Hazrati, Ebrahim, Eftekhar, Seyed Parsa, Mosaed, Reza et al. · Molecular pain · 2024 · DOI
This review examined how a specific pathway in the body that breaks down the amino acid tryptophan might contribute to chronic pain, including in ME/CFS patients. The review looked at research across various pain conditions and depression, finding that certain chemicals produced along this pathway can either protect or damage nerve cells. The authors suggest that targeting this pathway could lead to new, non-opioid treatments for chronic pain.
ME/CFS is explicitly included in this review's scope, making it directly relevant to understanding potential biological mechanisms underlying post-exertional malaise, pain, and fatigue. The identification of the kynurenine pathway as a druggable target could inform future research into non-opioid, mechanism-based treatments for ME/CFS patients who often experience multi-system pain and depression.
This narrative review does not establish causal relationships between kynurenine pathway dysregulation and ME/CFS symptoms—it synthesizes existing literature rather than providing new mechanistic evidence. The review does not prove that KP-targeting interventions will be effective in ME/CFS patients specifically, nor does it determine whether KP abnormalities are primary drivers or secondary consequences of chronic pain and fatigue.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Hazrati, Ebrahim, Eftekhar, Seyed Parsa, Mosaed, Reza, Shiralizadeh Dini, Saeed, & Namazi, Mehrshad (2024). Understanding the kynurenine pathway: A narrative review on its impact across chronic pain conditions.. Molecular pain. https://doi.org/10.1177/17448069241275097
BibTeX
@article{mecfsatlas-hazrati-2024-understanding-kynurenine,
author = {Hazrati, Ebrahim and Eftekhar, Seyed Parsa and Mosaed, Reza and Shiralizadeh Dini, Saeed and Namazi, Mehrshad},
title = {Understanding the kynurenine pathway: A narrative review on its impact across chronic pain conditions.},
journal = {Molecular pain},
year = {2024},
doi = {10.1177/17448069241275097},
note = {PubMed: 39093627},
url = {https://www.mecfsatlas.com/evidence/hazrati-2024-understanding-kynurenine},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/hazrati-2024-understanding-kynurenine
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