Tryptophan/kynurenine ratio as biomarker of bladder cancer.

To investigate plasma and urinary kynurenine/tryptophan (KYN/TRP) ratio in bladder cancer, expression of indoleamine 2,3-dioxygenase 1 (IDO1) vis-à-vis tryptophan 2,3-dioxygenase (TDO2) in bladder tumor and correlation of KYN/TRP ratio with bladder tumor burden.

Metabotyping of TRP-KYN metabolic axis was performed via a clinical case-control study. Expression of IDO1 and TDO2 was measured in human biopsied tissues. Correlational experiments between KYN/TRP ratio and bladder tumor were performed using a murine orthotopic prostate-specific antigen (PSA)-secreting MB49 bladder cancer model.

We established for the first time that plasma TRP level was significantly decreased while both plasma and urinary KYN/TRP ratios were significantly higher in bladder cancer patients and expression level of IDO1 but not TDO2 was increased in human bladder tumor. We reported the positive correlation between IDO1 expression, KYN/TRP ratio, normalized PSA to creatinine (CR) (PSA/CR) and bladder tumor burden in the murine model.

KYN/TRP ratio is promising surveillance biomarker for bladder cancer but would require further validation before clinical translation is possible.

BJU international. 2020 Aug 13 [Epub ahead of print]

Sze Han Lee, Ratha Mahendran, Sin Mun Tham, Thomas Paulraj Thamboo, Billy Jianhao Chionh, Yi Xin Lim, Woon Chau Tsang, Qing Hui Wu, Jun Yang Chia, Melissa Hui Wen Tay, Benjamin Yen Seow Goh, Kelven Weijing Chen, Jeane Zepeda Mallari, Revathi Periaswami, Lata Raman, Shoa Nian Choo, Dorinda Yan Qin Kioh, Edmund Chiong, Kesavan Esuvaranathan, Eric Chun Yong Chan

Department of Pharmacy, National University of Singapore, Singapore, 117543, Singapore., Department of Surgery, National University of Singapore, Singapore, 119228, Singapore., Department of Pathology, National University Health System, Singapore, 119074, Singapore., Department of Urology, National University Health System, Singapore, 119074, Singapore.