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Indoleamine 2,3-dioxygenase 1 (IDO1) is a normal endogenous mechanism of acquired peripheral immune tolerance and may therefore be tumor-promoting. This study investigated the clinical relevance of IDO1 expression by immune cells in the lymph nodes and blood and of the serum kynurenine\/tryptophan (Kyn\/Trp) ratio in 65 systemic treatment na\u00efve stage I-III melanoma patients. Blood samples were collected within the first year of diagnosis. Patients had a median follow-up of 61 months. High basal IDO1 expression in peripheral monocytes and low IFN\u03b3-induced IDO1 upregulation correlated with worse outcome independent from disease stage. Interestingly studied factors were not interrelated. During follow-up, the risk of relapse was 9% (2\/22) in the subgroup with high IFN\u03b3-induced IDO1 upregulation in monocytes. In contrast, if IDO1 upregulation was low, relapse occurred in 30% (3\/10) of patients with low basal IDO1 expression in monocytes and in 61.5% (8\/13) in the subgroup with high basal IDO1 expression in monocytes (Log-Rank test, p=0.008). This study reveals some immune features in the blood of early stage melanoma that may be of relevance for disease outcome. These may offer a target for sub-stratification and early intervention.<\/jats:p>","DOI":"10.3389\/fimmu.2021.736498","type":"journal-article","created":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T06:29:37Z","timestamp":1630996177000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Clinical Relevance of Serum Kyn\/Trp Ratio and Basal and IFN\u03b3-Upregulated IDO1 Expression in Peripheral Monocytes in Early Stage 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