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Eosinophilia–myalgia syndrome is a rare, sometimes fatal neurological condition linked to the ingestion of the dietary supplement L-tryptophan. [1] [2] The risk of developing EMS increases with larger doses of tryptophan and increasing age. [3]
Tryptophan contains an α-amino group, an α-carboxylic acid group, and a side chain indole, making it a polar molecule with a non-polar aromatic beta carbon substituent. Tryptophan is also a precursor to the neurotransmitter serotonin, the hormone melatonin, and vitamin B 3 (niacin). [4] It is encoded by the codon UGG.
The coincident occurrence of β-carboline alkaloids and serotonin in Peganum harmala indicates the presence of two very similar, interrelated biosynthetic pathways, which makes it difficult to definitively identify whether free tryptamine or L-tryptophan is the precursor in the biosynthesis of harmine. [7]
Droxidopa (L-DOPS) is a synthetic precursor or prodrug of norepinephrine used orally in the treatment of certain types of hypotension and other conditions. [ 6 ] [ 7 ] Dipivefrine is a synthetic precursor or prodrug of epinephrine used as an ophthalmic medication .
Kynurenic acid (KYNA or KYN) is a product of the normal metabolism of amino acid L-tryptophan. It has been shown that kynurenic acid possesses neuroactive activity. It acts as an antiexcitotoxic and anticonvulsant, most likely through acting as an antagonist at excitatory amino acid receptors. Because of this activity, it may influence ...
Tetrahydrobiopterin is a cofactor in the production of L-DOPA from tyrosine and 5-hydroxy-L-tryptophan from tryptophan, which must be supplemented as treatment in addition to the supplements for classical PKU. [citation needed] Other underlying causes of tetrahydrobiopterin deficiency are: [2] 6-Pyruvoyltetrahydropterin synthase (PTPS) deficiency
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