Editing Kynurenine

[[File:Kynurenine a role ME CFS.jpg|alt=Kynurenine: a role in ME? Kynurenine is "a key metabolite in the tryptophan metabolism, and serves several roles in the immune system and inflammation" - Open Medicine Foundation |border|right|frameless]]
'''Kynurenine''' is an [[amino acid]] that is produced in the body by the metabolism of the essential amino acid [[tryptophan]].<ref>{{Cite web|url=https://www.merriam-webster.com/medical/kynurenine | title = Medical Definition of KYNURENINE|website=Merrian-Webster Dictionary|language=en|access-date=2019-11-30}}</ref><ref name="pubchem">{{Cite web|url=https://pubchem.ncbi.nlm.nih.gov/compound/Kynurenine | title = PubChem Compound Summary for CID 846, Kynurenine | last = National Center for Biotechnology Information | first = | authorlink = | date = 2021 | website = PubChem Database|language=en|archive-url=|archive-date=|url-status=|access-date=2020-01-19}}</ref>

==ME/CFS ==
The [[Open Medicine Foundation]]'s [[ME/CFS Severely Ill, Big Data Study]] found that patients in the study group with [[Severe and very severe ME|severe ME]] had one of several defects involving the [[Indoleamine-2,3-dioxygenase 2|IDO2]] gene, which affected tryptophan - kynurenine metabolism.<ref name="Phair2019" /> This lead to the [[Metabolic trap|Metabolic Trap]] theory.<ref name="Phair2019">{{Cite journal | last = Phair | first = Robert D. | authorlink = Robert Phair | last2 = Davis | first2 = Ronald W. | authorlink2 = Ron Davis | last3 = Kashi | first3 = Alex A. | authorlink3 = Alex Kashi | authorlink4 =  | authorlink5 =  | authorlink6 = | date = 2019 | title=The IDO Metabolic Trap Hypothesis for the Etiology of ME/CFS|url=https://www.mdpi.com/2075-4418/9/3/82|journal=Diagnostics|language=en|volume=9|issue=3 | pages = 82|doi=10.3390/diagnostics9030082|quote=|via=}}</ref>

Kynurenine is a neuroprotectant and a potential treatment. A clinical trial has been announced to investigate the effects of kynurenine, [[Robert Phair]] has stated the potential benefits of kynurenine in people with ME/CFS that may be:
* reduced [[cognitive dysfunction|brain fog]]
* reduced [[Memory problems|memory impairment]], and 
* improvements in [[headache]] symptoms<ref name=OMF26May2020>{{Cite web|url=https://www.omf.ngo/2020/05/26/omf-announces-new-treatment-trial/ | title = OMF Announces New Treatment Trial | date = 2020-05-26 | last = Open Medicine Foundation | author-link=Open Medicine Foundation|language=en-US|access-date=2020-07-03}}</ref>

==Uppsala trial, Sweden ==
In April 2020, the Open Medicine Foundation announced a pilot treatment trial of kynurenine for [[ME/CFS]].<ref name="maymomentum">{{Cite web|url=https://www.omf.ngo/maymomentum/ | title = #May Momentum 2020 | last = Open Medicine Foundation | first = | authorlink = Open Medicine Foundation | date = May 2020 | website = Open Medicine Foundation|language=en-US|archive-url=https://web.archive.org/web/20200621215257/https://www.omf.ngo/maymomentum/|archive-date=2020-06-21|url-status=dead|access-date=2020-05-01}}</ref> Dr [[Jonas Bergquist]] will be running the trial.<ref name="omf-trial-2020">{{Cite web|url=https://www.omf.ngo/2020/04/26/kynurenine-clinical-trial-for-me-cfs/ | title = Kynurenine Clinical Trial for ME / CFS | last = Open Medicine Foundation | first = | authorlink = Open Medicine Foundation | date = 2020-04-26 | website = Open Medicine Foundation|language=en-US|archive-url=|archive-date=|url-status=|access-date=2020-05-05}}</ref>

=== Trial type ===
Pilot trial, with cross-over at 3 months. Patients receiving the kynurenine will change to the placebo after 3 months, and patients receiving the placebo will switch to the kynurenine. No control group.<ref name="omf-trial-2020" />

=== Aims===
To see whether kynurenine improves [[Cognitive dysfunction|cognitive impairment]] (brain fog), [[Headache|headaches]] and [[Memory problems|memory]] in ME/CFS patients.<ref name="omf-trial-2020" />

=== Patients ===
Only 20 out of a group of 100 ME/CFS patients. Patients will be those identified as having a low level of kynurenine in blood serum and ME/CFS.<ref name="omf-trial-2020" />

=== Outcomes ===
Measurements will be taken from wearable sensors.<ref name="omf-trial-2020" />

==Potential benefits==
Kynurenine might be beneficial to ME/CFS patients; the Open Medicine Foundation's kynurenine trial aims to investigate this.

{{Quote frame|Suppose that some brain cells in a particular brain nucleus are in the IDO metabolic trap. This means that in those cells the concentration of tryptophan is too high, and the concentration of kynurenine is too low. 

Supplying an outside source of kynurenine, as Dr. Bergquist proposes, could conceivably solve part of the problem by allowing those brain cells to make the neuroactive metabolites of kynurenine that they cannot make if the metabolic trap has been sprung. So, the clinical trial might improve symptoms caused by too little kynurenine or too little kynurenic acid, a known neuroprotectant.

Dr. Bergquist's expertly designed clinical trial of kynurenine in ME/CFS to improve brain fog, memory, and headache is both important and timely.<ref name=OMF26May2020 /> | author = Robert Phair | date = May 26, 2020 | title = Kynurenine and the Metabolic Trap Hypothesis|source=}}

==Learn more==
*[https://pubchem.ncbi.nlm.nih.gov/compound/Kynurenine Kynurenine] - PubChem 
*[https://pubchem.ncbi.nlm.nih.gov/compound/L-Kynurenine L-Kynurenine] - PubChem
*[https://www.omf.ngo/2020/04/26/kynurenine-clinical-trial-for-me-cfs/ Kynurenine clinical trial] - Open Medicine Foundation

==See also==
* [[Kynurenine pathway]]
*[[Metabolic trap]]
*[[Open Medicine Foundation]]
* [[Indoleamine-2,3-dioxygenase|IDO]]
*[[Indoleamine-2,3-dioxygenase 2|IDO2]]
* [[Tryptophan]]

==References==
{{Reflist}}

[[Category:Amino acids]]
[[Category:Biochemistry and cell biology]]
[[Category:Energy system]]
[[Category:Metabolism]]
[[Category:Potential treatments]]