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Tryptophan (Trp) metabolism, and consequently Trp-derived metabolite pathways such as the kynurenine and serotonin pathways, have long been known to be central to the pathophysiology of MDDlower blood concentrations of Trp have been described in several studies of MDD patients, and alterations in tryptophan and kynurenine levels have also been associated with symptomatology and treatment [24, 74]