L-tryptophan implicated in human eosinophilia-myalgia syndrome causes fasciitis and perimyositis in the Lewis rat

J Clin Invest. 1990 Nov;86(5):1757-63. doi: 10.1172/JCI114902.

Abstract

Tryptophan-associated eosinophilia-myalgia syndrome (L-TRP-EMS) is a newly described syndrome which occurred in epidemic fashion in the United States in the summer and fall of 1989. Epidemiologic data has linked the syndrome to intake of L-tryptophan (L-TRP) from one specific manufacturer, but the precise etiologic compound(s) must be established by replication of the syndrome in an appropriate animal model. In this study, implicated L-TRP, United States Pharmacopeia (USP) grade L-TRP, or vehicle was administered by gavage in a blinded fashion for 38 d to female Lewis rats at doses comparable with those ingested by patients who developed the eosinophilia-myalgia syndrome. Animals receiving implicated L-TRP, but not those receiving USP grade L-TRP or vehicle, developed histologic signs consistent with fasciitis and perimyositis, specific pathologic features of human L-TRP-EMS. Peripheral blood eosinophilia was not observed. Hypothalamic corticotropin releasing hormone mRNA levels were lower and plasma corticosterone levels tended to be lower in the animals that received implicated L-TRP. Plasma L-kynurenine was higher in both L-TRP-treated groups compared to the vehicle-treated animals. The female Lewis rat is known to be susceptible to a wide variety of inflammatory diseases. Identification of specific inflammatory changes in this rat following exposure to implicated L-TRP indicates that this animal model will be important in subsequent investigations into the etiology, pathogenesis, and treatment of human L-TRP-EMS.

MeSH terms

  • Animals
  • Brain Chemistry
  • Chromatography, High Pressure Liquid
  • Cortisone / blood
  • Disease Models, Animal
  • Eosinophilia / chemically induced
  • Fasciitis / chemically induced*
  • Female
  • Humans
  • Kynurenine / blood
  • Muscular Diseases / chemically induced
  • Myositis / chemically induced*
  • Nucleic Acid Hybridization
  • RNA, Messenger / analysis
  • Rats
  • Rats, Inbred Lew
  • Syndrome
  • Tryptophan / toxicity*

Substances

  • RNA, Messenger
  • Kynurenine
  • Tryptophan
  • Cortisone