Elevated Neopterin Levels Predict Early Death in Older Hip-fracture Patients

Larsen, Martin; Bayard, Charles; Lepetitcorps, Hélène; Cohen-Bittan, Judith; Appay, Victor; Boddaert, Jacques; Sauce, Delphine

doi:10.1016/j.ebiom.2017.11.003

Cited by 13 publications

(9 citation statements)

References 31 publications

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“…Patients with HF were 87 years old [83-92] and 27% were men. As expected, patients exhibit characteristics of geriatric population: they were comorbid (the median CIRS = 9 [7][8][9][10][11][12][13], polymedicated for 63% of them,…”

Section: Patients Characteristicssupporting

confidence: 72%

“…Finally, HF prognosis has been associated with an increase of pro-inflammatory cytokines (IL-6, TNF-α) and few biomarkers have been described (c-reactive protein, procalcitonin) ( 7 , 12 ). In a previous study, we observed that pre-operative rate of neopterin (a molecule secreted by myeloid lineage under IFN-γ stimulation) was strongly associated with long-term mortality ( 13 ). The objective of this longitudinal study is to decipher immune changes occurring in the 1st days following HF and determine how phenotype, function, and regulation of innate and adaptive compartments adapt during acute stress event.…”

Section: Introductionmentioning

confidence: 99%

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Hip Fracture Leads to Transitory Immune Imprint in Older Patients

et al. 2020

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Background: Hip fracture (HF) is common in the geriatric population and is associated with a poor vital and functional prognosis which could be impacted by immunological changes. The objective here is to decipher immune changes occurring in the 1st days following HF and determine how phenotype, function, and regulation of innate and adaptive compartments adapt during acute stress event. Methods: We included HF patients, aged over 75 years. For each patient, blood samples were taken at five different timepoints: four in the perioperative period (day 0 to hospital discharge) and one at long term (6-12 months). Phenotypical and functional analysis were performed longitudinally on fresh blood or cryopreserved PBMCs. Clinical data were prospectively collected. Results: One-hundred HF patients and 60 age-matched controls were included. Innate compartment exhibits pro-inflammatory phenotypes (hyperleukocytosis, increase of CD14+ CD16+ proportion and CCR2 expression), maintaining its ability to produce pro-inflammatory cytokines. Adaptive compartment extends toward a transitory immunosuppressive profile (leucopenia) associated with an active T-cell proliferation. Furthermore, increases of LAG-3 and PD-1 and a decrease of 2-B4 expression are observed on T-cells, reinforcing their transitory suppressive status. Of note, these immune changes are transitory and sequential but may participate to a regulation loop necessary for homeostatic immune control at long term. Conclusion: HF is associated with several transitory immunological changes including pro-inflammatory phenotype in innate compartment and immunosuppressive profile in adaptive compartment. A comprehensive assessment of immune mechanisms implicated in the patient's prognosis after HF could pave the way to develop new immune therapeutics strategies.

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Section: Patients Characteristicssupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Hip Fracture Leads to Transitory Immune Imprint in Older Patients

et al. 2020

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“…In addition, neopterin is thought to have a correlation with ROS production so that it can be an indicator of oxidative stress as a trigger for the progres-sion of HIV disease to become more severe as the number of CD4+ T-lymphocyte cells de-creases. 19 This study shows the results of the analysis of a significant difference in serum neopterin levels in the living group and the deceased group (p=0.041). While the correlation analysis between serum neopterin levels and CD4+ cell counts showed no significant correlation (p=0,132).…”

Section: Discussionmentioning

confidence: 63%

Association Between Neopterin Levels and Outcome in 30 Day HIV/AIDS Naive Patients

Juanita

Hadi

Arfijanto

2019

BHSJ

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Introduction: HIV/AIDS is still a major problem throughout the world even in Indonesia. Some markers can provide information regarding the description of immune activity in HIV/AIDS. Neopterin produced by macrophages as a catabolic result of Guanosine Triphosphate (GTP) is one of them. Neopterin has been widely studied as a prognostic indicator of the course in HIV/AIDS. Until now there have been no studies examine the association between neopterin levels and outcomes in 30 days of HIV/AIDS patients.Methods: A prospective longitudinal analytic study involved 56 samples of HIV/AIDS naive patients from January to April 2019. Serum neopterin levels were measured by the Enzyme Linked Immunosorbent Assay (ELISA) method. Outcome is a living condition or death within the first 30 days of the patient being treated. Discriminant function analysis was used to determine the association between variable and controlling confounding factors using the "R" program. Outputs of p value was significant if <0.05.Results: The average age of the study subjects was 39.7 ± 11 years old with predominantly male gender (71.4%). The median serum neopterin level of the study subjects was 168.13 nmol/L with the lowest levels of 11.78 nmol/L and the highest level of 196.95 nmol/L. Outcomes were grouped live and died, each group at 50%. There was a significant positive association between serum neopterin levels and outcomes in 30 days (p=0.02)Conclusion: Role of neopterin levels still need to be proven as a prognostic factor by evaluating other factors that influence the outcome of HIV/AIDS patients.

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“…Une publication récente a montré que les taux plasmatiques de néoptérine, une molécule produite par les macrophages et les monocytes sous l'influence de l'IFN-γ, sont prédictifs de mortalité à un an d'une FESF chez les personnes âgées. De plus, la néoptérine, mesurée à l'arrivée à l'hôpital, est corrélée négativement au temps de survie après la chirurgie [49]. Il est intéressant de noter que la voie conduisant à la production de néoptérine est couramment utilisée pour la synthèse de la 5,6,7,8-tétrahydrobioptérine (BH4), essentielle à la synthèse de la dopamine et de la sérotonine, deux hormones impliquées dans les réponses au stress.…”

Section: Fracture De L'extrémité Supérieure Du Fémur (Fesf)unclassified

Le vieillissement du système immunitaire : du fondamental à la clinique

Vallet

Fali

Sauce

2019

La Revue de Médecine Interne

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Major progress in preventing, delaying or curing various pathologies normally encountered in old age results in a continuous improvement in life expectancy. However, understanding the underlying cause of the disparate comorbidities occurrence with aging remains a priority in order to propose adapted care for the older population. In one hand, aging profoundly impairs the immune system; it is characterized by many changes in haematopoiesis, adaptive and innate systems, and is associated with pro-inflammatory environment. In another hand, stressful events (acute or chronic) can also impact the immune system through the secretion of hormones, which are also altered with aging. Blooming evidences from psychoneuroimmunology field suggest that, in acute medical conditions, elderly people are not equal in their responses to stressors depending on many extrinsic and intrinsic parameters. These factors could interfere with elderly's ability to mount an effective immune response. The objective of this review is to provide an overview of the literature (from fundamental to clinical observations) to draw a global picture of immunosenescence. Understanding this process could enable us to target fundamental age-related pathways and thus open new avenues in improving both lifespan and health span.

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Elevated Neopterin Levels Predict Early Death in Older Hip-fracture Patients

Cited by 13 publications

References 31 publications

Hip Fracture Leads to Transitory Immune Imprint in Older Patients

Hip Fracture Leads to Transitory Immune Imprint in Older Patients

Association Between Neopterin Levels and Outcome in 30 Day HIV/AIDS Naive Patients

Le vieillissement du système immunitaire : du fondamental à la clinique

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