Changes in serum neopterin and serum beta 2-microglobulin in subjects with lung infections

Abstract

C Ch ha an ng ge es s i in n sse er ru um m n ne eo op pt te er ri in n a an nd d s se er ru um m b be et ta a 2 2 --m mi ic cr ro og gl lo ob bu ul li in n i in n s su ub bj je ec ct ts s w wi it th h l lu un ng g i in nf fe ec ct ti io on ns s Thirty HIV-positive subjects with PCP, 9 HIV-positive patients with bacterial pneumonia, and 16 HIV-negative patients with bacterial pneumonia were investigated. Thirty eight asymptomatic HIV-positive subjects and 48 healthy blood donors were used as controls.The HIV-positive patients with PCP and the HIV-positive subjects with bacterial pneumonia had significantly and similarly elevated levels of neopterin and β 2 -microglobulin in the acute stage. In the weeks before the acute stage of PCP, neopterin and β 2 -microglobulin had been increasing. After start of treatment, serum neopterin declined significantly, whilst serum β 2 -microglobulin remained elevated. The HIV-negative patients with bacterial pneumonia had significantly increased serum concentrations of both markers in the acute stage, and had decreasing serum concentrations in the weeks after treatment.We conclude that neither neopterin nor β 2 -microglobulin seem to be of value in distinction between PCP and bacterial pneumonia in HIV-positive subjects. In the HIV-positive patients, neopterin may correlate partly with the clinical activity of PCP, whilst serum β 2 -microglobulin may remain elevated after PCP, despite treatment and recovery. The elevated level may, in part, be due to repeated infections and progression to acquired immune deficiency syndrome (AIDS). In the HIV-negative patients with pneumonia both parameters seem to correlate with disease activity and recovery.

Serum neopterin is elevated in patients infected with Shigella

“…Previous studies indicated that neopterin levels can be detected in morbidities such as lung infections, HIV infection, hepatitis B infection, sarcoidosis as well as in others chronic diseases [1,5,9-11]. To date, there is no published report describing elevated levels of neopterin in shigellosis or any other acute diarrheal diseases.…”

“…Neopterin levels in serum or urine usually correlate with the clinical course. The level is high early in the infection and it decreases as soon as antibodies against the pathogen become detectable [5,6]. Serial measurements of the level of neopterin in a particular patient may be useful in monitoring the course of a condition [4].…”

Procalcitonin and neopterin correlation with aetiology and severity of pneumonia

“…[33][34][35] Neopterin is considered a more sensitive indicator for the activation of monocytic and lymphocytic system and less specific for bacterial diseases, but did not seem to be of value in distinction between P. jirovecii and bacterial pneumonia in HIV-positive subjects. 36 The association between severity of infection and serum levels of inflammatory markers could be important in terms of a successful identification of those patients who might benefit from early intervention strategies. The current scoring systems for assessing the magnitude of the physiological insult and the degree of organ injury examine the host response at a single point in Table 3 Distribution (5 and 95 percentiles and median) of procalcitonin (PCT) and neopterin in patients with pneumococcal and Legionella pneumonia according to pneumonia severity index (PSI) and extent of the pneumonia Groups of patients n PCT (ng/ml) Neopterin (ng/ml) 38 PCT and neopterin yielded statistically significant differences between survivors and nonsurvivors in patients with sepsis and cardiac surgery with cardiopulmonary bypass.…”

Evaluation of Acute-phase Reactants, Immunologic Markers and other Clinical and Laboratory Parameters in Patients with Pneumonia and Non-pneumonic Lower Respiratory Tract Infections

“…The possible diagnostic value of β2-M in lower respiratory tract infections has not been addressed in the literature to date, because only a few studies marginally measured β2-M serum levels in a small number of patients with pneumonia among other diverse entities that did not include OALRTI [26][27][28] . We did not find β2-M to be useful in differentiating pneumonia from OALRTI.…”

“…Immune activation and increased turnover of these cells, particularly T-lymphocytes, result in an increased release of β 2 -M into the circulation. Increased levels of this protein have been found in a variety of infectious, inflammatory and neoplastic conditions [22][23][24][25][26] and it has been marginally evaluated in some studies dealing with a reduced number of patients with lower respiratory tract infections [26][27][28] . The aim of this prospective study was analyze the behavior of these acute-phase reactants and immune activation markers, as well as many other basic clinical and laboratory parameters, in patients with pneumonia and other acute lower respiratory tract infections (OALRTI) at the time of presentation to the emergency ward of our hospital.…”