Abstract
Abstract Introduction: Neopterin and 7,8-dihydroneopterin are used as biomarkers of oxidative stress and inflammation, but the effect of kidney function on these measurements has not been extensively explored. We examine the levels of oxidative stress, inflammation and kidney function in intensive patients and compare them to equivalent patients without sepsis. Methods: 34 Intensive care patients were selected for the study, 14 without sepsis and 20 with. Both groups had equivalent levels of trauma, assessed by SAPS II, SOFA, and APACHE II and III scores. Plasma and urinary neopterin and total neopterin (neopterin + 7,8-dihydroneopterin) values were measured. Results: Neopterin and total neopterin were significantly elevated in urine and plasma for multiple days in sepsis versus non-sepsis patients. Plasma neopterin and total neopterin have decreasing relationships with increased eGFR (p<0.008 and p<0.001, respectively). Plasma/urinary neopterin and total neopterin ratios demonstrate that total neopterin flux is more influenced by eGFR than neopterin, with significantce of p<0.02 and p<0.0002 respectively. Conclusion: Sepsis patients present with greater levels of oxidative stress and immune system activation than non-sepsis patients of equal levels of trauma, as measured by neopterin and total neopterin. eGFR may need to be taken into account when accessing the level of inflammation from urinary neopterin measurements.
Highlights
Neopterin and 7,8-dihydroneopterin are used as biomarkers of oxidative stress and inflammation, but the effect of kidney function on these measurements has not been extensively explored
Plasma/urinary neopterin and total neopterin ratios demonstrate that total neopterin flux is more influenced by Estimated glomerular filtration rate (eGFR) than neopterin, with significantce of p
The results indicate that eGFR has a moderately significant effect on neopterin flux into urine, and a highly significant effect on total neopterin, indicating that the level of 7,8-dihydroneopterin flux may be more effected by kidney function than neopterin
Summary
Neopterin and 7,8-dihydroneopterin are used as biomarkers of oxidative stress and inflammation, but the effect of kidney function on these measurements has not been extensively explored. We examine the levels of oxidative stress, inflammation and kidney function in intensive patients and compare them to equivalent patients without sepsis. Mortality rates increase up to a staggering 50% [1, 2]. A plethora of biomarkers have been investigated for assessing severity of sepsis patients. These include; neopterin (NP) [4], C- reactive protein (CRP) [5], procalcitonin [6] and interleukin-6 (IL-6) [7]. The presented study is a continuation of that work and has used the same patient cohorts while investigating different biomarkers. The CRP and IL-6 data from this study has been reanalysed in respect to correlations with neopterin and total neopterin (TNP) for greater comparison between inflammation biomarkers
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