Serum neopterin in patients with Chagas disease

Grotto, Helena Zerlotti Wolf; Costa, Fernando Ferreira; Carnéiro, Márcia Victor; Neto, Gentil Claudino Galiza

doi:10.1016/0035-9203(94)90506-1

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…A meta-analysis was performed using 91 studies with sufficient, nonoverlapping data on patient age divided by disease stage (Figure 2). 12,16,20,23,25,27,[29][30][31][32][34][35][36][37][38]41,[44][45][46][47]49 157,158,161,165,[168][169][170] In this analysis, older patient age was significantly associated with risk of Chagas cardiomyopathy, with an overall effect size (Hedge's g) of 0.66 (95% CI: 0.41-0.91). Heterogeneity in this analysis was high (97%).…”

Section: Resultsmentioning

confidence: 71%

Risk Factors for Progression to Chronic Chagas Cardiomyopathy: A Systematic Review and Meta-Analysis

Cutshaw

Sciaudone

Bowman

2023

The American Journal of Tropical Medicine and Hygiene

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Approximately one-third of people with chronic Trypanosoma cruzi infection develop Chagas cardiomyopathy, which carries a poor prognosis. Accurate prediction of which individuals will go on to develop Chagas cardiomyopathy remains elusive. We performed a systematic review of literature comparing characteristics of individuals with chronic Chagas disease with or without evidence of cardiomyopathy. Studies were not excluded on the basis of language or publication date. Our review yielded a total of 311 relevant publications. We further examined the subset of 170 studies with data regarding individual age, sex, or parasite load. A meta-analysis of 106 eligible studies indicated that male sex was associated with having Chagas cardiomyopathy (Hedge’s g: 1.56, 95% CI: 1.07–2.04), and a meta-analysis of 91 eligible studies indicated that older age was associated with having Chagas cardiomyopathy (Hedge’s g: 0.66, 95% CI: 0.41–0.91). A meta-analysis of four eligible studies did not find an association between parasite load and disease state. This study provides the first systematic review to assess whether age, sex, and parasite load are associated with Chagas cardiomyopathy. Our findings suggest that older and male patients with Chagas disease are more likely to have cardiomyopathy, although we are unable to identify causal relationships due to the high heterogeneity and predominantly retrospective study designs in the current literature. Prospective, multidecade studies are needed to better characterize the clinical course of Chagas disease and identify risk factors for progression to Chagas cardiomyopathy.

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Section: Resultsmentioning

confidence: 71%

Risk Factors for Progression to Chronic Chagas Cardiomyopathy: A Systematic Review and Meta-Analysis

Cutshaw

Sciaudone

Bowman

2023

The American Journal of Tropical Medicine and Hygiene

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“…In our analysis there were clear differences between the CSF of patients in stage 1 and late stage 2 HAT. Neopterin has previously been seen in stage 2 HAT patients, but its use as a biomarker is limited by the wide range of inflammatory disorders it is predictive of [18,50,51]. That, and the fact that our cohort contained only advanced stage 2 samples, is why specificity is much lower in the field [50].…”

Section: Discussionmentioning

confidence: 96%

Metabolomics Identifies Multiple Candidate Biomarkers to Diagnose and Stage Human African Trypanosomiasis

et al. 2016

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Treatment for human African trypanosomiasis is dependent on the species of trypanosome causing the disease and the stage of the disease (stage 1 defined by parasites being present in blood and lymphatics whilst for stage 2, parasites are found beyond the blood-brain barrier in the cerebrospinal fluid (CSF)). Currently, staging relies upon detecting the very low number of parasites or elevated white blood cell numbers in CSF. Improved staging is desirable, as is the elimination of the need for lumbar puncture. Here we use metabolomics to probe samples of CSF, plasma and urine from 40 Angolan patients infected with Trypanosoma brucei gambiense, at different disease stages. Urine samples provided no robust markers indicative of infection or stage of infection due to inherent variability in urine concentrations. Biomarkers in CSF were able to distinguish patients at stage 1 or advanced stage 2 with absolute specificity. Eleven metabolites clearly distinguished the stage in most patients and two of these (neopterin and 5-hydroxytryptophan) showed 100% specificity and sensitivity between our stage 1 and advanced stage 2 samples. Neopterin is an inflammatory biomarker previously shown in CSF of stage 2 but not stage 1 patients. 5-hydroxytryptophan is an important metabolite in the serotonin synthetic pathway, the key pathway in determining somnolence, thus offering a possible link to the eponymous symptoms of “sleeping sickness”. Plasma also yielded several biomarkers clearly indicative of the presence (87% sensitivity and 95% specificity) and stage of disease (92% sensitivity and 81% specificity). A logistic regression model including these metabolites showed clear separation of patients being either at stage 1 or advanced stage 2 or indeed diseased (both stages) versus control.

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“…Human monocytes and macrophages produce and release neopterin after activation by INF-c [47]. Neopterin is a pteridine derived from guanoside triphosphate and has been recognized as an indicator of cell-mediated immuneresponse activity in several conditions, such as organ transplantation, rheumatoid arthritis, systemic lupus erythematosus, diabetes and a number of infectious diseases [48][49][50][51][52][53].…”

Section: Causes Of Anaemiamentioning

confidence: 99%

Anaemia of cancer: an overview of mechanisms involved in its pathogenesis

Grotto

2007

Med Oncol

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Anaemia is a common complication in cancer patients. The decrease in haemoglobin is associated with an impaired quality of life, poorer response to therapy and worse prognosis. Numerous factors are involved in the physiopathology of cancer-related anaemia. Some factors such as bleeding, bone marrow infiltration, the effects of chemoradiotherapy and associated nutritional deficiencies are related to the disease itself. In addition, the interaction of the immune system with iron metabolism and erythropoiesis has been shown to be an important factor in the development of anaemia in cancer patients and can be seen in the action of several cytokines on different iron-homeostasis and erythrocyte-cell-production pathways. Some inhibitory cytokines, such as tumour necrosis factor-alpha and interleukin-1, act on the suppression of erythroid precursor cells and erythropoietic production and response; others, such as interleukins 1 and 6 and hepcidin, impair iron metabolism, causing iron to be diverted from erythropoiesis and retained within the reticuloendothelial system. The main mechanisms involved in the development of cancer-related anaemia are discussed in this review.

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Serum neopterin in patients with Chagas disease

Cited by 4 publications

References 6 publications

Risk Factors for Progression to Chronic Chagas Cardiomyopathy: A Systematic Review and Meta-Analysis

Risk Factors for Progression to Chronic Chagas Cardiomyopathy: A Systematic Review and Meta-Analysis

Metabolomics Identifies Multiple Candidate Biomarkers to Diagnose and Stage Human African Trypanosomiasis

Anaemia of cancer: an overview of mechanisms involved in its pathogenesis

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