Open this publication in new window or tab >>Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - BMC, Analytical Chemistry.
Karolinska Inst, Dept Physiol & Pharmacol, S-17177 Stockholm, Sweden..
Karolinska Inst, Dept Physiol & Pharmacol, S-17177 Stockholm, Sweden.;Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Stockholm, Sweden.;Stockholm Hlth Care Serv, Reg Stockholm, Stockholm, Sweden..
Karolinska Inst, Dept Physiol & Pharmacol, S-17177 Stockholm, Sweden.;Lithuanian Sports Univ, Inst Sport Sci & Innovat, Kaunas, Lithuania..
Karolinska Univ Hosp, Karolinska Inst, Ctr Mol Med, Unit Neuroimmunol,Dept Clin Neurosci, S-17177 Stockholm, Sweden.;Karolinska Univ Hosp, Div Neurol, S-17176 Stockholm, Sweden..
Univ Gothenburg, Sahlgrenska Acad, Inst Biomed, Dept Infect Dis, S-41685 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Infect Dis, Reg Vastra Gotaland, S-41685 Gothenburg, Sweden.;Publ Hlth Agcy Sweden, Solna, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Neurology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Neurology.
Karolinska Inst, Dept Physiol & Pharmacol, S-17177 Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Neurology. Karolinska Inst, Dept Neurosci, S-17177 Stockholm, Sweden.
Karolinska Inst, Dept Physiol & Pharmacol, S-17177 Stockholm, Sweden..
Karolinska Inst, Dept Physiol & Pharmacol, S-17177 Stockholm, Sweden..
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2025 (English)In: Brain, behavior, and immunity, ISSN 0889-1591, E-ISSN 1090-2139, Vol. 124, p. 163-176Article in journal (Refereed) Published
Abstract [en]
Long-term symptoms such as pain, fatigue, and cognitive impairments are commonly observed in individuals affected by coronavirus disease 2019 (COVID-19). Metabolites of the kynurenine pathway have been proposed to account for cognitive impairment in COVID-19 patients.
Here, cerebrospinal fluid (CSF) and plasma levels of kynurenine pathway metabolites in 53 COVID-19 patients and 12 non-inflammatory neurological disease controls in Sweden were measured with an ultra-performance liquid chromatography-tandem mass spectrometry system (UPLC-MS/MS) and correlated with immunological markers and neurological markers. Single cell transcriptomic data from a previous study of 130 COVID-19 patients was used to investigate the expression of key genes in the kynurenine pathway.
The present study reveals that the neuroactive kynurenine pathway metabolites quinolinic acid (QUIN) and kynurenic acid (KYNA) are increased in CSF in patients with acute COVID-19. In addition, CSF levels of kynurenine, ratio of kynurenine/tryptophan (rKT) and QUIN correlate with neurodegenerative markers. Furthermore, tryptophan is significantly decreased in plasma but not in the CSF. In addition, the kynurenine pathway is strongly activated in the plasma and correlates with the peripheral immunological marker neopterin. Single-cell transcriptomics revealed upregulated gene expressions of the rate-limiting enzyme indoleamine 2,3- dioxygenase1 (IDO1) in CD14+ and CD16+ monocytes that correlated with type II-interferon response exclusively in COVID-19 patients.
In summary, our study confirms significant activation of the peripheral kynurenine pathway in patients with acute COVID-19 and, notably, this is the first study to identify elevated levels of kynurenine metabolites in the central nervous system associated with the disease. Our findings suggest that peripheral inflammation, potentially linked to overexpression of IDO1 in monocytes, activates the kynurenine pathway. Increased plasma kynurenine, crossing the blood–brain barrier, serves as a source for elevated brain KYNA and neurotoxic QUIN. We conclude that blocking peripheral-to-central kynurenine transport could be a promising strategy to protect against neurotoxic effects of QUIN in COVID-19 patients.
Place, publisher, year, edition, pages
Elsevier, 2025
Keywords
Infectious disease, Cognition, Neuroinflammation
National Category
Neurosciences
Identifiers
urn:nbn:se:uu:diva-545745 (URN)10.1016/j.bbi.2024.11.031 (DOI)001375993400001 ()39615604 (PubMedID)2-s2.0-85211048036 (Scopus ID)
Funder
Karolinska InstituteKnut and Alice Wallenberg Foundation, 2020.0182Knut and Alice Wallenberg Foundation, 2020.0241Science for Life Laboratory, SciLifeLabKTH Royal Institute of TechnologySwedish Research Council, 2021-02251Swedish Research Council, 2019-01452Swedish Research Council, 2017-03054Swedish Research Council, 2019-06082Swedish Research Council, 2021-05045Swedish Research Council, 2021-06545The Swedish Brain Foundation, FO2022-0140Åhlén-stiftelsenFamiljen Erling-Perssons StiftelseMärta och Nicke Nasvells stiftelseRegion UppsalaSwedish Society for Medical Research (SSMF), SG-22-0192-H-01Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse
2024-12-202024-12-202024-12-20Bibliographically approved