Serum Neopterin Levels Research Articles

A study on the level of serum neopterin a new novel biomarker in acute myocardial infarction

Introduction: Acute myocardial infarction (AMI) is one of the most common diseases, and it is one of the important medical emergencies admitted in the hospitals. It is characterized by the presence of clinical features like sudden onset of severe chest pain with dysponea, palpitation and profuse sweating leading to cardiac arrythmias, cardiogenic shock, cardiac failure and death if not treated early(2). Among the biomarkers for diagnosis and prognosis in AMI, the Neopterin, a pteridine derivative is considered to be one of the new novel bio-markers which is found to be elevated in patients with AMI. Neopterin was first isolated from larvae of bee in 1963(3). Eventually Neopterin was identified as the fluorescent component that was elevated in the urine of mice with Ehrlich ascites tumor (4). Estimation of Serum levels of Neopterin is a new novel biomarker in AMI and seems to be a prognostic marker for MACE in AMI. Aim: To elucidate the role of Neopterin levels and its short term prognostic significance in AMI. Methods: Neopterin is an activation marker for monocytes / macrophages and its circulating levels in the Serum is considered to be one of the prognostic markers in the treatment of AMI.

Correlation between micronutrients and cellular immune responses after CoronaVac vaccination in elderly people

Background: Elderly individuals are often at risk for deficiencies in micronutrients like zinc (Zn) and magnesium (Mg), which are essential for cellular function and immune system homeostasis. Vaccination is a crucial strategy to prevent disease, but micronutrient deficiencies may diminish vaccine effectiveness. The immune response consists of cellular and humoral components, with neopterin serving as a marker for cellular immune activity. Objective: This study aimed to determine whether Zn or Mg deficiencies affect the decrease of cellular immunity between six and 24 weeks after vaccination. Method: This study was a prospective cohort involving eighty-eight elderly individuals (aged 60 and older) who received two doses of the CoronaVac vaccine. Blood samples were collected at six and 24 weeks post-vaccination to measure serum zinc (Zn) and magnesium (Mg) levels using inductively coupled plasma mass spectrometry (ICP-MS). The immune response was assessed by the decrease in serum neopterin levels at six and 24 weeks after vaccination, measured using an enzyme-linked immunoassay (ELISA). Result: There was a positive correlation between Mg and a decrease in neopterin between six and 24 weeks after vaccination, with p = 0.011 and r = -0.296. However, we did not find a correlation between Zn and neopterin levels. This study showed that the lower the Mg levels, the faster the cellular immune response after vaccination disappeared. Nevertheless, the role of Zn in cellular immune response after vaccination is still unclear. Conclusion: Mg deficiency, but not Zn, was correlated with a more rapid reduction of cellular immune response after vaccination.

Evaluation of serum neopterin levels in severe COVID-19 patients: An observational study.

In patients with coronavirus disease (COVID-19), a massive inflammatory response is a significant cause of morbidity and mortality. Inflammatory markers are prognostic indicators of disease severity and the ultimate clinical outcome. Several studies have demonstrated a correlation between serum levels of neopterin, which can be an immune system marker, disease severity, and poor outcomes in COVID-19 patients. Our study aimed to determine the diagnostic significance of neopterin in conjunction with routinely measured inflammatory markers in patients with severe COVID-19. Serum neopterin, C-reactive protein (CRP), albumin levels, and complete blood count were determined in 39 patients with severe COVID-19 and 30 healthy individuals. Demographic characteristics, serum neopterin levels, and other laboratory data were compared between patients and healthy volunteers and statistically analyzed. High neopterin levels were observed in patients with severe COVID-19 compared to healthy volunteers. Furthermore, albumin levels were decreased, while CRP levels were increased in patients, statistically significantly. Also, positive correlations were shown between serum neopterin levels and serum CRP levels, while negative correlations were shown between serum neopterin levels and serum albumin levels. Systemic inflammation markers, CRP/albumin ratio, neutrophil/lymphocyte ratio, and platelet/lymphocyte ratio were significantly higher, while lymphocyte/monocyte ratio was also significantly lower in patients with severe COVID-19 than in healthy volunteers. However, serum neopterin levels were not linked to the CRP/albumin ratio, the neutrophil/lymphocyte ratio, or the platelet/lymphocyte ratio. On the other hand, they were linked negatively to the lymphocyte/monocyte ratio. Our findings highlight the association between high neopterin levels and patients with severe COVID-19. Neopterin is correlated with traditional inflammatory biomarkers and may indicate general immune and inflammatory activation in patients with severe COVID-19.

Serum neopterin and orexin-A levels in different stages of diabetic retinopathy

ABSTRACT Clinical Relevance Retinopathy is one of the most common microvascular complications of diabetes mellitus and is the leading cause of vision loss in the working middle-aged population. Background This study aimed to investigate the value of neopterin and orexin-A levels in patients with diabetes mellitus with different stages of diabetic retinopathy and without diabetic retinopathy and to compare those findings with results from healthy individuals without diabetes mellitus. Methods In total, 65 patients with type 2 diabetes mellitus and 22 healthy individuals without diabetes mellitus were enrolled in this prospective study. The participants were separated into four subgroups. The first subgroup included 25 patients without diabetic retinopathy, the second subgroup included 20 patients non-proliferative diabetic retinopathy, the third subgroup included 20 patients with proliferative diabetic retinopathy, and the fourth subgroup included 22 healthy individuals without diabetes mellitus as controls. Serum neopterin and orexin-A levels were analysed and compared among the groups. Results The age and gender of the participants between the four subgroups were not statistically significantly different (p > 0.05). The mean neopterin levels were significantly higher in patients included in the diabetes mellitus subgroups compared with the controls (p < 0.001). Neopterin levels significantly increased as diabetic retinopathy progressed within the diabetes mellitus subgroups. Mean orexin-A levels were significantly lower in the diabetes mellitus subgroups compared with the controls (p < 0.001); however, orexin-A levels were not significantly different within the diabetes mellitus subgroups (p > 0.05). Conclusion Patients with diabetes mellitus have higher serum neopterin and lower serum orexin-A levels compared with healthy individuals without diabetes mellitus. Moreover, serum neopterin levels increase with progression of diabetic retinopathy.

Neopterin, 7,8-dihydroneopterin, total neopterin levels and their ratio in periodontitis: New dilemma.

Determine the saliva and serum levels of neopterin (NP) and 7,8-dihydroneopterin (7,8NP) in periodontitis patients and to reveal the relationship of these data with clinical periodontal parameters. Twenty-three patients with stage III/grade B periodontitis and 23 periodontally healthy individuals were included. Clinical periodontal measurements were recorded (plaque index, pocket depth, clinical attachment loss & bleeding on probing). Saliva and serum levels of NP and 7,8NP were analyzed by high-performance liquid chromatography. Saliva NP, 7,8NP and Total Neopterin (TNP) levels were significantly elevated in the periodontitis than the control group (p < 0.001).ROC analyses of saliva NP, 7,8NP and TNP yielded areas under the curves of 0.873-0.938 for discriminating periodontitis from health, and saliva TNP was found the most accurate biomarker (AUC = 0.938).There was no significant difference among the periodontitis and control groups for saliva TNP/NP and TNP/7,8NP ratios and serum NP, 7,8NP and TNP levels (p > 0.05). Increased saliva TNP, NP and 7,8NP levels in periodontitis may suggest these biomarkers are regulating immune activation and oxidative stress mechanism in periodontal inflammation. Additionally, together with these results, equivalence of the TNP/NP ratio in intergroups may suggest that the effects of immune activation and oxidative stress mechanisms are equal in the periodontitis.

Exploring S100A8/A9, neopterin, and MMP3 in familial Mediterranean fever.

Familial Mediterranean fever (FMF) is characterized by inflammatory attacks due to overactivation of pyrin inflammasome. This study aimed to investigate the reliability of S100A8/A9, neopterin, and matrix metalloproteinase 3 (MMP3) at monitoring subclinical inflammation and disease activity, and at differentiating FMF attacks from appendicitis, the most common misdiagnosis among FMF patients. Blood samples (n = 75), comprising from FMF patients during an attack (n = 20), the same FMF patients during the attack-free period (n = 14), patients with appendicitis (n = 24), and healthy volunteers (n = 17) were obtained. Duplicate determinations of S100A8/A9, neopterin, and MMP-3 levels were conducted using the enzyme-linked immunosorbent assay (ELISA). FMF patients with and without attack and patients with appendicitis had significantly elevated S100A8/A9 levels compared to healthy volunteers (P-values: < 0.001, 0.036, 0.002, respectively). Patients with appendicitis and FMF patients with and without attack had significantly increased serum neopterin levels compared to healthy volunteers (P-value: < 0.001). MMP3 levels were significantly higher among patients with appendicitis and FMF patients during attack compared to healthy controls (P-values: < 0.001, 0.001). Serum levels of S100A8/A9, neopterin, and MMP3 were increased significantly during attacks compared to attack-free periods among FMF patients (P-values: 0.03, 0.047, 0.007). S100A8/A9 emerges as a valuable marker for monitoring disease activity. Neopterin and S100A8/A9 might help physicians to monitor subclinical inflammation during the attack-free periods of FMF patients. MMP3 might aid in diagnosing FMF attacks when distinguishing between attack and attack-free periods is challenging.

P23 The influence of maternal inflammatory status on the risk of atopic eczema in offspring during infancy

Abstract Introduction and aims Maternal influences on infantile atopic eczema are complex, with emerging evidence for a protective role for maternal T helper (Th)1 inflammation during pregnancy. Substantial literature on characterization of a proinflammatory dietary pattern, led us to hypothesize that analyses of maternal diet and markers of inflammation might help identify mechanisms influencing the risk of infantile atopic eczema. The aim of this study was to examine the associations between energy-adjusted dietary inflammatory index (eDII) scores indicative of a proinflammatory diet pattern, maternal serum neopterin levels (a biomarker elevated in Th1 immune activation which counteracts Th2 inflammation seen in atopic eczema), and infantile risk of atopic eczema. Methods Within the UK Southampton Women’s Survey, scores for the eDII were derived from mothers’ diets (questionnaires at preconception, early and late pregnancy). Atopic eczema was ascertained at age 6 and 12 months using the UK Working Party Diagnostic Criteria (n = 262 and 270, respectively). Late pregnancy maternal serum neopterin levels were measured in a subsample (n = 497). Directed acyclic graphs were used to determine covariates to be included in linear regression analyses. Results A higher eDII score in late pregnancy was associated with a reduced risk of atopic eczema at age 6 months [odd ratios (OR) 0.89, 95% CI confidence interval (CI) 0.81–0.98; P = 0.02], with a similar trend at age 12 months (OR 0.91, 95% CI 0.83–1.00; P = 0.06). Consistent with this, and adjusting for maternal body mass index, education, smoking during pregnancy, and recent eczema, and infant filaggrin single-nucleotide polymorphism rs7512552, breastfeeding duration and sex, higher maternal serum concentrations of neopterin were associated with lower risks of infant eczema at age 6 months (OR 0.72, 95% CI 0.51–1.01; P = 0.05) and 12 months (OR 0.71, 95% CI 0.53–0.96; P = 0.03). Conclusions These findings suggest that a proinflammatory maternal diet that promotes a Th1 predominant environment protects the developing infant from Th2 inflammation and reduces the risk of atopic eczema.

Serum neopterin level in psoriatic patients treated with acitretin or narrowband ultraviolet B or both

Background A biological indicator of cellular immunity is neopterin. In certain studies, psoriasis patients had higher serum, and urine neopterin levels, which were reduced following therapy. Aims To evaluate the effect of acitretin versus narrowband ultraviolet B (NB-UVB) and combinations of them on psoriasis vulgaris and correlate it with neopterin level Patients and methods In this case-control research, a total of 120 respondents (30 healthy volunteers) served as the control group, in addition to 90 psoriasis patients randomly allocated into three equal groups: group (I): 30 patients received Acitretin for 3 months. Group (II): 30 patients were treated with NB-UVB. Group (III): 30 patients received Acitretin and NB-UVB (3 sessions/week) for 3 months. Serum neopterin levels were measured pre- and post-treatment. All patients were clinically and photographically evaluated using the Psoriasis Area and Severity Index (PASI) score. The study was registered at clinicaltrial.com. Approval numbers: NCT05401006 and date of registration: 1/6/2022. Results In this study, statistically significant higher serum neopterin levels have been found in psoriatic patients than healthy controls. We found a significant decrease in PASI scores in all groups. The relative reduction percentage in the PASI score was substantially different between groups (P&lt;0.001). The highest decrease percentage in PASI score was reported in group III compared with group II (NB-UVB) and group I (Acitretin group), (P&lt;0.001). The median s. neopterin levels after treatment varied substantially among the three groups (P&lt;0.001). Conclusion When compared with healthy controls, serum neopterin levels in psoriatic patients were substantially greater (P&lt;0.05).

Serum Neopterin, Biopterin, Tryptophan, and Kynurenine Levels in Patients with Fabry Disease

Fabry disease is characterized by the accumulation of globotriaosylceramide. Substrate accumulation in lysosomes is thought to trigger an inflammatory response and is responsible for progressive organ damage through the induction of autoimmunity. The levels of pteridine and kynurenine pathway metabolites increase when immune activation is observed and are employed to monitor several diseases and determine prognosis. To elucidate the effects of immune activation on the pathophysiology of Fabry disease and to investigate the potential utility of pteridine and kynurenine metabolites. A prospective case-control study. In this study, 33 patients with Fabry disease and 33 age-and sex-matched healthy controls were included. Blood pteridine and kynurenine metabolites were studied in both groups. Organ involvement in Fabry disease and its correlation with the pteridine and kynurenine pathways were also investigated. The patients’ neopterin and biopterin levels and the tryptophan/kynurenine ratio were statistically higher than those of the healthy control group (p < 0.05). A statistically significant association was found between neopterin levels and hypertrophic cardiomyopathy, cardiac arrhythmias, and GFR values (p = 0.044, p = 0.021, and p = 0.030, respectively), tryptophan and corneal verticillate, hearing loss and tinnitus (p = 0.010, p = 0.009 and p = 0.046, respectively), and kynurenine levels and valvular heart disease (p = 0.020). From the onset of the disease, patients with Fabry disease exhibited elevated levels of inflammation and immune activation. Furthermore, inflammation and immune activation markers can be used as early disease biomarkers.

Pteridine and tryptophan pathways in children with type 1 diabetes: Isoxanthopterin as an indicator of endothelial dysfunction

AimType 1 diabetes (T1D) and its complications are known to be associated with oxidative stress. Pteridine derivatives and indoleamine 2,3-dioxygenase (IDO) activity can be used as biomarkers in the evaluation of oxidative stress. In this study, our aim is to compare the concentrations of serum and urinary pteridine derivatives, as well as serum IDO activity, in children and adolescents diagnosed with T1D and those in a healthy control group. MethodA cross-sectional study was performed and included 93 patients with T1D and 71 healthy children. Serum and urine biopterin, neopterin, monapterin, pterin, isoxanthopterin, and pterin-6-carboxylic acid (6PTC) and serum tryptophan and kynurenine levels were analyzed and compared with healthy controls. High-performance liquid chromatography was used for the analysis of pteridine derivatives, tryptophan, and kynurenine. Xanthine oxidase (XO) activity, a marker of oxidative stress, was defined by measurement of serum and urine isoxanthopterin. As an indicator of indolamine 2,3-dioxygenase (IDO) activity, the ratio of serum kynurenine/tryptophan was used. ResultsSerum isoxanthopterin and tryptophan concentrations were increased, and serum 6PTC concentration was decreased in children with T1D (p=0.01, p=0.021, p<0.001, respectively). In children with T1D, IDO activity was not different from healthy controls (p>0.05). Serum neopterin level and duration of diabetes were weakly correlated (p=0.045, r=0.209); urine neopterin/creatinine and isoxanthopterin/creatinine levels were weakly correlated with HbA1c levels (p=0.005, r=0.305; p=0.021, r=0.249, respectively). Urine pterin/creatinine level negatively correlated with body mass index-SDS. (p=0.015, r=-0.208). ConclusionWe found for the first time that isoxanthopterin levels increased and 6PTC levels decreased in children and adolescents with T1D. Elevated isoxanthopterin levels suggest that the XO activity is increased in TID. Increased XO activity may be an indicator of vascular complications reflecting T1D-related endothelial dysfunction.

Increased percentage of HLA-DR T cells in untreated juvenile dermatomyositis

This study investigates HLA-DR expression on activated T cells and serum neopterin levels in Juvenile Dermatomyositis (JDM) children pre- and post-treatment. Sixty-nine JDM children (less than 18 years) were included. Elevated HLA-DR+ T cells (>7 %) were observed in 19 % of untreated cases. Post-treatment, mean HLA-DR+ T cells decreased from 5.1 to 2.9 (P < 0.001), and serum neopterin levels declined from 19.3 to 9.1 nmol/L (P < 0.0001). A positive correlation between serum neopterin and HLA-DR T cell percentage was observed (r = 0.39, P = 0.01). Intravenous steroid treatment exhibited a 47.4 % improvement in HLA-DR+ T cells and a 50.5 % reduction in serum neopterin levels, in contrast to 14.8 % and 34.1 % in the oral steroid group. In conclusion, treatment, particularly with IV steroids, significantly improved HLA-DR+ T cells percentage and neopterin levels. A correlation between HLA-DR+ T cells percentage and serum neopterin was noted in untreated JDM patients.

Serum neopterin, YKL-40, IL-6, and TNF-α in patients with obstructive sleep apnea

Objective: Obstructive Sleep Apnea (OSA) is characterized by recurrent episodes of complete or partial upper airway obstruction during sleep. The role of locally increased inflammation in the upper respiratory tract is known in the pathogenesis of OSA. This study aimed to examine the role of some inflammatory markers in OSA. Materials and Methods: Adult patients who underwent diagnostic polysomnography (PSG) for the first time, were evaluated in this prospective study. Serum levels of neopterin, human cartilage glycoprotein 39 (YKL-40), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were examined in the study group. Results: The study included 165 adult patients. Individuals of 56 who were did not have OSA were taken as the control group. Patients diagnosed with OSA (n=109) were included in the study and divided into two groups mild-moderate and severe based on the OSA apnea-hypopnea index (AHI). The study groups were divided into 3 cathegories: AHI &lt;5 (control) Group 1, AHI 5-15 (mild), and AHI 15-30 (moderate) Group 2, AHI&gt;30 (severe) Group 3. Individuals of 165 who completed the study [Group 1 (n=56), Group 2 (n=69), Group 3 (n=40)] were included in the statistical evaluation. There was a significant difference between the groups in terms of neopterin, YKL-40, and IL-6 values (p&lt;0.05). The median value of IL-6 and neopterin measured in the severe group was significantly higher than the value measured in the control and mild-moderate groups (p&lt;0.001). The mean value of YKL-40 measured in the severe group was significantly higher than the value measured in the control group (p=0.012). No significant difference was observed in TNF-α serum levels of groups. Conclusion: Serum levels of neopterin, YKL-40, and IL-6 were found to be elevated in OSA patients (especially in the severe group).

Evaluation of Neopterin as a Neuroinflammatory Marker for Peripheral Neuropathy in Type 2 Diabetic Patients

Background: Elevation of the marker neopterin is associated with the progression and consequences of diabetes. Although the clinical relationship between the high levels and peripheral neuropathies other than diabetic peripheral neuropathy is unknown, it has been linked to them. Objective: To evaluate the difference in serum neopterin levels between diabetic individuals who have peripheral neuropathy and those who do not. Methods: This seven-month cross-sectional study at the Diabetic Center began in December 2022 and included 126 patients with the second type of diabetes mellitus. Following verbal consent, the included patients were subjected to neurological and physical evaluations. Along with the blood pressure, the weight and height were noted. Glucose, TG, CH, HDL-c, fasting insulin, and neopterin were all analyzed using serum. Formulas were used to compute BMI, LDL-c, and VLDC. Results: When diabetic individuals with peripheral neuropathy were compared to those without, the serum levels of neopterin in the former group revealed a marginally higher level than in the latter, but this difference was not statistically significant. Conclusion: Neopterin levels were not altered in diabetic individuals with peripheral neuropathy, indicating that it is not a reliable indicator of the condition.

Investigation of serum neopterin levels and adenosine deaminase enzymatic activity in measles infection

The aim of this study was to investigate the serum neopterin level and ADA activity in acute measles infection and determine whether there is a correlation between the measles optical density values, and the neopterin and ADA levels. The neopterin level and ADA activities were investigated in the samples of 136 measles IgM-positive patients along with those of 40 measles IgM-negative patients as the control group. The most important findings of the study was the determination of significantly higher neopterin levels and ADA activity in the measles IgM-positive group when compared to the measles IgM-negative group. These findings have shown that the neopterin level and ADA activity can assist in the diagnosis of measles in the acute period as biomarkers.

Inflammatory markers and neopterin levels in relation to mild COVID-19.

The immunopathology of acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection involves an excessive inflammatory response. Approximately 80% of patients with coronavirus disease 2019 (COVID-19) have a mild illness, 20% require hospitalization, and approximately 5% require intensive care. Neopterin is a macrophage activation marker produced by monocytes and macrophages following activation by interferon-gamma (IFN-γ). It is crucial to determine neopterin levels and evaluate them together with inflammatory, coagulation, and biochemical markers in moderate/mild SARS-CoV-2 infection. The present study compared plasma neopterin and inflammatory as well as biochemical markers of 50 patients with COVID-19 and 38 healthy volunteers without COVID-19. The data of 38 participants did not show statistically significant differences in serum neopterin levels between the mild/moderate COVID-19 and control groups (p=0.259). White blood cell (WBC), neutrophil, lymphocyte, platelet (PLT), hemoglobin (HGB), procalcitonin (PCT), ferritin, prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR) and lymphocyte CRP ratio (LCR) values were significantly different between the study groups (p<0.001, p=0.001, p=0.001, p<0.001, p=0.014, p<0.001, p=0.001, p<0.001, p=0.004, p<0.001, p<0.001, respectively). According to the ROC analysis, the WBC, PT, Na, and LCR values exceeding the cutoff values may be predictive of COVID-19. Although there were no significant differences in serum neopterin levels between the groups, there were high values in patients with severe SARS-CoV-2 infection in previous studies and these values were maintained for a long time. The present study found that neopterin levels were not elevated in mild/moderate COVID-19 patients.

CANLI DONÖR KARACİĞER NAKLİNİN ÖNGÖRÜSEL BİYOBELİRTEÇLERİ

Objective: Liver transplantation using a living donor (LDLT) is currently the most popular method used in the worldwide. Appropriate biomarkers that predict graft status should be used to detect early post-transplant complications that may lead to a rejection reaction. Material and Method: The study involved a total of 44 liver recipients and 44 liver donors, from whom preoperative blood samples were taken and immunoassay and spectrophotometric studies were carried out. The levels of serum neopterin, interferon-gamma (IFN- y), indoleamine-2,3 dioxygenase (IDO), and -glutathione S transferase (a-GST) were assessed using an enzyme-linked immunosorbent test. The activity of glutathione reductase (GR) and glucose-6-phosphate dehydrogenase (G6PD) in erythrocytes was measured using spectrophotometry. Result and Discussion: “Neopterin, IDO, and G6PD levels were significantly higher in the recipient group than in the donor group. The differences in gender and blood groups were statistically insignificant. The rejection reaction developed in 25% of patients and none survived. These findings may facilitate the identification of novel predictive biomarkers for the diagnosis of acute rejection reactions after LDLT. The clinical use of novel non-invasive biomarkers may provide time and cost advantages.

Association of angiotensin-converting enzyme (ACE) I/D variation with biochemical parameters and oxidative stress markers in systemic lupus erythematosus patients in west of Iran.

We aimed to study insertion/deletion (I/D) variation (rs4646994) of ACE gene in a group of SLE patients in west of Iran and its possible relationship with oxidative stress. Genotypes and allele frequencies related to ACE (I/D) variation were determined in 108 SLE patients and 110 gender and age-matched healthy controls using PCR. Neopterin, malondialdehyde (MDA), and serum lipid concentrations were determined by HPLC and enzyme assay respectively. The overall distribution of ACE I/D genotypes in SLE patients was different from that of the control group (P = 0.005). DD genotype compared to ID genotype increased the risk of SLE (OR = 2.57, 95% CI 1.4-4.8, P = 0.003). ID genotype compared to the II genotype decreased the risk of disease (OR = 0.45, 95% CI 0.2-0.99, p = 0.042). SLE patients with DD, ID, and II genotypes had lower paraoxonase (PON) activity and higher serum levels of MDA and neopterin versus control patients. We also detected a significant protective effect against SLE in presence of ACE I alleles and lack of angiotensin II receptor, type 1 (AGTR1) A1166C (NCBI reference SNP id: rs5186), C alleles in this study (OR = 0.31, 95% CI 0.14-0.68, P = 0.002). Carriers of the DD genotype of ACE gene with higher serum concentrations of neopterin and MDA, and lower PON activity had a high risk to develop SLE, while ID genotype decreased the risk of disease development by 2.22 times compared to II genotype.

Neopterin and the anti-Mullerian hormone's role in Unexplained Recurrent Pregnancy Loss

Background: Recurrent pregnancy loss were prevalent complications in pregnancy. Immunological biomarkers as Neopterin used as a marker in recurrent pregnancy loss. Anti-Mullerian hormone is a reliable marker of the ovarian reserve. Therefore, was also considered as a marker to evaluate its role in the recurrent pregnancy losses. This study was conducted to assess whether neopterin and Anti- Mullerian hormone can be used as a marker in the condition of unexplained recurrent pregnancy loss. Material’s and Methods: A case control study was done in the Department of Obstetrics and Gynecology Salahdeen general hospital in Tikrit city from first January to thirty of August 2020. One hundred patient enrolled in the study. Study contains two groups:1- Group A as cases. 2- Group B as control group. The data collection done through:1-Designed closed and open-ended questionnaire, 2- Laboratory investigations of : Serum Neopterin and Anti-Mullerian hormone levels using enzyme-linked immunosorbent assay. Results: Mean Neopterin level was significantly higher among cases (24.3±10.7)nml/l than control group (2.9±1.1) nml/l. Mean Neopterin level increased with increasing abortion number. It was significantly higher among those with ≥5 abortions (30.02±10.04) nml/l than those with (3-4) and 2 abortions (28.7±15.29) nml/l and (20.1±0.03) nml/l. The mean Neopterin level increased with increasing age among cases and controls. Among cases was (28.7±12.03) nmol/L among those aged (31- 35) year, which was higher than those aged (18-25), and those aged (26-35) years Mean Anti-Mullerian hormone level was significantly lower among cases (0.8±0.6) ng/ml than control group (5.01±2.7) ng/ml. Mean Anti-Mullerian hormone level was significantly higher among those with 2 abortions (1.06±0.7) ng/ml than those with (3-4) and 5 abortions (0.6±0.56) ng/ml and (0.97±0.4) ng/ml respectively. Among case the mean AMH level was lower among those aged (31-35) years (0.5±0.31) ng/ml than those aged (26-30), and (18-25) years (0.8±0.7) ng/ml, (0.97±0.7) ng/ml, respectively Conclusions: A statistically significant high Mean Neopterin level among cases and its increased mean Neopterin level with increasing abortion number. A statistically significant low levels of mean Anti-Mullerian hormone level among cases, more reduction in its level with increasing abortion. This pioneer study in Iraq, determined the significant association between the unexplained recurrent pregnancy loss with the increased levels of Neopterin and its effect on Anti-Mullerian hormone that lead to recurrent pregnancy loss.

Effect of NB-UVB therapy on IL-6 and neopterin levels in patients with psoriasis

Abstract Background Psoriasis is a chronic and non-transient disease with increased epidermal proliferation in the skin. Dysregulation of the immune system is an important factor in this pathology. Inflammation markers, pro-inflammatory cytokines, and immune cells are reported to be changed in psoriasis. Study design In the current cohort study, the possible changes in interleukin-6 (IL-6), neopterin levels, and kynurenine (Kyn) pathway in 42 psoriasis patients compared to 30 controls, and their change with narrow-band (NB) UVB treatment were investigated. Methodology IL-6 and serum neopterin levels were analyzed with ELISA kits. HPLC analyses were performed to detect urinary neopterin, serum Kyn, and tryptophan (Trp) levels. Results IL-6 levels were lower, while Kyn levels and the Kyn-to-Trp ratio were higher in psoriasis patients compared to control subjects (p &lt; 0.01, all). Conclusion Narrow-band ultraviolet B (NB-UVB) treatment decreased Psoriasis Area and Severity Index (PASI) scores and increased urinary neopterin levels of the patients (both, p &lt; 0.01). Serum neopterin was correlated with Kyn and Kyn/Trp levels before and after NB-UVB treatment (p &lt; 0.05, all). These findings point out that the measured parameters might be considered to support the PASI score in both diagnosis and prognosis of psoriasis rather than evaluating the severity of the disease.

Assessment of Serum Neopterin Levels in patients hospitalized with severe COVID-19

Background: COVID-19 has caused a considerable number of hospital admissions in China since December 2019. Many COVID-19 patients experience signs of acute respiratory distress syndrome, and some are even in danger of dying. Objective: to measure the serum levels of D-dimer, Neutrophil-Lymphocyte count ratio (NLR), and neopterin in patients hospitalized with severe COVID-19 in Baghdad, Iraq. And to determine the cut-off values (critical values) of these markers for the distinction between the severe patients diagnosed with COVID‐19 and the controls. Materials and methods: In this case-control study, we collect blood from 89 subjects, 45 were severe patients hospitalized in many Baghdad medical centers who were diagnosed with COVID-19 infection, and 44 were apparently healthy subjects as a control. The time of collection is from September 15 th to December 31 th, 2021. The optimal cut-off points (critical values) and prognostic relevance of D-dimer, Neutrophil-Lymphocyte count ratio (NLR), and neopterin were investigated using (ROC) curves analysis. Results: In severe patients hospitalized with COVID-19 the levels of D-dimer, NLR, and neopterin were statistically significantly higher than in control participants (P&lt; 0.005). The D-dimer, NLR, and neopterin tests have areas under the receiver operating characteristic (ROC) curves of 0.920, 0.90, and 0.74 respectively, and their critical values for the differentiation between the severe patients and control were 0.22 μg/ml, 2.56, and 3.02 nmol/L. Conclusions: D-dimer, NLR, and neopterin levels in sever COVID-19 patients were higher than control, with values of greater than 0.22μg/ml, 2.56 and 3.02nmol/L respectively was linked to a severe COVID-19infection with good sensitivity and selectivity.