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The endogenous lens hromofore, tryptophan metabolites (kynurenine, 3-hydroxykynurenine, 3-hydroxykynurenine glucoside), which are relatively inert photochemically, during oxidative stress and/or aging are formed photochemically active tryptophan metabolite (N-formyl-kynurenine, xanthurenic acid) that have photochemical properties, and also act as an endogenous photosensitizers in the lens 53

doi: 10.1136/annrheumdis-2021-221295 100 SchrezenmeierEDornerT

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In addition, replenishment of B-complex vitamins, such as B-12, B-6 and folic acid, is suggested to prevent homocysteine accumulation and to enhance the availability of methyl groups (225, 228, 256) Figure 2 For the treatment of SIBO outbreaks, as a consequence of immunosuppression and mucosal inflammation, the use of antibiotic agents is considered relevant (258)