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However, the Trp-Kyn metabolism\u2013associated immune regulation in dermatomyositis (DM) remains unknown. Therefore, we aimed to investigate the clinical relevance of the Trp-Kyn metabolism via IDO1 induction in DM.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Liquid chromatography-mass spectrometry (HPLC\u2013MS) was used to examine the serum Kyn and Trp concentrations in DM. In addition, we used X-tile software to determine the optimal cutoff value of the Kyn\/Trp ratio, a surrogate marker for Trp-Kyn metabolism. Spearman analysis was performed to evaluate the association of Trp-Kyn metabolism with muscle enzymes and inflammatory markers.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>DM patients had significantly higher serum Kyn\/Trp ratio (\u00d7\u200910<jats:sup>\u22123<\/jats:sup>) when compared with the healthy controls. The serum Kyn\/Trp ratio was positively correlated with the levels of muscle enzymes and inflammatory markers. In addition, the serum Kyn\/Trp ratio significantly decreased (36.89 (26.00\u201354.00) vs. 25.00 (18.00\u201337.00), <jats:italic>P<\/jats:italic>\u2009=\u20090.0006) after treatment. DM patients with high serum Kyn\/Trp ratio had a significantly higher percentage of muscle weakness symptoms (62.5% vs. 20.0%, <jats:italic>P<\/jats:italic>\u2009=\u20090.019) and higher levels of LDH (316.0 (236.0\u2013467.0) vs<jats:italic>.<\/jats:italic> 198.0 (144.0\u2013256.0), <jats:italic>P<\/jats:italic>\u2009=\u20090.004) and AST (56.5 (35.0\u201392.2) vs. 23.0 (20.0\u201336.0), <jats:italic>P<\/jats:italic>\u2009=\u20090.002)) than those with low serum Kyn\/Trp ratio. Multiple Cox regression analyses identified ln(Kyn\/Trp) (HR 4.874, 95% <jats:italic>CI<\/jats:italic> 1.105\u201321.499, <jats:italic>P<\/jats:italic>\u2009=\u20090.036) as an independent prognostic predictor of mortality in DM.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>DM patients with enhanced Trp-Kyn metabolism at disease onset are characterized by more severe disease status and poor prognosis. Intrinsic immune regulation function via enhanced Trp-Kyn metabolism by IDO1 induction may be a potential therapeutic target in DM.<jats:table-wrap><jats:table><jats:tbody>\n                      <jats:tr>\n                        <jats:td colspan=\"2\"><jats:bold>Key Points<\/jats:bold><jats:italic>\u2022 HPLC\u2013MS identified increased serum Kyn\/Trp ratio in DM patients, which positively correlated with levels of muscle enzymes and inflammatory markers and was downregulated upon treatment.<\/jats:italic><jats:italic>\u2022\u00a0<\/jats:italic><jats:italic>Cox regression analyses identified ln(Kyn\/Trp) as an independent prognostic predictor of mortality in DM.<\/jats:italic><jats:italic>\u2022\u00a0<\/jats:italic><jats:italic>Monitoring intrinsic immune regulation function should be considered a potential therapeutic target in DM patients.<\/jats:italic><\/jats:td>\n                      <\/jats:tr>\n                    <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10067-022-06263-3","type":"journal-article","created":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T17:08:59Z","timestamp":1656695339000},"page":"3107-3117","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Enhanced tryptophan-kynurenine metabolism via indoleamine 2,3-dioxygenase 1 induction in dermatomyositis"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2153-7734","authenticated-orcid":false,"given":"Dan","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0611-7547","authenticated-orcid":false,"given":"Mengya","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8550-8767","authenticated-orcid":false,"given":"Shile","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0013-2815","authenticated-orcid":false,"given":"Shimin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7286-5423","authenticated-orcid":false,"given":"Yongheng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2277-6243","authenticated-orcid":false,"given":"Qian","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2537-1724","authenticated-orcid":false,"given":"Ke","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2630-8460","authenticated-orcid":false,"given":"Feng","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3286-0035","authenticated-orcid":false,"given":"Xiaosong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8718-8506","authenticated-orcid":false,"given":"Min","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7900-0852","authenticated-orcid":false,"given":"Hao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7961-6427","authenticated-orcid":false,"given":"Jie","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4440-5854","authenticated-orcid":false,"given":"Yunchen","family":"Le","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5908-6206","authenticated-orcid":false,"given":"Hua","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,1]]},"reference":[{"issue":"1","key":"6263_CR1","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1038\/s41572-021-00321-x","volume":"7","author":"IE Lundberg","year":"2021","unstructured":"Lundberg IE, Fujimoto M, Vencovsky J, Aggarwal R, Holmqvist M, Christopher-Stine L et al (2021) Idiopathic inflammatory myopathies. 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