Serum Neopterin Levels In Patients Research Articles

High serum levels of neopterin in patients with Crimean–Congo hemorrhagic fever and its relation with mortality

ObjectiveNeopterin is generated and released in increased amounts by macrophages upon activation by interferon-gamma during cellular immune response. In this study, we aimed to investigate serum neopterin levels in patients with Crimean–Congo hemorrhagic fever (CCHF) and its clinical significance as a predictor factor of mortality.MethodsNeopterin concentrations on the first day of hospitalization were measured in serum samples from 51 CCHF patients. Serum neopterin levels and other clinical–laboratory parameters for fatal and nonfatal CCHF patients were compared.ResultsSerum neopterin levels (73.22 ± 54.30 nmol/L) were highly elevated in all CCHF patients (p < 0.0001) with higher levels in fatal group (153.66 ± 81.34 nmol/L, p = 0.0001) compared to nonfatal disease (55.99 ± 24.09 nmol/L). In univariate analysis, the level of neopterin on the first day of hospitalization, bleeding, platelet count, aspartate transferase and lactate dehydrogenase were associated with mortality. In multivariate analysis, only the serum level of neopterin was associated with mortality. As a mortality risk factor, area under the curve was 0.939 (p = 0.0001, 95% confidence interval: 0.85–1.00).ConclusionsIn this first study of serum neopterin levels for CCHF, elevated serum neopterin level showing strong activation of monocytes/macrophages was a risk factor for CCHF.

Serum neopterin levels in patients with breast cancer

The aim of this study was to determine the importance of serum neopterin level in female patients with breast cancer of various clinical stages. The study consisted of 75 female patients with breast cancer who were diagnosed and treated at the Gazi University Department of Medical Oncology. The patients were classified into three representative groups and a control group: group A (n = 26), patients with newly diagnosed primary breast cancer and without metastasis; group B (n = 33), patients with metastatic breast cancer who had undergone treatment for their diseases and on whom metastasis was detected during their follow-up; group C (n = 16), off-therapy patient whose cancer had been in remission for at least 5 years; group D (n = 20) healthy controls. The median serum neopterin levels of the 75 patients with breast cancer 11.0 (range, 0-23.6) nmol/L were significantly higher than those of controls (8.3 (range, 1.2-12.0) nmol/L). In group B patients, neopterin levels (12.6 (range, 0-23.6) nmol/L) were statistically significantly higher than those of controls, primary breast cancer patients, and off-therapy patients (P < .05). In group B, patients with visceral metastases had higher neopterin levels than did those with bone or local metastases; however, that difference was not statistically significant. The median serum neopterin levels of the primary breast cancer patients in group A (8.8 (range, 0-20) nmol/l) were not statistically significantly different from those in controls and off-therapy patients. Serum neopterin levels were significantly elevated in patients with metastatic breast cancer. Neopterin seems to be an indicator of metastatic cancer rather than a marker for local cancer. In patients with metastatic breast cancer, determining the serum neopterin levels may be useful in estimating survival; however, additional long-term follow-up will be needed.

Serum neopterin levels in patients with replicative and nonreplicative HBV carriers

BackgroundInfection by hepatitis B virus (HBV) causes complicated biochemical, immunological and histological changes in host immune response against the virus which can be specific or non-specific. Recent attention has focused on neopterin as a marker for the activation of cell mediated immunity. The aim of this study was to define the pattern of neopterin levels in replicative and nonreplicative HBV carriers.MethodsThirty HBV replicative carriers and 25 nonreplicative HBV carriers and 30 healthy adult patients were included this study. Hepatitis markers were determined by commercial kit based on chemilumminesans assay. HBV DNA was quantified by hybrid capture system. Serum neopterin levels were measured by the method of competitive enzyme-linked immunosorbent assay. Results were expressed as mean ± SD and ranges.ResultsIn the nonreplicative group, except for one patient, all the patients' HBeAg were negative and anti-HBe were positive. That particular patient was HBeAg positive and anti-HBe negative. In the replicative group, 23 out of 30 patients have positive HBeAg and negative anti-HBe; 7 out of 30 patients have negative HBeAg and positive anti-HBe. Serum neopterin concentrations were 14.5 ± 10.0 (4.2–41) nmol/L in replicative HBV carriers, 8.9 ± 4.3 (2.1–22) nmol/L in nonreplicative HBV carriers and 7.1 ± 2.2 (4.0–12) nmol/L in the control group. Serum neopterin levels and the rates of abnormal serum neopterin levels in the replicative group were higher than the control group (P < 0.01 and P < 0.05). In the nonreplicative group, serum neopterin levels were not different from those of the control. There was a difference between replicative and nonreplicative groups in the respect of neopterin levels.ConclusionIn the hepatitis B infected carriers, elevated neopterin levels may be an indicator of the presence of replication.

Serum neopterin levels in patients with brucellosis

Objectives The aim of this study was to evaluate the importance of neopterin levels in brucellosis and its alterations with treatment. Methods Thirty patients who had positive clinical findings, Brucella standard tube agglutination tests and/or positive blood culture were included in the study. The control group was composed of 30 healthy subjects. Neopterin (NPT) levels were measured by ELISA according to the protocol of manufacturer. Results Mean NPT levels were 54.15±33.7 nmol/l in study groups and 8.75±2.48 nmol/l in controls ( P<0.001). It was determined that NPT levels measured at the time of admission of the patients had a linear correlation between the duration of complaint ( r=0.560, P=0.001). While the mean NPT levels in patients with complaints of over 30 days were 79.07±34.9 nmol/l and it was 39.71±23.4 nmol/l in the patients with complaints of less than or equal to 30 days ( P=0.002). NPT values measured after treatment (20.48±25.6) was determined lower by statistical means than the values measured before treatment (54.15±33.7, P=0.0001). The NPT levels of patients with positive blood culture (75.56±33.6) were higher than those of with negative blood cultures (32.72±15.2, P=0.001). Conclusion It was concluded that the NPT levels were higher in patients with brucellosis. In addition, it was found that the levels of NPT were higher in non-responding patients than responded to the brucellosis treatment. It was thought that monitoring NPT levels could be useful for the extent and activity of the disease.

Evaluation of serum neopterin levels in patients with chronic coronary artery disease and hyperlipidaemia before and after lipid lowering treatment

Evaluation of serum neopterin levels in patients with chronic coronary artery disease and hyperlipidaemia before and after lipid lowering treatment

BAL Neopterin: A Novel Marker for Cell-Mediated Immunity in Patients With Pulmonary Tuberculosis and Lung Cancer

Neopterin is derived from guanosine triphosphate and is produced by stimulated macrophages under the influence of gamma-interferon of lymphocyte origin. It has been suggested that it is an excellent marker for the activation of the monocyte/macrophage axis in some clinical situations. However, to our knowledge, the relationship of BAL neopterin levels to disease states has not been studied. To assess the usefulness of BAL neopterin levels as an index of disease activity in patients with pulmonary tuberculosis and lung cancer. BAL and serum neopterin levels were evaluated in 20 patients with pulmonary tuberculosis, 20 patients with bronchogenic carcinoma, and 10 healthy individuals. The concentration of neopterin was evaluated by radioimmunoassay technique. The BAL level of neopterin was standardized using the BAL urea level. The neopterin levels (mean +/- SD) in the BAL and serum of tuberculous patients (88.6 +/- 27.4 nmol/L epithelial lining fluid [ELF], 61.3 +/- 29.4 nmol/L, respectively) were significantly higher when compared with those in lung cancer patients (40.7 +/- 16.6 nmol/L ELF, 26.8 +/- 6.58 nmol/L, respectively, p < 0.001) and when compared with those in control subjects (26.3 +/- 11.3 nmol/L ELF, 6.8 +/- 2.7 nmol/L, respectively, p < 0.001). In the tuberculous group, BAL and serum neopterin levels in patients with far-advanced disease were significantly higher when compared with those in patients with moderately and minimally advanced diseases (p < 0.001). BAL and serum neopterin levels were significantly higher in patients with small cell carcinoma than in those with adenocarcinoma (p < 0.05). BAL neopterin levels were significantly (p < 0.001) higher than serum levels in all patients and control groups. In addition, there were significant positive correlations between BAL and serum neopterin levels in tuberculous (r = 0.92, p < 0.001), lung cancer (r = 0.62, p < 0.001), and control groups (r = 0.93, p < 0.001). The levels of neopterin in BAL fluid may reflect the degree of disease activity in pulmonary tuberculous patients. In addition, BAL neopterin levels are elevated in patients with lung cancer, especially the small-cell carcinoma type.

血清ｎｅｏｐｔｅｒｉｎ値と消化器担癌患者のｐｅｒｆｏｒｍａｎｃｅ ｓｔａｔｕｓとの関係についての検討

血清ｎｅｏｐｔｅｒｉｎ値と消化器担癌患者のｐｅｒｆｏｒｍａｎｃｅ ｓｔａｔｕｓとの関係についての検討

Elevated neopterin levels in Guillain-Barré syndrome. Further evidence of immune activation.

Neopterin is a by-product of guanosine triphosphate metabolism and is produced by macrophages in response to lymphocytic activation. We have studied serum neopterin levels in patients with Guillain-Barré syndrome to obtain further evidence of immune activation in this disease. Serum neopterin levels were significantly elevated in patients with Guillain-Barré syndrome compared with patients with other peripheral neuropathies and multiple sclerosis and with healthy control subjects. Serial analysis demonstrated that as neopterin levels fell, the clinical status of the patients with Guillain-Barré syndrome improved and soluble interleukin 2 receptor levels dropped. Thus, lymphocytic and macrophage activation may play a role in the pathogenesis of Guillain-Barré syndrome.

Markedly Elevated Serum Neopterin Levels in Patients with Hemophagocytic Histiocytosis

Markedly Elevated Serum Neopterin Levels in Patients with Hemophagocytic Histiocytosis

Cerebrospinal fluid and serum neopterin levels in patients with Lyme neuroborreliosis

Elevated (greater than 3.0 nmol/l) cerebrospinal fluid neopterin concentrations were observed in 20 of 21 patients with Lyme neuroborreliosis compared with three of 11 control patients with headache, back pain or psychoneurotic disorders. Neopterin concentrations were correlated to mononuclear cell counts and protein concentrations in the cerebrospinal fluid (CSF). Following antibiotic treatment, CSF neopterin levels decreased. Serum neopterin levels were not significantly raised in patients with neuroborreliosis when compared to control subjects. Neopterin levels as well as cell count and protein concentration in the CSF are valuable inflammation markers of disease activity in Lyme neuroborreliosis.