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As such surgery is associated with signs of inflammation and pro\u2010inflammatory mediators activate tryptophan oxidation to neuroactive kynurenines which modulate NMDA receptor function and oxidative stress, we have measured blood concentrations of kynurenines and inflammatory markers in 28 patients undergoing coronary arterial graft surgery and, for comparison, 28 patients undergoing non\u2010bypass thoracic surgery. A battery of cognitive tests was completed before and after the operations. The results show increased levels of tryptophan with decreased levels of kynurenine, anthranilic acid and 3\u2010hydroxyanthranilic acid associated with bypass, and a later increase in kynurenic acid. Levels of neopterin and lipid peroxidation products rose after surgery in non\u2010bypass patients whereas tumour necrosis factor\u2010\u03b1 and S100B levels increased after bypass. Changes of neopterin levels were greater after non\u2010bypass surgery. Cognitive testing showed that the levels of tryptophan, kynurenine, kynurenic acid and the kynurenine\/tryptophan ratio, correlated with aspects of post\u2010surgery cognitive function, and were significant predictors of cognitive performance in tasks sensitive to frontal executive function and memory. Thus, anaesthesia and major surgery are associated with inflammatory changes and alterations in tryptophan oxidative metabolism which predict, and may play a role in, post\u2010surgical cognitive function.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1471-4159.2011.07414.x","type":"journal-article","created":{"date-parts":[[2011,8,5]],"date-time":"2011-08-05T20:48:31Z","timestamp":1312577311000},"page":"136-152","source":"Crossref","is-referenced-by-count":47,"title":["Kynurenine metabolism predicts cognitive function in patients following cardiac bypass and thoracic surgery"],"prefix":"10.1111","volume":"119","author":[{"given":"Caroline M.","family":"Forrest","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian M.","family":"Mackay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Oxford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Millar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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