Serum Neopterin, an Immune Activation Marker, Independently Predicts Disease Progression in Advanced HIV-1 Infection

Mildvan, Donna; Spritzler, John; Grossberg, Sidney E.; Fahey, John L.; Johnston, David; Schock, Barbara; Kagan, Jonathan

doi:10.1086/427877

Cited by 82 publications

(73 citation statements)

References 36 publications

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“…It may assist future studies that seek a more robust surrogate, pending its availability and cost. 24,25 The study had several limitations. First, our study was a sin- gle-centre cross-sectional observational study.…”

Section: Discussionmentioning

confidence: 99%

The use of readily available biomarkers to predict CD4 cell counts in HIV-infected individuals

Moolla

Reddy³

et al. 2015

South African Family Practice

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Background:The use of readily available biochemical investigations to predict the CD4 cell count in HIV-infected patients may provide clinicians with insight regarding disease severity at first contact. The aims of the study were to determine the relationship of calculated globulin and white cell count (WCC) with CD4 cell count. Methods: Data were collected prospectively from ambulatory HIV-infected, anti-retro viral therapy (ART) naive patients at the HIV clinic of King Edward Hospital, Durban, between 2010 and 2012. Results: The mean age of the participants was 39 ± 9.53 years and 70% were female. Median calculated globulin and WCC was 49 g/l and 4.74 × 10 9 cells/l respectively, whilst the CD4 cell count was 244 cells/mm 3 . A significant positive correlation was demonstrated between CD4 cell count and WCC (r = 0.25, p < 0.001). WCC and albumin were identified as potential surrogate markers for CD4 count ≤ 200 cells/mm 3 . Combination of WCC with either albumin or globulin predicts a CD4 count of less than 200 cells/ mm 3 with moderate accuracy. Conclusion:The use of combined biomarkers may influence initiation of Pneumocystis jiroveci pneumonia prophylaxis in resource-limited settings. Further evaluation is warranted to assess the role of these markers in disease progression and ART.

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Section: Discussionmentioning

confidence: 99%

The use of readily available biomarkers to predict CD4 cell counts in HIV-infected individuals

Moolla

Reddy³

et al. 2015

South African Family Practice

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“…Neopterin has been reported as a sensitive marker of cell-mediated immune activity (3). Elevated plasma levels of neopterin have been detected in association with cancers (18), during sepsis (3) and numerous infections, including febrile neutropenia (15) and human immunodeficiency virus infection (14), hepatitis B-related chronic liver disease (7), and atherosclerosis (20). Serum neopterin levels have also been reported to correlate with disease activity in JDM patients (4).…”

Section: Discussionmentioning

confidence: 99%

“…It is known to be a marker of inflammation associated with cell-mediated immunity in various diseases (7,14,15,18,20). In our institution, we had observed that patients with a confirmed diagnosis of HLH had very high serum neopterin levels.…”

mentioning

confidence: 80%

Serum Neopterin Levels as a Diagnostic Marker of Hemophagocytic Lymphohistiocytosis Syndrome

Ibarra¹,

Klein-Gitelman²,

Morgan³

et al. 2010

Clinical Immunology

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The objective of this study was to retrospectively evaluate the utility of serum neopterin as a diagnostic marker of hemophagocytic lymphohistiocytosis (HLH). The medical records of patients diagnosed with HLH (familial and secondary) between January 2000 and May 2009 were reviewed retrospectively, and clinical and laboratory information related to HLH criteria, in addition to neopterin levels, was recorded. A group of 50 patients with active juvenile dermatomyositis (JDM) (who routinely have neopterin levels assessed) served as controls for the assessment of the accuracy, sensitivity, and specificity of neopterin as a diagnostic test for HLH. The Pearson correlation was used to measure the association between serum neopterin levels and established HLH-related laboratory data. Serum neopterin levels were measured using a competitive enzyme immunoassay. During the time frame of the study, 3 patients with familial HLH and 18 patients with secondary HLH were identified as having had serum neopterin measured (all HLH patients were grouped together). The mean neopterin levels were 84.9 nmol/liter (standard deviation [SD], 83.4 nmol/liter) for patients with HLH and 21.5 nmol/liter (SD, 10.13 nmol/liter) for patients with JDM. A cutoff value of 38.9 nmol/liter was 70% sensitive and 95% specific for HLH. For HLH patients, neopterin levels correlated significantly with ferritin levels (r ‫؍‬ 0.76, P ‫؍‬ 0.0007). In comparison to the level in a control group of JDM patients, elevated serum neopterin was a sensitive and specific marker for HLH. Serum neopterin has value as a diagnostic marker of HLH, and prospective studies are under way to further evaluate its role as a marker for early diagnosis and management of patients.

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“…It is produced by macrophages stimulated by the interferon-γ (IFN-γ), of which activated Th1-type lymphocytes are a source. Viral antigens, by the stimulation of IFN-γ production, cause the increase of neopterin concentrations in serum, and this concentration does not depend on the kind of the virus and it could serve as non-specific marker of viral infection (4)(5)(6)(7). In contrast to highly increased neopterin concentrations in patients with virus infections, in patients with acute bacterial infections usually normal or slightly increased values can be detected.…”

Section: Introductionmentioning

confidence: 99%

Neopterin Concentration in Serum and Chosen Markers of Inflammatory Process in Children with Acute Diarrhea Caused by Rotavirus or Salmonella

Kozłowska-Murawska

Obuchowicz

2009

Pteridines

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Neopterin concentrations reflect the activation of the cellular immune system. Neopterin is released by macrophages stimulated by interferon-γ (IFN-γ), which is produced by activated T lymphocytes. Raised neopterin concentrations in body fluids are found in various disorders, e.g. viral infections (AIDS, cytomegalovirus, hepatitis), intracellular bacteria infections (Mycobacteruim tuberculosis, Mycobacterium leprae), autoimmune disorders and malignancy. Neopterin concentrations are low or not significantly increased in bacterial infections, with exception of infections with intracellular bacteria. The aim of this study was to evaluate the usefulness of neopterin in the differential diagnosis of viral (Rotavirus) and bacterial (Salmonella) origin of diarrhoea. 129 children, aged 1 month -14 years, who were hospitalized for rotavirus gastroenteritis or salmonellosis were included into the study. Rotavirus was identified by latex test and Salmonella by stool cultures and the children were divided into 2 groups: with rotavirus infection (group I (R) -71 children) and with salmonellosis (group II (S) -58 children). In this study it was analyzed: disease duration before hospitalization, the general condition of a child on admission, body temperature, the number of loose and bloody stools and the number of vomits. On their admission to hospital, erythrocyte sedimentation rate (ESR), leukocyte count, and in the sera of all children C-reactive protein (CRP) and neopterin concentrations were determined. The serum neopterin concentrations were analyzed by ELISA. Mean neopterin concentration was 35.0 nmol/L in patients with salmonellosis, and it was significantly higher than in patients with rotavirus infection (22.0 nmol/L; p <0,001). The neopterin level that reliably discriminated between rotavirus diarrhoea and salmonellosis was 22 nmol/L: neopterin concentration higher than 22 nmol/L suggested diarrhoea caused by Salmonella, and neopterin concentrations equal or lower than 22 nmol/L suggested a rotavirus diarrhoea The combination of the results of two (neopterin >10 nmol/L and CRP >10mg/L) or three (neopterin >10nmol/L, ESR >10mm/h, CRP >10mg/L) serum markers helps to achieve better results. The best specificity (100%) was obtained for CRP concentration >15mg/L and neopterin concentration >37 nmol/L. We conclude that serum neopterin concentrations in children with acute diarrhea are not a laboratory indicator diversifying salmonellosis and rotavirus infection, because it increases in both infections. However higher concentrations indicate salmonellosis.

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Serum Neopterin, an Immune Activation Marker, Independently Predicts Disease Progression in Advanced HIV-1 Infection

Cited by 82 publications

References 36 publications

The use of readily available biomarkers to predict CD4 cell counts in HIV-infected individuals

The use of readily available biomarkers to predict CD4 cell counts in HIV-infected individuals

Serum Neopterin Levels as a Diagnostic Marker of Hemophagocytic Lymphohistiocytosis Syndrome

Neopterin Concentration in Serum and Chosen Markers of Inflammatory Process in Children with Acute Diarrhea Caused by Rotavirus or Salmonella

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