Neopterin and Beta-2 Microglobulin Relations to Immunity and Inflammatory Status in Nonischemic Dilated Cardiomyopathy Patients

Abstract

Background. The aim of the study was to assess the relationships among serum neopterin (NPT), β2-microglobulin (β2-M) levels, clinical status, and endomyocardial biopsy results of dilated cardiomyopathy patients (DCM). Methods. Serum NPT and β-2 M were determined in 172 nonischaemic DCM patients who underwent right ventricular endomyocardial biopsy and 30 healthy subjects (ELISA test). The cryostat biopsy specimens were assessed using histology, immunohistology, and immunochemistry methods (HLA ABC, HLA DR expression, CD3 + lymphocytes, and macrophages counts). Results. The strong increase of HLA ABC or HLA DR expression was detected in 27.2% patients—group A—being low in 72.8% patients—group B. Neopterin level was increased in patients in group A compared to healthy controls 8.11 (4.50–12.57) versus 4.99 (2.66–8.28) nmol/L (P < 0.05). β-2 microglobulin level was higher in DCM groups A (2.60 (1.71–3.58)) and B (2.52 (1.51–3.72)) than in the control group 1.75 (1.28–1.96) mg/L, P < 0.001. Neopterin correlated positively with the number of macrophages in biopsy specimens (P < 0.05) acute phase proteins: C-reactive proteins (P < 0.05); fibrinogen (P < 0.01); and NYHA functional class (P < 0.05) and negatively with left ventricular ejection fraction (P < 0.05). Conclusions. Neopterin but not β-2 microglobulin concentration reflected immune response in biopsy specimens. Neopterin correlated with acute phase proteins and stage of heart failure and may indicate a general immune and inflammatory activation in heart failure.

Inflammation, iron and vitamin D metabolism in different cardiomyopathy aetiologies

“…Interestingly, there were no differences of median CRP and neopterin levels between patients with virus positive and virus negative inflammatory CMP as well as between patients with and without signs of myocarditis in the EMB (both acute and/or chronic). This is in contrast to previous studies, which described higher neopterin levels in patients with inflammatory CMP, especially in patients with active myocarditis [42][43][44]. Since immune activation goes along with increased ferritin levels (ferritin is inter alia an acute phase protein), significantly higher ferritin levels in patients with inflammatory CMP might be expected [45].…”

Evaluation of serum neopterin levels in severe COVID-19 patients: An observational study

“…A positive correlation was also observed between neopterin and CRP levels in different pathology related to immunity and inflammatory status. [31][32][33] Additionally, in our study, low albumin concentration was also detected, in addition to the systemic inflammatory status indicated by high neopterin and CRP levels. Studies also indicated that hypoalbuminemia was an independent and early predictor of poor prognosis in patients with COVID-19.…”

Biomarkers in differentiating clinical dengue cases: A prospective cohort study

“…Other studies have shown that neopterin is a non-specific biomarker which its level also elevated in other conditions such as cardiovascular disease, pneumonia and colorectal cancer [20][21][22]. Hence, this could possibly explain the failure to differentiate between non-dengue fever and dengue without warning signs in our study.…”