Plasma Neopterin as an Adjunct to C-Reactive Protein in Assessment of Infection

Abstract

C-reactive protein (CRP) concentrations are increased in plasma in people with inflammatory conditions and bacterial infections. Plasma neopterin concentrations are increased in people with bacterial septicemias, viral infections, and graft vs host disease. Plasma concentrations of CRP and neopterin were measured daily in 21 bone-marrow transplant (BMT) patients, 64 patients in intensive-care units (ICU), and 12 patients with squamous cell carcinoma of the head and neck (HN). In the BMT patients, plasma neopterin measurements in addition to CRP measurements allowed infectious episodes to be distinguished from graft vs host disease. In the ICU patients, increased concentrations of CRP were not specific for infection and the additional plasma neopterin measurements did not improve this specificity. In all three patient groups, the derivation of a neopterin/CRP ratio was of no clinical use. These three groups of patients showed patterns of CRP and neopterin concentrations characteristic of their underlying diseases, the BMT patients with the immunological activation of graft vs host disease showed predominantly increased concentrations of plasma neopterin, ICU patients with infectious and inflammatory conditions had increased concentrations of both CRP and neopterin in plasma, and the HN group with localized inflammation showed increased plasma concentrations of CRP without increases in neopterin.

Usefulness of procalcitonin for differentiation between activity of systemic autoimmune disease (systemic lupus erythematosus/systemic antineutrophil cytoplasmic antibody-associated vasculitis) and invasive bacterial infection

“…Of particular interest was the course of PCT levels during clinically highly active disease. Neopterin, interleukin-6 (IL-6), and CRP, 3 other marker proteins of systemic inflammation (10)(11)(12), were tested in parallel.…”

Neopterin Counters Vascular Inflammation and Atherosclerosis

“…This study investigated the roles of neopterin in both pathophysiology and treatment of atherosclerosis. Because neopterin can exert atheroprotective effects in all 3 types of vascular cells, as with incretins, adiponectin, omentin 1, urocortin 1, catestatin 1, and tumor necrosis factor–stimulated gene 6, neopterin is a convincing candidate as a therapeutic agent against atherosclerosis. Further studies are needed to determine pharmacodynamics and pharmacokinetics of neopterin in animals and humans.…”

“…Blood was drawn from 92 patients with angiographically proven CAD who were hospitalized at Showa University Hospital (64 men, 28 women; aged 40–82 years), including 22 with unstable angina pectoris, 67 with acute myocardial infarction, 2 with recent myocardial infarction, and 1 with old myocardial infarction; in addition, 43 age‐matched non‐CAD patients (17 men, 26 women; aged 50–82 years) with mild hypertension, diabetes mellitus, and dyslipidemia were recruited because plasma neopterin levels are known to correlate with age . Exclusion criteria (confirmed by medical history and routine laboratory examination) included patients with infection and inflammatory disease, as both increase plasma neopterin levels . Plasma neopterin levels were measured using the neopterin ELISA kit.…”

Rheumatoid arthritis and bacterial infections

“…Внутрисуставное введение ГК за 12 мес до выявления очага инфекции выполнялось 8(17,4 %) больным. [52], так и для мониторирования бакте риальных инфекционных осложнений [48]. В ходе нашего исследования выявлено снижение hs-CPB по мере санации очага инфекции, однако достовер ной динамики не отмечено, что может объясняться небольшим размером выборки, а также повыше нием активности РА ввиду отмены БПВП у ряда пациентов.…”