Neopterin as a prognostic biomarker in intensive care unit patients

Baydar, Terken; Yüksel, Osman; Sahin, Tevfik Tolga; Dikmen, Kürşat; Girgin, Gözde; Sipahi, Hande; Kurukahvecioğlu, Osman; Bostancı, Hasan; Şare, Mustafa

doi:10.1016/j.jcrc.2008.06.013

Cited by 47 publications

(42 citation statements)

References 17 publications

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“…In the LA group the postoperative rise in neopterin was significantly greater than the GA group at 6 hours PO. A strong association between urinary neopterin levels and multiple organ failure and death has been reported in other studies [10,11]. The mechanism of the elevation of urinary neopterin in LA is unclear.…”

Section: Discussionmentioning

confidence: 79%

“…The mechanism of the elevation of urinary neopterin in LA is unclear. Neopterin is a pteridine derivative and is released by mononuclear white blood cells into plasma and body fluid during or after surgery [10]. It is recognized as a marker of cell mediated immunity [10].…”

Section: Discussionmentioning

confidence: 99%

“…Neopterin is a pteridine derivative and is released by mononuclear white blood cells into plasma and body fluid during or after surgery [10]. It is recognized as a marker of cell mediated immunity [10]. The production of neopterin is stimulated mostly by interferon γ and tumor necrotic factor α following various stressors, such as severe trauma, elective surgery, and sepsis [8].…”

Section: Discussionmentioning

confidence: 99%

“…The level of neopterin has been used as a marker of the inflammatory process in many surgical studies [7][8][9]. In critical care patients, high levels of urinary neopterin are associated with high mortality [10,11]. In the current study the effects of GA and LA on urinary neopterin were determined in CEA patients.…”

Section: Introductionmentioning

confidence: 91%

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Anaesthesia during Carotid Endarterectomy and Urinary Neopterin

Shearman

2012

ISRN Stroke

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Recent systematic reviews of randomized controlled trials show that the rate of postoperative complications after carotid endarterectomy (CEA) was not significantly different between operations performed under general anesthesia (GA) or local anesthesia (LA). However, these studies were not large enough to draw meaningful conclusions about any difference in mortality. This study therefore aimed to compare a surrogate endpoint of postoperative mortality between GA and LA by using urinary neopterin. 68 consecutive patients admitted electively for CEA were studied. Urinary neopterin levels were assayed preoperatively, immediately postoperatively (PO), 4, 6, 12, and 24 hrs PO. This study compared the level of urinary neopterin between GA and LA. Of the 68 CEAs, 48 operations were performed under GA. Urinary neopterin concentration in LA group increased PO and reached a peak at 6 hrs PO. At this point, the urinary neopterin levels in the GA group (85.3 μmol/mol creatinine) were significantly lower than those under the LA group (123.4 μmol/mol creatinine) (P = 0.02). We found that the level of urinary neopterin level after operation in LA was significantly higher than those under GA. More studies are needed.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

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Anaesthesia during Carotid Endarterectomy and Urinary Neopterin

Shearman

2012

ISRN Stroke

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“…Produksi neopterin erat kaitannya dengan aktivasi sistem imun seluler, sedangkan biosintesis neopterin dalam keadaan inflamasi itu disebabkan oleh peningkatan kadar interferon gama endogen yang dilepaskan dari sel limfosit T yang diaktifkan. 10,11 Berdasar atas kurva ROC, kadar AUC neopterin 98,1% (95% IK=0,882-1,000; p<0,001) secara statistik kadar tersebut tergolong sangat baik. Kadar AUC 98,1% artinya apabila kadar neopterin digunakan untuk memprediksi ada atau tidak perburukan pada sepsis neonatorum terdapat 98 neonatus yang mengalami perburukan.…”

Section: Pembahasanunclassified

Neopterin Serum sebagai Prediktor Dini Luaran Perburukan pada Sepsis Neonatorum

Hafidz

Yuniati

Solek

2017

GMHC

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AbstrakNeopterin telah diketahui sebagai biomarker untuk diagnostik sepsis neonatorum awitan dini. Hingga saat ini belum diketahui peran neopterin sebagai biomarker untuk memprediksi luaran sepsis neonatorum awitan dini maupun awitan lanjut. Tujuan penelitian ini menentukan neopterin serum sebagai biomarker prediktor sepsis neonatorum awitan dini dan lanjut. Penelitian dilakukan pada bulan Mei-Juli 2017 di RSUP Dr. Hasan Sadikin Bandung. Seluruh neonatus yang memenuhi kriteria sepsis neonatorum, yaitu didapatkan skor Tollner ≥10, dilakukan pemeriksaan neopterin serum menggunakan metode ELISA. Subjek kemudian diikuti dan dikelompokkan menjadi luaran perbaikan dan perburukan. Analisis menggunakan receiver operating characteristic (ROC) untuk mendapatkan luas area under curve, menentukan titik potong serta sensitivitas dan spesifisitas. Subjek penelitian terdiri atas 42 neonatus, mayoritas karakteristik neonatus yang mengalami luaran perburukan berjenis kelamin laki-laki (10 subjek), sepsis awitan dini (11 subjek), cara persalinan dengan operasi (11 subjek), dan tempat persalinan di RS (14 subjek). Temuan kadar neopterin pada luaran perburukan lebih tinggi dibanding dengan luaran perbaikan dan disimpulkan terdapat perbedaan yang bermakna (p<0,01). Kadar neopterin rata-rata yang didapatkan pada sepsis luaran perburukan 60,97 ng/mL dengan rentang kadar 40,63-92,04 ng/mL. Luas area di bawah kurva ROC kadar neopterin adalah 0,981 (95% IK=0,882-1,000; p<0,001). Kadar titik potong neopterin >43,13 dengan sensitivitas 94,1% dan spesifisitas 96,0%. Simpulan, kadar titik potong neopterin adalah 43,13 ng/mL serta memiliki sensitivitas 94,1% dan spesifisitas 96,0%. Biomarker ini dapat menjadi salah satu parameter dalam memprediksi dini luaran perburukan sepsis neonatorum awitan dini dan awitan lanjut. Kata kunci: Luaran, neopterin, sepsis neonatorum Neopterin Serum as Early Predictor of Poor Outcome in Neonatal Sepsis AbstractNeopterin was known as the biomarker for diagnosed early onset neonatal sepsis. Nowadays it has been proven for neopterin as predictors of poor outcome in early and late neonatal sepsis. The objective of this study was to determine serum levels of neopterin as predictors of poor outcome in early and late neonatal sepsis. The study held from May to July 2017 in Dr. Hasan Sadikin General Hospital Bandung. All subjects were neonatal sepsis with Tollner score ≥10 observed for serum levels of neopterin with ELISA method and then followed during hospitalization. The outcome defined as good and poor outcomes. The data were analyzed using receiver operating characteristic (ROC) for getting area under curved, cut-off point and also sensitivity, specificity. Research subjects consisted of 42 neonates, the majority which experienced poor outcomes were male (10 subjects), early onset sepsis (11 subjects), section cesarean procedure (11 subjects) and were born in a hospital (14 subjects). Serum neopterin levels findings significantly correlated with poor outcomes. Mean of poor outcomes in sepsis was 60.97 ng/mL with ...

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