Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital

Exercise-mediated improvement of depression in patients with gastro-esophageal junction cancer is linked to kynurenine metabolism

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Use of primary health care and participation in colorectal cancer screening - a Danish national register-based study

    Research output: Contribution to journalLetterResearchpeer-review

  2. Circulating tumour DNA alterations as biomarkers for head and neck cancer: a systematic review

    Research output: Contribution to journalReviewResearchpeer-review

  3. Incidence and malignant transformation of glottic precursor lesions in Denmark

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Difficult journeys in sarcoma care; socioeconomic disparity added to the multiple challenges of a rare tumor diagnosis

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Using computerized assessment in simulated colonoscopy: a validation study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Development of limb muscle dysfunction in chronic obstructive pulmonary disease: Smoking, inflammation, or simply disuse?

    Research output: Contribution to journalEditorialResearchpeer-review

  3. GLP-1 secretion is regulated by IL-6 signalling: a randomised, placebo-controlled study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. The Incidence of Free Peritoneal Tumor Cells before and after Neoadjuvant Chemotherapy in Gastroesophageal Junction Cancer

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

Background: Exercise may improve depression in cancer patients, yet the molecular mechanism behind this protection is poorly understood. Here, we aimed to explore the link between exercise and regulation of kynurenine (Kyn) metabolism and inflammation in patients with operable gastro-esophageal junction (GEJ) cancer patients, who improved significantly in depression score with exercise training. Material and Methods: Fifty GEJ cancer patients were allocated to 12 weeks of supervised training twice weekly including interval-based aerobic exercise and resistance training, or standard care. Depression score was evaluated by HADS, and blood samples and muscle biopsies were collected for determination of Kyn metabolism and inflammation across the intervention. Results: Depression scores decreased by -1.3 points in the exercise group ( p  < 0.01), whereas no changes were observed in the control group. Plasma 3-hydroxykynurenine (HK), a Kyn metabolite giving rise to other neurotoxic metabolites, increased by 48% ( p  <0.001) in the control group, while exercise training attenuated this accumulation. The production of HK is induced by inflammation, and while we observed no differences in systemic pro-inflammatory cytokines, exercise training ameliorated the treatment-induced intramuscular inflammation. Moreover, exercise has been suggested to convert Kyn to the neuroprotective metabolite, kynurenic acid (KA), but despite marked functional and muscular exercise-mediated adaptations, we did not observe any enhancement of KA production and related enzyme expression in the muscles of GEJ cancer patients. Conclusion: Exercise training reduced symptoms of depression in patients with GEJ cancer, and this effect was associated with an exercise-dependent attenuation of the inflammation-induced conversion of Kyn to neurotoxic metabolites.

Original languageEnglish
JournalActa oncologica
Issue number5
Pages (from-to)579-587
Number of pages9
Publication statusPublished - 4 May 2019

    Research areas

  • Aged, Anxiety/etiology, Depression/etiology, Exercise/physiology, Female, Humans, Inflammation/metabolism, Kynurenic Acid/metabolism, Kynurenine/metabolism, Male, Middle Aged, Neoadjuvant Therapy/adverse effects, Stomach Neoplasms/drug therapy, Treatment Outcome

ID: 56520630