{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:22:17Z","timestamp":1787775737162,"version":"build-2784847793"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"Abstract<\/jats:title>\n \n INTRODUCTION:<\/jats:title>\n Patients with tuberculosis (TB) may have depression as a comorbidity, which may be associated with poor treatment outcomes. Increased production of pro-inflammatory cytokines activating enzyme indoleamine 2,3-dioxygenase (IDO) has been reported in TB. We studied the association of IDO activity and comorbid depression in TB patients.<\/jats:p>\n <\/jats:sec>\n \n MATERIALS AND METHODS:<\/jats:title>\n Newly diagnosed, treatment-na\u00efve TB patients were evaluated for symptoms of depression using the Patient Health Questionnaire (PHQ)-9 scale. A PHQ-9 score of \u22655 was taken as an indicator for depression. Patients were further categorized into two groups based on their PHQ-9 scores, Group-I with a PHQ-9 score of <5 and Group-II with a PHQ-9 score \u22655. The serum kynurenine (KYN) and tryptophan (TRP) levels were determined using liquid chromatography\u2013mass spectrometry (LC-MS) and the KYN\/TRP ratio was taken as a measure for IDO activity.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n A total of 106 TB patients and 106 healthy controls were enrolled in this study. Over 73.5% of TB patients had PHQ-9 scores of above 5 with an average score of 7.09 \u00b1 2.83, a significant difference (\n P<\/jats:italic>\n < 0.05) as compared to the average PHQ-9 scores of healthy controls (2.93 \u00b1 1.20). Group-II TB patients had lower serum TRP 539.55 \u00b1 194.31 ng\/mL versus 1109.45 \u00b1 186.04 ng\/mL (\n P<\/jats:italic>\n < 0.01) in Group-I; higher serum KYN 425.81 \u00b1 65.51 ng\/mL versus 250.06 \u00b1 40.28 ng\/mL (\n P<\/jats:italic>\n < 0.01) and higher K\/T ratio 0.906 \u00b1 0.56 versus 0.251 \u00b1 0.052 (\n P<\/jats:italic>\n < 0.01). There was a significant linear correlation between PHQ-9 and serum KYN (\n r<\/jats:italic>\n : 0.969;\n P<\/jats:italic>\n : <0.01;\n R<\/jats:italic>\n 2:<\/jats:sup>\n 0.909); serum TRP (\n r<\/jats:italic>\n : 0.841;\n P<\/jats:italic>\n : <0.01;\n R<\/jats:italic>\n 2:<\/jats:sup>\n 0.745); and KYN\/TRP ratio (\n r<\/jats:italic>\n : 0.745;\n P<\/jats:italic>\n < 0.01;\n R<\/jats:italic>\n 2:<\/jats:sup>\n 0.618).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION:<\/jats:title>\n These findings suggest that in TB patients, induction of IDO activity may be relevant to the development of comorbid depression.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijp.ijp_252_23","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T21:05:26Z","timestamp":1746479126000},"page":"21-26","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Tuberculosis and comorbid depression: Association with serum indoleamine 2,3-dioxygenase activity"],"prefix":"10.4103","volume":"57","author":[{"given":"Proteesh","family":"Rana","sequence":"first","affiliation":[{"name":"Department of Pharmacology, University College of Medical Sciences, University of Delhi, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijo","family":"Varughese","sequence":"additional","affiliation":[{"name":"Department of Paediatric Research and Genetic Division, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vandana","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Maulana Azad Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreshth","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Maulana Azad Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Department of Paediatric Research and Genetic Division, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwani","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Chest and Tuberculosis Clinic, Lok Nayak Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"R2-20250506","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1002\/wps.20134","article-title":"Depression: A silent driver of the global tuberculosis epidemic","volume":"13","author":"Sweetland","year":"2014","journal-title":"World Psychiatry"},{"key":"R3-20250506","doi-asserted-by":"crossref","first-page":"852","DOI":"10.5588\/ijtld.16.0584","article-title":"Addressing the tuberculosis-depression syndemic to end the tuberculosis epidemic","volume":"21","author":"Sweetland","year":"2017","journal-title":"Int J Tuberc Lung Dis"},{"key":"R4-20250506","first-page":"18","article-title":"Depression: A neglected comorbidity in patients with tuberculosis","volume":"66","author":"Shyamala","year":"2018","journal-title":"J Assoc Physicians India"},{"key":"R5-20250506","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1007\/s11606-011-1704-y","article-title":"Depression and medication adherence in the treatment of chronic diseases in the United States: A meta-analysis","volume":"26","author":"Grenard","year":"2011","journal-title":"J Gen Intern Med"},{"key":"R6-20250506","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.ijtb.2019.02.007","article-title":"Tuberculosis \u2013 Depression syndemic: A public health challenge","volume":"66","author":"Chandra","year":"2019","journal-title":"Indian J Tuberc"},{"key":"R7-20250506","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1128\/CVI.05402-11","article-title":"Serum indoleamine 2,3-dioxygenase activity predicts prognosis of pulmonary tuberculosis","volume":"19","author":"Suzuki","year":"2012","journal-title":"Clin Vaccine Immunol"},{"key":"R8-20250506","doi-asserted-by":"crossref","first-page":"372","DOI":"10.3389\/fcimb.2019.00372","article-title":"Indoleamine 2, 3-dioxygenase-mediated tryptophan catabolism: A leading star or supporting act in the tuberculosis and hiv pas-de-deux?","volume":"9","author":"Adu-Gyamfi","year":"2019","journal-title":"Front Cell Infect Microbiol"},{"key":"R9-20250506","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s43168-022-00174-2","article-title":"Activities of plasma indoleamine-2, 3-dioxygenase (IDO) enzyme in Nigerian patients with lung diseases: basis for tryptophan supplementation or IDO inhibitor 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tuberculosis patients and its relation with their life satisfaction","volume":"6","author":"Bhat","year":"2015","journal-title":"JMSCR"},{"key":"R14-20250506","first-page":"2212","article-title":"Prevalence of depression among tuberculosis patients","volume":"5","author":"Dahiya","year":"2017","journal-title":"Sch J App Med Sci"},{"key":"R15-20250506","first-page":"496","article-title":"Assessment of the frequency of depression and anxiety among tuberculosis patients at a tertiary care health centre. A cross sectional study","volume":"5","author":"Ravi","year":"2018","journal-title":"Eur J Pharm Med Res"},{"key":"R16-20250506","doi-asserted-by":"crossref","first-page":"100281","DOI":"10.1016\/j.jctube.2021.100281","article-title":"Depression among tuberculosis patients and its association with treatment outcomes in district Srinagar","volume":"25","author":"Rouf","year":"2021","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"key":"R17-20250506","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1002\/JLB.MR0119-023R","article-title":"The interplay between depression and tuberculosis","volume":"106","author":"Zhang","year":"2019","journal-title":"J Leukoc Biol"},{"key":"R18-20250506","doi-asserted-by":"crossref","first-page":"718","DOI":"10.4049\/jimmunol.0801212","article-title":"Tuberculosis is associated with a down-modulatory lung immune response that impairs Th1-type immunity","volume":"183","author":"Almeida","year":"2009","journal-title":"J Immunol"},{"key":"R19-20250506","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.5588\/ijtld.13.0082","article-title":"Indoleamine 2,3-dioxygenase in the pathogenesis of tuberculous pleurisy","volume":"17","author":"Suzuki","year":"2013","journal-title":"Int J Tuberc Lung Dis"}],"container-title":["Indian Journal of Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijp.ijp_252_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:40:44Z","timestamp":1787773244000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijp.ijp_252_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijp.ijp_252_23","relation":{},"ISSN":["0253-7613","1998-3751"],"issn-type":[{"value":"0253-7613","type":"print"},{"value":"1998-3751","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2023-05-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}