated by the products of TRP metabolism.

Urine 5-Hydroxyindoleacetic Acid Negatively Correlates with Migraine Occurrence and Characteristics in the Interictal Phase of Episodic Migraine

“…In our previous works, we considered tryptophan metabolism in the context of the gut-brain-microbiota axis [45][46][47][48]. However, those studies were performed on hospital patients, but this study enrolled patients of an outpatient clinic and most of them were not willing to donate blood or undergo the examination of the gut and the microbiota.…”

Urine 5-Hydroxyindoleacetic Acid Negatively Correlates with Migraine Occurrence and Characteristics in the Interictal Phase of Episodic Migraine

“…In our previous works, we considered tryptophan metabolism in the context of the gut-brainmicrobiota axis [44][45][46][47]. However, those studies were performed on hospital patients, but this study enrolled patients of an outpatient clinic and most of them were not willing to donate blood or undergo the examination of the gut and the microbiota.…”

Tryptophan in the mouse diet is essential for embryo implantation and decidualization

“…All proteins in the mouse diets were replaced with amino acid premixes in the process of making feed to ensure that the Trp content in the food was 0.2%, 0.062% and 0 of the total feed (see Table 1 for specific feed formulations). In vivo experiments with dietary for Trp addition or deficiency are generally a long-term process for 12 weeks, 8 weeks, or 70 days in previous studies ( 71 – 74 ). Therefore, we first fed female mice with different amounts of Trp for 2 months and then performed different treatments.…”