Clinical Usefulness of Determining the Concentration of Neopterin

Abstract

Neopterin is one of biochemical markers of immune activity, which seems to be useful in monitoring inflammatory diseases. Increased serum concentration of neopterin is observed in conditions with cell-mediated immune response involvement. In clinical practice, neopterin evaluation is applied in medical conditions such as: infectious diseases, oncology, rheumatology, transplantology, transfusiology, cardiology, neurology and many others. Neopterin can be detected in serum, urine, cerebrospinal fluid, synovial fluid, saliva, ascitic fluid, bile, pancreatic juice and gastric juice. In recently published studies, various non-specific indicators of inflammation such as neopterin, C-reactive protein, procalcitonin were compared and proved to be independently useful.

A non-specific biomarker of disease activity in HIV/AIDS patients from resource-limited environments

“…It is said that when cell-mediated immunity dominates, circulating neopterin levels are usually high and when humoral immunity dominates, neopterin levels are low [3][4][5][6][7][8][9][10][11] . Abundant evidence exists for neopterin levels to be increased in disturbances marked by inflammatory activity and raised neopterin levels and increases with disease progression, have previously been described 12 . However, other substances, in particular CRP and IL-6, have also been described as markers of inflammation.…”

“…The statement is further supported by previously supported diagnostic and prognostic associations between plasma neopterin levels and disorders other than HIV/AIDS. These include viral, intracellular bacterial and parasitic infections, burns, cancer, cardiovascular disease, neurodegeneration, graft versus host disease, autoimmune disorders and a variety of oral afflictions 12 . However, in view of the effect of inflammation on all physiological systems, the primary importance of neopterin probably lies in its reflection of the degree of inflammation, a major contributor to the pathogenesis of HIV/AIDS and a process involved in a wide variety of pathological processes.…”

“…In the present study the value of neopterin as general marker of the inflammatory status was examined by comparing neopterin levels to that of two other recognised biomarkers of inflammation, i.e., CRP and IL-6 6, [11][12][13] . As seen in Table 2, the mean neopterin levels were significantly higher than that of the control group for both the HAART-naïve (p<0.001) and the HAART (p<0.001) groups.…”

Laboratory medicine and medical oncology: the tale of two Cinderellas

“…Neopterin may be determined in the serum or in the urine by immunoassay or by high-performance liquid chromatography [77,78] . Increased neopterin concentrations are observed across a spectrum of disorders ranging from acute myocardial infarction [79,80] , infectious or autoimmune disorders [81] to malignant tumors [82] . Increased urinary or serum neopterin concentrations in patients are also associated with poor prognosis across the range of primary tumors [82,83] .…”

PSA, PCA3 and thephilosophy of prostate cancer management

“…Neopterin, a pteridine compound that is produced from guanosine triphophate by macrophages activated with interferon-γ and that can be determined in serum or urine using immunoassay or high-performance liquid chromatography [ 39 , 40 ], has been studied in-depth in patients with advanced cancer of different primary locations [ 41 ]. While elevated neopterin concentrations are observed in disorders including acute myocardial infarction [ 42 , 43 ], infections, autoimmune disorders [ 44 ] or malignant tumors [ 41 , 45 ], and, therefore, high neopterin concentrations are non-diagnostic, neopterin represents a biomarker indicating poor prognosis across a spectrum of different primary tumors [ 41 , 45 ]. Of note, neopterin concentrations increase after administration of systemic chemotherapy [ 46 ].…”