{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:51:16Z","timestamp":1787986276706,"version":"build-2784847793"},"reference-count":44,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Primary premature ejaculation (PPE) is a common male neurobiological disorder. Currently, there is consensus that the impairment in central serotonin (5\u2010HT) neurotransmission constitutes a key pathogenic factor in PPE. Selective serotonin reuptake inhibitors (SSRIs) serve as the primary pharmacological intervention; however, a comprehensive elucidation of their mechanism of action remains incomplete. Owing to significant individual variability in efficacy, SSRIs exhibit a high discontinuation rate. Hence, there is an urgent need to address the selection of SSRIs for PPE treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to investigate the characteristics of tryptophan (TRP) metabolism in patients with PPE and to assess its influence on the efficacy of SSRIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The exploratory study included a total of 16 patients with PPE and 16 control subjects who were healthy men without any sexual dysfunction. Upon enrollment in the study, all participants underwent a thorough medical history review and physical examination. Subsequently, their serum levels of TRP, its metabolites, large neutral amino acids (LNAAs), and metabolite ratios were assessed using a liquid chromatography\u2013mass spectrometry (LC\u2013MS) assay. After a period of 4\u00a0weeks of dapoxetine treatment, all patients with PPE underwent reassessment using the Premature Ejaculation Diagnostic Tool (PEDT) score and intravaginal ejaculatory latency time (IELT) test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The ratio of serum TRP to other LNAAs (TRP\/LNAAs) in patients with PPE was found to be significantly lower compared to the control group (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). Conversely, the ratio of kynurenine to TRP (KYN\/TRP) was observed to be significantly higher in the PPE patients compared to the control group (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). Including the serum TRP\/LNAAs ratio and KYN\/TRP ratio in the prediction model yielded the highest prediction efficiency for PPE. There was a significant negative correlation between the ratio of TRP\/LNAAs before the treatment and the IELT after 4\u00a0weeks of the treatment. Additionally, there was a significant positive correlation observed between the ratio of TRP\/LNAAs before the treatment and the PEDT score after 4\u00a0weeks of the treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates that the reduction in the TRP\/LNAAs ratio and the elevation of the KYN\/TRP ratio are significant characteristics associated with PPE. These findings suggest that diminished tryptophan availability in the brain and the activation of the kynurenine (KYN) pathway may play a role in the pathogenesis of PPE. The TRP\/LNAAs ratio has potential as a reliable indicator of central serotonin (5\u2010HT) levels. Considering the TRP\/LNAAs ratio when selecting SSRIs for the treatment of PPE may enhance the response rate of this medication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/andr.13632","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T08:14:15Z","timestamp":1711008855000},"page":"1830-1840","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Correlation between serum tryptophan metabolism and treatment efficacy of dapoxetine in patients with premature ejaculation: A pilot study"],"prefix":"10.1111","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0402-7635","authenticated-orcid":false,"given":"Chenglun","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Infertility and Sexual Medicine the Third Affiliated Hospital, Sun Yat\u2010sen University  Guangzhou Guangdong 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