Assessment of Serum Neopterin as a Biomarker in Peripheral Artery Disease.

Agnieszka Zembron-Lacny,Anna Tylutka,Marek Wozniewski,Barbara Morawin,Andrzej Szuba,Malgorzata Stefanska,Wioletta Dziubek,Katarzyna Bulinska,Eryk Wacka

doi:10.3390/diagnostics11101911

Abstract

Neopterin (NPT), a pyrazino-pyrimidine compound mainly produced by activated macrophages, has been regarded as a proinflammatory and proatherosclerotic agent. The study was designed to evaluate NPT level and its interaction with conventional peripheral artery disease (PAD) biomarkers and vascular regenerative potential in severe PAD. The study included 59 patients (females n = 17, males n = 42) aged 67.0 ± 8.2 years classified into two groups based on ankle-brachial index (ABI) measurements (ABI ≤ 0.9 n = 43, ABI ≤ 0.5 n = 16). A total of 60 subjects aged 70.4 ± 5.5 years (females n = 42, males n = 18) with ABI > 0.9 constituted a reference group. NPT concentration reached values above 10 nmol/L in patients with PAD, which differed significantly from reference group (8.15 ± 1.33 nmol/L). High levels of CRP > 5 mg/L, TC > 200 mg/dL as well as lipoproteins LDL > 100 mg/dL and non-HDL > 130 mg/dL were found in the same group, indicating the relationship between NPT and conventional atherogenic markers. The endothelial progenitor cells (EPCs) tended toward lower values in patients with ABI ≤ 0.5 when compared to reference group, and inversely correlated with NPT. These findings indicate a crucial role of NPT in atheromatous process and its usefulness in monitoring PAD severity. However, the role of NPT in chronic PAD needs further studies including relatively high number of subjects.

Highlights

Endothelial dysfunction is an essential factor preceding the development of peripheral artery disease (PAD) including chronic lower limb ischemia
There were significant differences identified in the individuals without PAD, the results suggest that female gender increases the risk of lowdensity lipoproteins (LDL) oxidation and atherogenesis in old age
Peripheral artery disease is a manifestation of atherosclerosis with a poor prognosis

Summary

Introduction

Endothelial dysfunction is an essential factor preceding the development of peripheral artery disease (PAD) including chronic lower limb ischemia. PAD represents a major public health problem due to its high and increasing prevalence, worldwide distribution, and significant morbidity and mortality rates. The prevalence of PAD increases with age, especially in individuals over 65 years old. 10–25% of people over 55 years of age and 40% of people aged over 70 years suffer from this disease. With a growing aging population, the prevalence of PAD is likely to increase even further [1]. Female gender is a risk factor for PAD with apparently higher rates in low- and middle-income countries, whereas in high-income countries, the male gender tends to be an independent risk factor for PAD [2]

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