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

Abstract

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.

Lipid metabolism contribute to the pathogenesis of IgA Vasculitis

“…Plasmalogen PC and plasmalogen PE were reported to be associated with oxidative stresses which are important in IgAV pathogenesis [ 43 ]. In our result PE(36:4)-H, PE (38:5)-H, PE (38:5)-H PE (34:2)-H and PCs rose, while PE (21:4)-H declined.…”

Proanthocyanidins: A novel approach to Henoch‑Schonlein purpura through balancing immunity and arresting oxidative stress via TLR4/MyD88/NF‑κB signaling pathway (Review)

“…As immune imbalance and OS-induced IgA mediated vessel injury are implicated in HSP and proanthocyanidins have immunoregulatory, antioxidant and anti-inflammatory activity, it is hypothesized that proanthocyanidins may be beneficial to patients with HSP. HSP is a recurrent, immune-mediated vasculitis that invades arterioles and capillaries, typically featuring IgA deposition along vascular walls ( 23 , 45 , 46 , 123 ); immune imbalance and OS are responsible for HSP pathogenesis and involve signals from TLR4 and its downstream pathways MyD88/NF-κB ( 5 , 23 , 46 , 61 , 62 ); high proportions of Th2/Th1 as well as Th17/Treg and Th2 and Th17 overactivation are associated with increased ROS and redox imbalance in lesions and blood samples from patients with HSP; furthermore, Th2/Th17 promotion of Ig (primarily IgA) production and deposition are frequently observed in patients with HSP. The aforementioned factors stimulate and maintain the progression of HSP and, therefore may serve as potential targets for treatment of HSP ( 26 , 27 , 62 , 124 ).…”

The potential role of neopterin in Covid-19: a new perspective

“…Different studies have shown that high NPT serum level is linked to diverse infectious diseases and immunological disorders, including autoimmune diseases [ 13 ], malignancy [ 14 ], and viral infections, like rubella, cytomegalovirus, hepatitis C, and dengue fever [ 15 ]. Also, Omma et al [ 16 ] observed that NPT serum level is correlated with disease severity. However, El-Lebedy et al, [ 17 ] showed that NPT serum level is not correlated with the disease’ severity in patients with rheumatoid arthritis.…”