Serum level of neopterin is not a marker of disease activity in treated rheumatoid arthritis patients

El-Lebedy, Dalia; Hussein, Jihan; Ashmawy, Ingy; Mohammed, Asmaa M.

doi:10.1007/s10067-016-3433-4

Cited by 16 publications

(22 citation statements)

References 19 publications

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“…However, in contrast to our study, El-Lebedy et al (15) found no significant correlations between neopterin levels and any of the disease activity parameters.…”

Section: Discussioncontrasting

confidence: 99%

“…D'agostino et al (13) also agreed with our study results as the mean neopterin concentrations in early JIA patients (8.92nmol/l)were significantly higher than the mean neopterin concentrations in healthy volunteers (5.62 nmol/l). This is also in agreement to El-Lebedy et al (15) who found significantly higher levels of neopterin in JIA patients (11.46 ± 3.56 nmol/L) compared to healthy controls (4.74 ± 1.98 nmol/L).…”

Section: Discussionsupporting

confidence: 93%

“…On the contrary El-Lebedy et al (15) found no significant difference regarding neopterin levels in the different disease activity phases. The results indicated that neopterin is a marker of JIA but not a marker of disease activity in treated JIA patients.…”

Section: Discussionmentioning

confidence: 87%

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Serum Neopterin Level in Children with Juvenile Idiopathic Arthritis

Dower

Abdelhameed²,

Maksoud³

et al. 2018

Egyptian Journal of Hospital Medicine

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Background: Juvenile idiopathic arthritis (JIA) is generally considered a clinical syndrome involving several disease subsets, with a number of inflammatory flows, leading to an eventual common pathway in which persistent synovial inflammation and associated damage to articular cartilage and underlying bone are present. Neoptrin is a reliable marker in the assessment of the rate of IFN-γ production. Levels of neoptrin increase in direct proportion with the level of interferon. Measurement of neopterin level is useful because of its relative stability also it is a prognostic indicator for cell-mediated immunity. Aims: This study aims to assess serum level of neopterin in patients with Juvenile Idiopathic Arthritis (JIA) in relation to the disease activity, severity and response to conventional and biological therapy. Methodology: The study was conducted on 30 patients (Group A) previously diagnosed as SoJIA, they were divided into two subgroups according to their therapy into Group AI on biological therapy (15 patients) and Group AII on conventional therapy (15 patients). These in addition to 20 healthy controls (Group B). Results: Basic clinical evaluation and laboratory investigations were done. We found that JIA patients had significantly higher levels of serum neopterin than healthy controls. We also found a highly significant difference between neopterin levels in the activity and remission states among all patients (Group AI and Group AII). Conclusion: We concluded that serum neopterin is a useful marker for cellular immune activation and also indicative of the activity of JIA. Our findings are supported by positive correlations between serum neopterin levels and other markers of activity as TLC, PLT counts, ESR, and CRP. We also concluded that serum neopterin is a sensitive and accurate predictor of disease activity where sensitivity of that test was 93.3% and accuracy was 72.5%. Recommendations: Investigating the serum neopterin measurement in other autoimmune collagen diseases. Assessment the influence of biological therapy on neopterin levels in relation to disease progression.

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“…However, in contrast to our study, El-Lebedy et al (15) found no significant correlations between neopterin levels and any of the disease activity parameters.…”

Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 93%

See 1 more Smart Citation

Serum Neopterin Level in Children with Juvenile Idiopathic Arthritis

Dower

Abdelhameed²,

Maksoud³

et al. 2018

Egyptian Journal of Hospital Medicine

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“…Neopterin indicates a proinflammatory condition and increased status of oxidative stress. The most important trigger of neopterin is interferon‐γ, which is secreted from activated T‐helper cells . In recent studies it was shown that high neopterin levels are related to cardiovascular diseases, stroke and autoimmune diseases like rheumatoid arthritis, several infections, diabetes mellitus and malignancies …”

Section: Introductionmentioning

confidence: 99%

“…The most important trigger of neopterin is interferon-γ, which is secreted from activated T-helper cells. 6,7 In recent studies it was shown that high neopterin levels are related to cardiovascular diseases, stroke and autoimmune diseases like rheumatoid arthritis, several infections, diabetes mellitus and malignancies. [8][9][10][11] Ischemia and increased oxidative stress bring structural changes which affect the N-terminal peptides of albumin.…”

Section: Introductionmentioning

confidence: 99%

Serum neopterin and ischemia modified albumin levels are associated with the disease activity of adult immunoglobulin A vasculitis (Henoch‐Schönlein purpura)

et al. 2019

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Aim The aims of the study are to investigate serum neopterin and ischemia modified albumin (IMA) levels in patients with immunoglobulin A vasculitis (IgAV) and evaluate the association of these markers with disease activity and relapse. Method Thirty‐four consecutive adult patients (24 male and 10 female) admitted to the rheumatology clinic and met the IgAV American College of Rheumatology (ACR) criteria were enrolled in this cross‐sectional study. Demographic and clinical features of IgAV and a control group were recorded into a predefined protocol. Disease activity was categorized as “remission” or “active” according to Birmingham Vasculitis Activity Score (BVAS). BVAS ≥ 1 was accepted as "active". Serum neopterin levels, high‐sensitivity C‐reactive protein (hsCRP) and IMA were evaluated according to BVAS and compared to the healthy control group. Results Serum median (interquartile range) neopterin, IMA levels and hsCRP were higher in the study group than in control group (2.01 [12.5] ng/mL vs 1.77 [1.37] ng/mL, 0.67 [0.2] ng/mL vs. 0.43 [0.17] ng/mL, 5.6 [17.1] mg/L vs. 1.55 [1.6] mg/L, P = .095, P < .001 and P = .002, respectively). When evaluated according to BVAS, IMA and hsCRP levels were significantly higher in the group with active disease (0.77 [0.12] vs 0.61 [0.13] and 14.85 [4.6], P = .009 and P = .03, respectively). Serum neopterin levels were significantly higher in the active group compared to BVAS (18.95 [32.36] vs 1.63 [1.48], P < .001). Conclusion Oxidative stress is important in IgAV pathogenesis. Roles of hsCRP, neopterin and IMA as potential markers of diagnosis and disease activity seem to be worth studying in future studies with larger study groups.

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Neopterin serum level does not reflect the disease activity in rheumatoid arthritis: A systematic review and meta‐analysis

et al. 2020

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Rheumatoid arthritis (RA) is a chronic autoimmune disease caused by established chronic inflammation. Neopterin levels have extensively been considered as a marker of immune activation during inflammation. In this study, we performed a systematic evaluation and meta-analysis to elucidate the overall relationship between neopterin concentration and RA disease activity. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a systematic review was conducted using PubMed, Google Scholar, Web of Science, and Scopus from 2000 to August 2020. The Newcastle-Ottawa scale was used to assess the quality of eligible studies. The effect size (ES) and corresponding 95% confidence intervals (CIs) were calculated to evaluate this association. A total of 15 studies out of 98 met our inclusion criteria. The pooled analysis found that patients with RA had high level of neopterin; however, no statistically significant association was found between neopterin levels with high, intermediate, and low diseases activity score (DAS)-28 (ES =11.18, 95% CI: 6.02 to 16.34, and I 2 = 91.8%; and ES = 8.57, 95% CI: 6.41 to 10.37, and I 2 = 99.5%; and ES =12.45, 95% CI: −1.68 to 26.58, and I 2 = 99.0%, respectively). Our results indicated that the neopterin concentration does not seem to have any substantial impact on the RA disease activity.

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Serum level of neopterin is not a marker of disease activity in treated rheumatoid arthritis patients

Cited by 16 publications

References 19 publications

Serum Neopterin Level in Children with Juvenile Idiopathic Arthritis

Serum Neopterin Level in Children with Juvenile Idiopathic Arthritis

Serum neopterin and ischemia modified albumin levels are associated with the disease activity of adult immunoglobulin A vasculitis (Henoch‐Schönlein purpura)

Neopterin serum level does not reflect the disease activity in rheumatoid arthritis: A systematic review and meta‐analysis

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