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Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
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Dried Blood Spot Collection of Health Biomarkers to Maximize Participation in Population Studies
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Biomarkers.

Lieke Bakker1,2,3, Sebastian Köhler1,2,3, Kyonghwan Choe2,3

  • 1Alzheimer Center Limburg, Maastricht University, Maastricht, Limburg, Netherlands.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
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Summary
This summary is machine-generated.

The tryptophan-kynurenine pathway appears dysregulated after stroke, irrespective of cognitive impairment. This study investigated kynurenine and B-vitamin levels across cognitive decline stages.

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Area of Science:

  • Neuroscience
  • Biochemistry
  • Metabolomics

Background:

  • The tryptophan-kynurenine pathway is implicated in cognitive decline in neurodegenerative and cerebrovascular disorders.
  • Previous clinical studies on kynurenines are limited in size and scope, particularly concerning prodromal disease stages.
  • A transdiagnostic approach is needed to investigate kynurenine and B-vitamin levels across dementia and cognitive impairment phases.

Purpose of the Study:

  • To investigate plasma levels of tryptophan, kynurenine metabolites, and B-vitamins.
  • To compare these levels across different diagnostic phases of cognitive decline, including healthy controls, subjective cognitive decline (SCD), mild cognitive impairment (MCI), dementia, and post-stroke cognitive impairment (PSCI/PSNCI).
  • To explore the role of the tryptophan-kynurenine pathway in cognitive decline and cerebrovascular disorders.

Main Methods:

  • Analysis of blood plasma samples from 2,452 healthy older adults and 759 patients with cognitive impairment or post-stroke conditions.
  • Quantification of tryptophan, seven kynurenine metabolites, and two B-vitamins using liquid chromatography-tandem mass spectrometry (LC-MS/MS).
  • Linear regression analyses were performed to assess differences between groups, adjusting for confounders. Metabolites were log-transformed and standardized for comparison.

Main Results:

  • Stroke patients exhibited significantly lower plasma levels of tryptophan, xanthurenic acid, pyridoxal 5'-phosphate, riboflavin, and the kynurenic acid-to-quinolinic acid ratio compared to controls.
  • Conversely, stroke patients showed higher levels of kynurenine, 3-hydroxykynurenine, 3-hydroxyanthranilic acid, quinolinic acid, and the kynurenine-to-tryptophan ratio.
  • These alterations were observed in both patients with post-stroke cognitive impairment (PSCI) and without (PSNCI), with no significant differences between these subgroups.

Conclusions:

  • Preliminary findings suggest dysregulation of the kynurenine pathway following stroke, independent of cognitive impairment.
  • Further research is required to validate these observations and elucidate the precise mechanisms involved.
  • The study highlights the potential of targeting the kynurenine pathway in managing cognitive deficits associated with cerebrovascular events.