Plasma Concentrations Of Neopterin Research Articles

Neopterin, PMN Elastase, and Complement Components as Monitoring Parameters in Women with the Syndrome of Hemolysis, Elevated Liver Enzymes and Low Platelet Count

SummaryPreeclampsia is a pregnancy induced hypertensive disease with an incidence of about 5% in primigravida and it significantly contributes to maternal and neonatal morbidity and mortality. The primary cause remains unknown but might be immunologic. Our previous studies have shown that complement neutrophils and macrophages are activated in preeclampsia. The present study evaluated whether the extension of the macrophage, the neutrophil and the complement activation is related to the severity of preeclampsia. Patients with severe preeclampsia. complicated by the syndrome of hemolysis. elevated liver enzymes and low platelet count (HELLP) and women with preeclampsia were studied. Women with uncomplicated pregnancies were controls. To detect activation of macrophages and polymorphonuclear neutrophils (PMN), respectively. the formations of neopterin and PMN elastase were analyzed. For evaluation of complement activation. the biologically active components C5a and the terminal C5b-9 complement complex (TCC) were determined in plasma. Patients with the HELLP syndrome had significantly elevated plasma concentrations of neopterin and C5a at delivery compared to women with preeclampsia. and compared to the controls, the HELLP group had significantly raised plasma levels of neopterin. PMN elastase. C5a and TCC. Women with preeclampsia had significantly higher plasma concentrations of neopterin and TeC at delivery as compared to the controls. In preeclamptics and HELLP patients, the plasma concentrations at delivery of PMN elastase, C5a and TCC were normalized within one week. but the plasma levels of neopterin remained elevated after one week. Neopterin, PMN

Plasma Neopterin as an Adjunct to C-Reactive Protein in Assessment of Infection

C-reactive protein (CRP) concentrations are increased in plasma in people with inflammatory conditions and bacterial infections. Plasma neopterin concentrations are increased in people with bacterial septicemias, viral infections, and graft vs host disease. Plasma concentrations of CRP and neopterin were measured daily in 21 bone-marrow transplant (BMT) patients, 64 patients in intensive-care units (ICU), and 12 patients with squamous cell carcinoma of the head and neck (HN). In the BMT patients, plasma neopterin measurements in addition to CRP measurements allowed infectious episodes to be distinguished from graft vs host disease. In the ICU patients, increased concentrations of CRP were not specific for infection and the additional plasma neopterin measurements did not improve this specificity. In all three patient groups, the derivation of a neopterin/CRP ratio was of no clinical use. These three groups of patients showed patterns of CRP and neopterin concentrations characteristic of their underlying diseases, the BMT patients with the immunological activation of graft vs host disease showed predominantly increased concentrations of plasma neopterin, ICU patients with infectious and inflammatory conditions had increased concentrations of both CRP and neopterin in plasma, and the HN group with localized inflammation showed increased plasma concentrations of CRP without increases in neopterin.

Elevated serum neopterin levels in atherosclerosis

Plasma levels of neopterin were determined in patients with different clinical stages of atherosclerosis. Non-hospitalized patients with atherosclerosis had serum and plasma neopterin levels within the normal range of the assay (6 ± 2 nM). These values were not significantly different from those reported for healthy blood donors (5 ± 2 nM). In contrast, about 50% (29 out of 61) of hospitalized patients undergoing conservative or surgical therapy had neopterin plasma levels, which exceeded the normal range (> 10 nM) up to 10-fold. The two groups differ on a significance level of P < 0.01. For further evaluation hospitalized patients were subgrouped according to neopterin levels. In the subgroup with elevated neopterin levels patients with higher Frederickson types of atherosclerosis were overrepresented compared to patients with normal neopterin levels. Type 4 differed significantly from patients without pathological changes of lipoprotein ( P < 0.05). Only 3 patients suffered from minimal skin necrosis, two of them had elevated neopterin levels. Significantly more patients with peripheral artery occlusions had elevated neopterin levels than patients with occlusions of central arteries ( P < 0.05). All other criteria used for comparison (sex, age, smoking, antioxidant status, diabetes, hypertension, adipositas, hyperuricemia) did not vary significantly in both subgroups. These data indicate that neopterin plasma levels might be a valuable parameter in activity staging and therapeutic follow up of atherosclerosic patients. Additionally, an involvement of the nonspecific immune system in atherogenesis is suggested by the increased plasma neopterin concentrations.