D-amino acid aberrations in cerebrospinal fluid and plasma of smokers

Research output: Contribution to journalArticle


The glutamatergic neurotransmission system and the N-methyl-D-aspartate receptor (NMDAR) have been implicated in smoking and alcohol consumption behavior. Preclinical studies have demonstrated that nicotine and ethanol influence NMDAR functionality, which may have a role in tendencies to consume these substances. Nonetheless, little is known about concentrations of NMDAR coagonists in the cerebrospinal fluid (CSF) and plasma of individuals who smoke or consume alcohol. Glycine and L- and D-stereoisomers of alanine, serine, and proline were therefore measured using ultra-high-performance liquid chromatography-tandem mass spectrometry in 403 healthy subjects. Nicotine and alcohol consumption were quantified using questionnaires. Possible differences in NMDAR coagonist concentrations in plasma and CSF were investigated using ANCOVA with age, body mass index, and storage duration as covariates. The significance threshold was Bonferroni corrected (α=0.00625). Compared with non-smokers, smokers displayed lower levels of D-proline in plasma (p=0.0027, Cohen's d=-0.41) and D-proline in CSF (p=0.0026, Cohen's d=-0.43). D-Serine in CSF was higher in smokers than in non-smokers (p=0.0052, Cohen's d=0.41). After subdividing participants based on smoking quantity, dose-dependent decreases were demonstrated in smokers for D-proline in plasma (F=5.65, p=0.0039) and D-proline in CSF (F=5.20, p=0.0060). No differences in NMDAR coagonist levels between alcohol consumption groups were detected. To our knowledge, this is the first report to implicate D-amino acids in smoking behavior of humans. Whether such concentration differences lie at the root of or result from smoking habits may be addressed in prospective studies.


  • Jurjen J. Luykx
  • Steven C. Bakker
  • Loes Van Boxmeer
  • Christiaan H. Vinkers
  • Hanne E. Smeenk
  • Wouter F. Visser
  • Nanda M. Verhoeven-Duif
  • Eric Strengman
  • Jacobine E. Buizer-Voskamp
  • Lizzy De Groene
  • Eric Pa Van Dongen
  • Paul Borgdorff
  • Peter Bruins
  • Tom J. De Koning
  • René S. Kahn
  • Roel A. Ophoff
External organisations
  • University Medical Center Groningen
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Substance Abuse


  • addiction & substance abuse, biological psychiatry, cerebrospinal fluid, glutamate, neurotransmitters, NMDA, plasma, proline, serine, smoking
Original languageEnglish
Pages (from-to)2019-2026
Number of pages8
Issue number10
Publication statusPublished - 2013 Sep 1
Publication categoryResearch
Externally publishedYes