Serum Neopterin and its Significance as Biomarker in Differentiation of Mods From Sepsis

Zhang, Xiaohong; Chen, Qingli; Ni, Shuangling; Xiang, Zemin; Zhou, Xiaohui; Huang, Yuanyuan

doi:10.1515/pteridines-2018-0018

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…It is produced as the oxidation product of 7,8-dihydroneopterin, which is generated by IFN-γ (produced by T lymphocytes)-activated macrophages . Levels of neopterin can indicate infection, trauma, cancer, and cardiovascular disease − and neopterin levels have been shown to be increased in sepsis patients, which is consistent with the findings in the current study. Some studies have shown that neopterin correlates with mortality in patients with sepsis and in one study in liver transplant patients, early post-transplant neopterin plasma levels were identified as a sensitive predictive marker of bacteremia and mortality 1 year post-transplant .…”

Section: Resultssupporting

confidence: 90%

Stratification of Sepsis Patients on Admission into the Intensive Care Unit According to Differential Plasma Metabolic Phenotypes

Lodge,

Litton,

Gray

et al. 2024

J. Proteome Res.

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Delayed diagnosis of patients with sepsis or septic shock is associated with increased mortality and morbidity. UPLC-MS and NMR spectroscopy were used to measure panels of lipoproteins, lipids, biogenic amines, amino acids, and tryptophan pathway metabolites in blood plasma samples collected from 152 patients within 48 h of admission into the Intensive Care Unit (ICU) where 62 patients had no sepsis, 71 patients had sepsis, and 19 patients had septic shock. Patients with sepsis or septic shock had higher concentrations of neopterin and lower levels of HDL cholesterol and phospholipid particles in comparison to nonsepsis patients. Septic shock could be differentiated from sepsis patients based on different concentrations of 10 lipids, including significantly lower concentrations of five phosphatidylcholine species, three cholesterol esters, one dihydroceramide, and one phosphatidylethanolamine. The Supramolecular Phospholipid Composite (SPC) was reduced in all ICU patients, while the composite markers of acute phase glycoproteins were increased in the sepsis and septic shock patients within 48 h admission into ICU. We show that the plasma metabolic phenotype obtained within 48 h of ICU admission is diagnostic for the presence of sepsis and that septic shock can be differentiated from sepsis based on the lipid profile.

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Section: Resultssupporting

confidence: 90%

Stratification of Sepsis Patients on Admission into the Intensive Care Unit According to Differential Plasma Metabolic Phenotypes

Lodge,

Litton,

Gray

et al. 2024

J. Proteome Res.

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show abstract

“…Ci et al found that the serum neopterin level of trauma patients and critical ill patients was higher than that of the healthy controls and serum neopterin level was positively correlated with the severity of the disease [24]. Studies have demonstrated that serum neopterin levels in patients with sepsis were elevated and can be used as a promising biomarker for multiple organ dysfunction syndrome (MODS) diagnosis in patients with sepsis [25][26][27]. In our work, the findings demonstrated that serum neopterin may reflect the severity of AP at a late stage and may be a potential serological maker for death prediction, which was in accordance with the previous studies.…”

Section: Discussionmentioning

confidence: 99%

Changes of serum neopterin and its significance as biomarker in prediction the prognosis of patients with acute pancreatitis

Zhang

Wang

Ji³

et al. 2020

Journal of Laboratory Medicine

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ObjectivesTo investigate the dynamic changes of serum neopterin and its significance as biomarker in prediction the prognosis of patients with acute pancreatitis.Methods54 cases with confirmed diagnosis of acute pancreatitis were included in the present work. Of the included 54 cases, 21 were mild acute pancreatitis and other 33 were server diseases. For the 33 severe cases, nine were finally dead and 24 were survived. The serological neopterin level of the 54 acute pancreatitis was continuously examined at the time point of days 0 (diagnosis), 1 (24 h after diagnosis), 2, 4, 8 and 14 by the enzyme linked immunosorbent assay (ELISA). The severity or death risk of the acute pancreatitis patients was predicted by the serological neopterin.ResultsThe serological neopterin was gradually increasing from days 0 to 8, but descending at day 14 in mild and survival groups. For days 8 and 14, the serological levels of neopterin in severe group were higher than those of mild group with statistical difference (p<0.05). The serum neopterin was statistical different in the time point of day 8 and day 14 between death and survival groups (p<0.05). For day 8, the serological neopterin as biomarker for death prediction sensitivity and specificity were 88.89% (95% CI: 51.75–99.72%) and 83.33% (95% CI: 62.62–95.26%) respectively with the AUC of 0.95 (95% CI: 0.88–1.00). For day 14, the death prediction sensitivity and specificity were 77.78% (33.99–97.19%) and 95.83% (78.88–99.89%) respectively with the AUC of 0.94 (95%CI:0.87–1.00).ConclusionsSerological neopterin level was elevated with the development of the pancreatitis. Continuously monitoring the serum neopterin may helpful for prediction death risk of acute pancreatitis. In the later phase of disease beginning on day 8, neopterin levels may be used for risk assessment and possibly change of therapy regiment.

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“…Zhang et al in his study showed that neopterin can help in differentiating MODS from sepsis. Along with above, we have calculated cut off for neopterin and also other markers and we have also compared the e cacy of different markers in sepsis and also in sepsis with MODS, which is novel in our study [13] and also the correlation of serum neopterin with the different sepsis scores was also calculated in our study.…”

Section: Mods and Nonmentioning

confidence: 91%

To Determine The Association Of Serum Neopterin Levels In Sepsis

Hakeem

2023

Preprint

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Background: Sepsis is a leading cause of death worldwide. Sepsis results in state of multiorgan dysfunction in the body. Early identification and appropriate treatment is the key in sepsis management. Many biomarkers have been studied in sepsis. Serum Neopterin is a biomarker, synthesised by human macrophages upon stimulation with the cytokine interferon-gamma(INF-γ) and is indicative of a pro-inflammatory immune status. Since neopterin is an indirect measure of T cell activation, it could be a useful tool in evaluation of clinical course in septic patients. Methods It is a case control study conducted in Amrita Institute of Medical sciences.Patients were categorised into 3 groups: Sepsis with MODS (Group 1, n=22), Sepsis Non MODS(Group 2 , n=17), and Non sepsis (Group 3, n=16). Serum Neopterin levels and along other markers like CRP, Procalcitonin, ESR and Total counts were taken from the 3 groups of patients at 0, 48 and 96 hours. RESULTS Data was analysed using SPSS statistics. The median Neopterin Levels performed at 48 hours were compared between Sepsis Group and Non-Sepsis patients. The median Neopterin levels in sepsis group was 87.00 (40.00,129.00) and in non-sepsis groups was 22.00(12.00, 39.00) and p value obtained was <0.001, hence neopterin is significant marker in diagnosing sepsis. The median levels were then compared between group 1 and group 2. The median values in sepsis with MODS was 123.00(79.25, 146.00) and in sepsis without MODS was 54.00(34.00, 88.50) and the p value obtained was 0.001. Hence Neopterin is significant marker in diagnosing patients with MODS in patients with sepsis. Serum Neopterin had sensitivity of 92.31%, specificity of 100% and accuracy of 94.55 % in predicting sepsis. In predicting MODS, its sensitivity was 92.31%, specificity was 100% and accuracy was 94.55%. It also showed good correlation with SOFA, qSOFA and APACHE scores. Conclusion Serum Neopterin is a marker which can help in diagnosing sepsis and can also be a useful marker in differentiating patients with MODS from patients without MODS. Neopterin has showed that it is better marker in identifying MODS in patients with sepsis than Procalcitonin, ESR and total counts. The levels of Neopterin also correlated with the severity of sepsis and showed a good relation with SOFA, APACHE and Qsofa scores. The dynamic measurements of neopterin are predictive of the clinical status of the patient. Hence Serum Neopterin is a good marker to diagnose sepsis and also a good marker to prognosticate sepsis.

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Serum Neopterin and its Significance as Biomarker in Differentiation of Mods From Sepsis

Cited by 4 publications

References 14 publications

Stratification of Sepsis Patients on Admission into the Intensive Care Unit According to Differential Plasma Metabolic Phenotypes

Stratification of Sepsis Patients on Admission into the Intensive Care Unit According to Differential Plasma Metabolic Phenotypes

Changes of serum neopterin and its significance as biomarker in prediction the prognosis of patients with acute pancreatitis

To Determine The Association Of Serum Neopterin Levels In Sepsis

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