Trp metabolism towards Kyn formation in high-grade serous ovarian cancer patients and healthy donors. (A) Trp and Kyn levels and (B) Kyn/Trp ratios as indirect measures of IDO1/TDO enzymatic activity in plasma of healthy donors (HD) (n = 30) and plasma and ascites of ovarian cancer patients (OC) (n = 24 and 32, respectively, with n = 22 overlapping patients). Horizontal lines indicate geometric means. Repeated unpaired, two-tailed Kruskal–Wallis tests yielded significant results for comparison of Trp levels, Kyn levels and Kyn/Trp ratios between the groups (p < 0.001 for all). Results of Dunn’s post hoc test are indicated in the graphs. (C) Comparison and (D) correlation of Kyn/Trp ratios in paired plasma and ascites samples of ovarian cancer patients (n = 22). Results of a paired, two-tailed Student’s t-test and Pearson’s correlation analysis, both performed with log-transformed concentrations, are indicated in the graphs. IDO1: indoleamine 2,3-dioxygenase; Kyn: l-kynurenine; NFK: N-formylkynurenine; r: Pearson’s correlation coefficient; TDO: tryptophan 2,3-dioxygenase; Trp: l-tryptophan.