Increased urinary neopterin: creatinine ratio as a marker of activation of cell-mediated immunity and oxidative stress in the Iranian patients with multiple sclerosis.

Abstract

Neopterin, a pyrazinopyrimidine compound, is produced by macrophages after induction by interferon gamma (IFN-g) and serves as a marker of cellular immune system activation followed by oxidative stress. The aim of this study was to determine urinary neopterin to creatinine ratio (UNCR) as a surrogate marker of cell-mediated immune activation in multiple sclerosis (MS). Three weekly early morning urine samples were collected from 27 patients with MS and 31 age- and sex-matched apparently healthy subjects. Urinary neopterin and creatinine were determined using reversed phase high-performance liquid chromatography and Jaffe reaction, respectively. UNCR was significantly higher in patients than in healthy controls indicating IFN-g-induced cellular immunity activation and oxidative stress in multiple sclerosis. As a non-invasive method, UNCR determination may be helpful in monitoring disease progression and the effects of therapies, as well.