High Rate of Deficiency in the Amino Acids Tryptophan and Histidine in People with Wounds: Implication for Nutrient Targeting in Wound Management-A Pilot Study
Abstract
BACKGROUND: Malnutrition resulting from inadequate protein, energy, or micronutrient intake has been identified as an independent risk factor for the development of pressure ulcers in older adult patients and is associated with increased morbidity and death. OBJECTIVE: To assess the relationship between albumin, the standard biochemical marker of nutritional adequacy, and amino acid status in people with wounds. METHODS: The authors performed tests for serum albumin, prealbumin, and amino acid profiles on 18 consecutive hospital patients with wounds and 7 patients without wounds. RESULTS: A low level of the essential amino acids tryptophan and histidine was a common finding in older people with wounds. Of the 18 consecutive wound cases, 16 (88.9%) were found to be deficient in tryptophan, histidine, or both. Moreover, levels were generally found to be lower than those in the group without wounds. The levels of all other amino acids were essentially normal for all patients. Finally, although serum albumin is often used as a surrogate marker of amino acid adequacy or nutritional status, clinically abnormal albumin had poor specificity (63.2%), poor sensitivity (60.7%), and low positive predictive value (70.8%) for the identification of a low tryptophan or histidine level. CONCLUSIONS: People with wounds are a relatively at-risk group and are likely to be overlooked in terms of micronutrient deficiencies, and these findings have important implications in terms of potential specific targeting of nutrient supplementation.
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There is a positive correlation between the content of histidine and wound healing.
“Importantly, there is a positive correlation between the content of histidine (the substrate for production of UCA) and wound healing [13,14].”
From Ternary Cu(II) Complex with GHK Peptide and Cis-Urocanic Acid as a Potential Physiologically Functional Copper Chelate (2020) · cites this paper as [13]
A deficiency in histidine was observed in skin wounds.
“a deficiency in histidine was observed in skin wounds [13].”
From Ternary Cu(II) Complex with GHK Peptide and Cis-Urocanic Acid as a Potential Physiologically Functional Copper Chelate (2020) · cites this paper as [13]
Cites
Omega-3 Fatty Acids in Inflammation and Autoimmune Diseases
Simopoulos, A. P. (2002) · Journal of the American College of Nutrition · doi:10.1080/07315724.2002.10719248 · Cited by 2,014 · see citing works
The underappreciated role of muscle in health and disease
Wolfe, R. R. (2006) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/84.3.475 · Cited by 1,563 · see citing works
POOR NUTRITIONAL STATUS AND INFLAMMATION: Serum Albumin: Relationship to Inflammation and Nutrition
Don, B. R., & Kaysen, G. A. (2004) · Seminars in Dialysis · doi:10.1111/j.0894-0959.2004.17603.x · Cited by 1,423 · see citing works
Monitoring tryptophan metabolism in chronic immune activation
Schröcksnadel, K., Wirleitner, B., Winkler, C., & Fuchs, D. (2006) · Clinica Chimica Acta · doi:10.1016/j.cca.2005.06.013 · Cited by 551 · cited 1× · see citing works
“2,3-dioxygenase is induced by cytokines, to facilitate the degradation of tryptophan via the kynurenine pathway.(12) If this is the cause of the decreased level of tryptophan, then increasing B group vitamins (B3 in particular) or providing a diet rich in omega-3 fatty acids may lessen the degradation and allow increa…”
BackgroundCorrelation of Pressure Sores and Nutritional Status
Pinchcofsky‐Devin, G. D., & Kaminski, M. V. (1986) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1986.tb03411.x · Cited by 318 · see citing works
Pressure Ulcers among the Elderly
Desforges, J. F., & Allman, R. M. (1989) · New England Journal of Medicine · doi:10.1056/nejm198903303201307 · Cited by 270 · see citing works
The Importance of Dietary Protein in Healing Pressure Ulcers
Breslow, R., Hallfrisch, J., Guy, D. G., Crawley, B., & Goldberg, A. P. (1993) · Journal of The American Geriatrics Society · doi:10.1111/j.1532-5415.1993.tb06940.x · Cited by 252 · see citing works
Nicotinamide is a potent inhibitor of proinflammatory cytokines
Ungerstedt, J. S., Blombäck, M., & Söderström, T. (2003) · Clinical & Experimental Immunology · doi:10.1046/j.1365-2249.2003.02031.x · Cited by 222 · see citing works
Malnutrition, Tube Feeding and Pressure Sores: Data Are Incomplete
Finucane, T. E. (1995) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1995.tb05822.x · Cited by 99 · see citing works
Optimizing protein intake in aging
Walrand, S., & Boirie, Y. (2004) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/00075197-200501000-00014 · Cited by 99 · see citing works
Clinical nutrition: 1. Protein-energy malnutrition in the inpatient.
Hoffer, L. J. (2001) · Europe PMC (PubMed Central) · Cited by 69 · see citing works
The Role of Nutrition in Wound Care
Posthauer, M. E. (2006) · Advances in Skin & Wound Care · doi:10.1097/00129334-200601000-00015 · Cited by 55 · see citing works
The Difference between Albumin and Prealbumin
Collins, N. (2001) · Advances in Skin & Wound Care · doi:10.1097/00129334-200109000-00009 · Cited by 50 · see citing works
Determination of malnutrition in hospitalized patients with the use of a group-based reference.
Spiekerman, A. M., Ra, R., & Lh, B. (1993) · PubMed · Cited by 23 · see citing works
Nutrition and the Geriatric Rehabilitation Patient
Asai, J. L. (2004) · Topics in Geriatric Rehabilitation · doi:10.1097/00013614-200401000-00006 · Cited by 17 · see citing works
Potential benefits of improved protein intake in older people
Dawson, B., TAYLOR, J., & Favaloro, E. J. (2008) · Nutrition & Dietetics · doi:10.1111/j.1747-0080.2008.00250.x · Cited by 16 · see citing works
Self-citationPosthauer, M. E. (2005) · Advances in Skin & Wound Care · doi:10.1097/00129334-200507000-00009 · Cited by 2 · see citing works
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1 of the 18 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Kim, Y., Kim, E., & Kim, Y. (2019) · Journal of Functional Foods · doi:10.1016/j.jff.2019.04.060 · Cited by 35 · see citing works
Inhibition of Pseudomonas aeruginosa biofilm formation on wound dressings
Brandenburg, K. S., Calderon, D. F., Kierski, P. R., Brown, A. L., Shah, N. M., Abbott, N. L., Schurr, M. J., Murphy, C. J., McAnulty, J. F., & Czuprynski, C. J. (2015) · Wound Repair and Regeneration · doi:10.1111/wrr.12365 · Cited by 33 · see citing works
Barouti, N., Mainetti, C., Fontao, L., & Sorg, O. (2015) · Dermatology · doi:10.1159/000371876 · Cited by 29 · see citing works
Bossak-Ahmad, K., Wiśniewska, M. D., Bal, W., Drew, S. C., & Frączyk, T. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21176190 · Cited by 25 · see citing works
An overview of integrative care options for patients with chronic wounds.
Rosenbaum, C. C. (2012) · PubMed · Cited by 18 · see citing works
PRACTICAL USE OF GOAT MILK AND COLOSTRUM
Voloshyna, I. M. (2021) · Biotechnologia Acta · doi:10.15407/biotech14.05.038 · Cited by 15 · see citing works
Zhao, X., Meng, L., Wang, D., Shi, J. C., Wu, W., Fan, G., Shi, H., Dong, J., Yu, P., & Yang, R. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-04937-y · Cited by 8 · see citing works
Tryptophan as a Safe Compound in Topical Ophthalmic Medications: In Vitro and In Vivo Studies
Matysik-Woźniak, A., Turski, W. A., Turska, M., Paduch, R., Łańcut, M., Piwowarczyk, P., Czuczwar, M., & Ręjdak, R. (2021) · Ocular Immunology and Inflammation · doi:10.1080/09273948.2020.1856883 · Cited by 2 · see citing works
Świątkiewicz, M., Lejczak, A., Foltyński, P., & Grieb, P. (2025) · Amino Acids · doi:10.1007/s00726-025-03489-8 · Cited by 1 · see citing works
Supportive Treatment of Pressure Ulcers with Dietary Supplementation
Grieb, T. K. P. (2015) · Clinical Pharmacology & Biopharmaceutics · doi:10.4172/2167-065x.1000130
Zhao, X., Meng, L., Wang, D., Shi, J., Wu, W., Fan, G., Shi, H., Dong, J., Yu, P., & Yang, R. (2024) · Figshare · doi:10.6084/m9.figshare.25608791
Czuma-Pokusa, M., Zakrzewska, A., Kurpińska, A., & Walczak, M. (2026) · Electrophoresis · doi:10.1002/elps.70145
- Authors
- Dawson, B., & Favaloro, E. J.
- Venue
- Advances in Skin & Wound Care
- Published
- 2009-02
- Volume
- 22
- Issue
- 2
- Pages
- 79-82
- ISSN
- 1527-7941 (ISSN-L)
- OpenAlex
- W1997924947
- Cited by
- 12
- References
- 18
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2021: 2 · 2020: 1 · 2019: 1 · 2015: 3 · 2012: 1
- FWCI
- 1.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Advances in Skin & Wound Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Occupational Therapy › Pressure Ulcer Prevention and Management
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Rehabilitation › Wound Healing and Treatments
- Keywords
- tryptophan deficiency, histidine deficiency, wound healing, malnutrition, pressure ulcers, older adults, serum albumin, prealbumin, micronutrient deficiency, dietary biomarkers, nutrient supplementation
- MeSH terms
- Adult, Aged, Aged, 80 and over, Albumins, Female, Histidine, Humans, Male, Middle Aged, Nutritional Status, Pilot Projects, Tryptophan, Wound Healing, Wounds and Injuries, Biomarkers, Case-Control Studies, Risk Assessment, Antidepressive Agents, Second-Generation, Dietary Supplements
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