Kavyani, Bahar, Lidbury, Brett A, Schloeffel, Richard et al. · Cellular and molecular life sciences : CMLS · 2022 · DOI
This review explores whether problems with how your body processes an amino acid called tryptophan might explain ME/CFS symptoms. The kynurenine pathway is a biochemical process that helps your cells make energy and affects immune function and brain inflammation. The authors suggest that abnormalities in this pathway could be a missing piece in understanding why ME/CFS develops.
Understanding the kynurenine pathway's role in ME/CFS could identify new biomarkers for diagnosis and point toward novel treatments, addressing a critical gap in a disease with no proven cure. For patients, this research offers hope that researchers are investigating specific biological mechanisms rather than viewing ME/CFS as purely psychological.
This review does not provide new experimental data proving the kynurenine pathway is definitively abnormal in ME/CFS patients—it synthesizes existing literature and proposes a hypothesis. The studies reviewed show correlation between KP abnormalities and ME/CFS-like symptoms, but do not establish causation. Further clinical studies directly measuring KP metabolites in well-characterized ME/CFS cohorts are needed before confirming this mechanism.
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 →
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Primary citation
Kavyani, Bahar, Lidbury, Brett A, Schloeffel, Richard, Fisher, Paul R, Missailidis, Daniel, Annesley, Sarah J, et al. (2022). Could the kynurenine pathway be the key missing piece of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) complex puzzle?. Cellular and molecular life sciences : CMLS. https://doi.org/10.1007/s00018-022-04380-5
BibTeX
@article{mecfsatlas-kavyani-2022-could-kynurenine,
author = {Kavyani, Bahar and Lidbury, Brett A and Schloeffel, Richard and Fisher, Paul R and Missailidis, Daniel and Annesley, Sarah J and Dehhaghi, Mona and Heng, Benjamin and Guillemin, Gilles J},
title = {Could the kynurenine pathway be the key missing piece of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) complex puzzle?},
journal = {Cellular and molecular life sciences : CMLS},
year = {2022},
doi = {10.1007/s00018-022-04380-5},
note = {PubMed: 35821534},
url = {https://www.mecfsatlas.com/evidence/kavyani-2022-could-kynurenine},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/kavyani-2022-could-kynurenine
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