Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Therapeutic Potential of the Kynurenine Pathway of Tryptophan Metabolism in Abdominal Migraine

Version 1 : Received: 8 August 2023 / Approved: 9 August 2023 / Online: 9 August 2023 (09:38:57 CEST)

How to cite: Fila, M.; Chojnacki, C.; Chojnacki, J.; Blasiak, J. Therapeutic Potential of the Kynurenine Pathway of Tryptophan Metabolism in Abdominal Migraine. Preprints 2023, 2023080760. https://doi.org/10.20944/preprints202308.0760.v1 Fila, M.; Chojnacki, C.; Chojnacki, J.; Blasiak, J. Therapeutic Potential of the Kynurenine Pathway of Tryptophan Metabolism in Abdominal Migraine. Preprints 2023, 2023080760. https://doi.org/10.20944/preprints202308.0760.v1

Abstract

Background: Abdominal migraine (AM) is a clinical diagnosis specified by Rome IV and ICHD III as a functional gastrointestinal disease (FGID) and a migraine associated syndrome, respectively. AM is undiagnosed and undertreated, and thus far the FDA has not approved any drug for AM treatment. We and others showed that changes in the kynurenine (KYN) pathway of tryptophan (TRP) metabolism played an important role in the pathogenesis and treatment of FIGDs. Changes in the KYN pathway were shown in migraine. Findings: Abdominal migraine reflects impairments in communication within the gut-brain axis. Treatment approaches have not been sufficiently documented and are based on experience of physicians, presenting personal rather than evidence-based practice and including efficacy of some drugs used in adult migraine. Non-pharmacological treatment of AM is aimed preventing or ameliorating AM triggers. Modulations within the KYN pathway of TRP metabolism induced by changes in TRP content in the diet, may ameliorate FGIDs and support their pharmacological treatment. Pharmacological manipulations of brain KYNs in animals have brought promising results for clinical applications. Conclusions: In conclusion, controlled placebo-based clinical trials with dietary manipulation to adjust the amount of the product of the KYN pathway of TRP metabolism are justified in children and adolescents with AM. Further preclinical studies are needed to establish details of these trials.

Keywords

abdominal migraine; tryptophan metabolism; kynurenine; gut-brain axis; metabolic treatment in migraine

Subject

Medicine and Pharmacology, Neuroscience and Neurology

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