Assessment of Serum Neopterin as a Biomarker in Peripheral Artery Disease

Abstract

Neopterin (NPT), a pyrazino-pyrimidine compound mainly produced by activated macrophages, has been regarded as a proinflammatory and proatherosclerotic agent. The study was designed to evaluate NPT level and its interaction with conventional peripheral artery disease (PAD) biomarkers and vascular regenerative potential in severe PAD. The study included 59 patients (females n = 17, males n = 42) aged 67.0 ± 8.2 years classified into two groups based on ankle-brachial index (ABI) measurements (ABI ≤ 0.9 n = 43, ABI ≤ 0.5 n = 16). A total of 60 subjects aged 70.4 ± 5.5 years (females n = 42, males n = 18) with ABI > 0.9 constituted a reference group. NPT concentration reached values above 10 nmol/L in patients with PAD, which differed significantly from reference group (8.15 ± 1.33 nmol/L). High levels of CRP > 5 mg/L, TC > 200 mg/dL as well as lipoproteins LDL > 100 mg/dL and non-HDL > 130 mg/dL were found in the same group, indicating the relationship between NPT and conventional atherogenic markers. The endothelial progenitor cells (EPCs) tended toward lower values in patients with ABI ≤ 0.5 when compared to reference group, and inversely correlated with NPT. These findings indicate a crucial role of NPT in atheromatous process and its usefulness in monitoring PAD severity. However, the role of NPT in chronic PAD needs further studies including relatively high number of subjects.

Immunosenescence in Aging-Related Vascular Dysfunction

“…In our study, oxLDL increased in patients with CRP ≥ 3 mg/L and was highly correlated with endothelium-specific variables, even though the total cholesterol, LDL, and HDL levels did not differ between groups. This confirms previous observations that the detection and quantification of oxLDL could be used as an early indicator for the pathological processes in vascular endothelium [ 27 , 49 ]. In the early stages of atherogenesis, oxLDL promotes endothelial injury, induces expression of adhesion molecules, and attracts macrophages [ 19 ].…”

“…The study group was stratified according to CRP (LGI < 3 mg/L or HGI ≥ 3 mg/L), which is one of the most widely studied inflammatory molecules for CVD evaluation [ 26 , 27 ]. Several processes are induced by CRP and include the release of chemoattractants, which, in turn, attract monocytes toward the endothelial barrier.…”

Neopterin, the Cell-Mediated Immune Response Biomarker, in Inflammatory Periodontal Diseases: A Narrative Review of a More than Fifty Years Old Biomarker

“…Neopterin levels were found to be affected by a wide variety of diseases and conditions. In coronary artery diseases and peripheral artery diseases, Np is considered an etiologic and prognostic factor due to the bioavailability of the regulation of nitric oxide (NO) [76,77]. Increased circulating neopterin levels confirm the impact of activated macrophages on vascular rebuild, which, in turn, is able to promote nitro-oxidative stress [78].…”

Insights into Molecular Structure of Pterins Suitable for Biomedical Applications

“…High Nep levels are indicative of atherosclerosis and other cardiovascular diseases. Nep has a crucial role in the atheromatous process and its useful in monitoring the severity of peripheral artery disease [ 90 ]. Nep is expressed at high levels in atheromatous plaques within the human carotid, coronary arteries, and aorta.…”