The Value of Neopterin and Procalcitonin in Patients with Sepsis

Fışgın, Nuriye Taşdelen; Aliyazıcıoğlu, Yüksel; Tanyel, Esra; Çoban, Ahmet Yılmaz; Ülger, Fatma; Zivalioglu, Muammer; Esen, Şaban; Leblebicioğlu, Hakan

doi:10.1097/smj.0b013e3181cf11a1

Cited by 24 publications

(12 citation statements)

References 25 publications

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“…There was no significant difference in neopterin levels between patients with febrile neutropenia and underlying haematological and oncological conditions and gram-negative versus gram-positive infections [ 61 ]. In patients on an intensive care unit with sepsis and septic shock urinary neopterin/creatinine ratios were found to be significantly higher compared to patients with other forms of systemic inflammatory responses syndromes [ 62 ] and serum neopterin levels were higher in nonsurvivors compared to survivors of sepsis and multiorgan failure scores correlated with neopterin levels [ 63 – 66 ]. In this context it was however noted that neopterin levels correlated negatively with reduced renal function reflecting renal failure causing a reduced excretion of neopterin.…”

Section: Neopterin Levels In Bacterial Infectionsmentioning

confidence: 99%

Neopterin in Diagnosis and Monitoring of Infectious Diseases

Eisenhut

2013

Journal of Biomarkers

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Neopterin is produced by activated monocytes, macrophages, and dendritic cells upon stimulation by interferon gamma produced by T-lymphocytes. Quantification of neopterin in body fluids has been achieved by standard high-performance liquid chromatography, radioimmunoassays, and enzyme-linked immunosorbent assays. Neopterin levels predict HIV-related mortality more efficiently than clinical manifestations. Successful highly active antiretroviral therapy is associated with a decrease in neopterin levels. Elevated neopterin levels were associated with hepatitis by hepatitis A, B, and C viruses. Serum neopterin levels were found to be a predictor of response to treatment of chronic HCV infection with pegylated interferon combined with ribavirin. Neopterin levels of patients with pulmonary tuberculosis were found to be higher in patients with more extensive radiological changes. Elimination of blood donors with elevated neopterin levels to reduce risk of transmission of infections with known and unknown viral pathogens has been undertaken. Neopterin measurement is hereby more cost effective but less sensitive than screening using polymerase chain reaction based assays. In conclusion neopterin is a nonspecific marker of activated T-helper cell 1 dominated immune response. It may be a useful marker for monitoring of infectious disease activity during treatment and for more accurate estimation of extent of disease and prognosis.

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Section: Neopterin Levels In Bacterial Infectionsmentioning

confidence: 99%

Neopterin in Diagnosis and Monitoring of Infectious Diseases

Eisenhut

2013

Journal of Biomarkers

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“…Conversely, the group of survivors had lower serum neopterin levels [ 26 ]. In addition to being an inflammatory response marker, neopterin also serves as a significant prognostic factor for sepsis [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Neopterin, kynurenine and tryptophan as new biomarkers for early detection of rectal anastomotic leakage

Dušek

Örhalmi

Sotona

et al. 2018

wiitm

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IntroductionAt present, there are no strong predictors, nor a useful scoring system, that clearly identifies patients at risk for anastomotic leakage.AimThis study aimed to investigate a new method that assesses this risk by monitoring levels of neopterin, tryptophan, and kynurenine, in bodily fluids.Material and methodsThis prospective study included patients who underwent elective rectal resection for carcinoma. The basic condition for inclusion was rectal anastomosis using the double-stapling technique. Preoperative levels of neopterin, tryptophan, kynurenine, and their ratios, were assessed with blood and urine samples. These levels were then monitored for 6 postoperative days in venous blood, urine, and abdominal drainage fluid.ResultsA total of 42 patients were enrolled in the study. Thirty-six patients underwent a laparoscopic resection and 6 patients had an open procedure. No differences were found among neopterin, tryptophan, and kynurenine serum levels. However, the groups were observed to have significant differences in the urinary neopterin/creatinine ratio: the preoperative neopterin/creatinine ratio was 139.5 μmol/mol in the group with leakage, vs 114.8 μmol/mol in the group without complications, p = 0.037. The same results were observed during the postoperative period, p = 0.012. Additionally, the group with complications had a higher mean value of neopterin in drainage fluid, p = 0.048.ConclusionsOur study demonstrated that high preoperative levels of urinary neopterin could be interpreted as a risk for anastomotic leakage. Moreover, pathological levels of neopterin in urine and abdominal drainage fluid could be useful for early identification of anastomotic leakage during the postoperative period prior to its clinical development.

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“…Timely and accurate diagnosis of postoperative infectious complications determines whether and when to administer antibiotics. Indeed, elevations in LF and NT have been used to direct antibiotic therapy [ 11 , 21 ], but the predictive value of LF and NT has not been explored in patients with SCI. In the present study, we addressed the issue by examining the serum LF and NT levels for diagnosing early postoperative infectious complications in a large cohort of SCI patients.…”

Section: Discussionmentioning

confidence: 99%

“…Elevated serum NT occurs before the peak proliferation of T cells and is also a potential marker for predicting peripheral infections after surgery and central nervous system infection [ 9 ]. In fact, increased NT was more specific than CRP for diagnosing patients with septic complications [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Elevated serum lactoferrin and neopterin are associated with postoperative infectious complications in patients with acute traumatic spinal cord injury

Huang¹,

Du²,

Wei³

et al. 2013

aoms

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IntroductionSeveral studies have shown that lactoferrin (LF) and neopterin (NT) are correlated with infection. The aim of this study is to determine whether serum levels of LF and NT are associated with postoperative infectious complications in patients with acute traumatic spinal cord injury.Material and methodsA total of 268 patients with acute traumatic spinal cord injury who underwent spinal surgery were enrolled in this study. Serum levels of LF, NT, and C-reactive protein (CRP), in addition to white blood cell count (WBC) and erythrocyte sedimentation rate (ESR), were measured preoperatively and 24 h postoperatively.ResultsIn total, 22 of 268 patients (8.2%) developed postoperative infectious complications. The levels of serum LF, NT, and CRP were significantly higher in the infected patients than in the non-infected patients. No significant differences were observed in postoperative WBC count and ESR between the two groups. Multivariate logistic regression revealed that LF (OR: 1.004 (1.002–1.007)), NT (OR: 1.137 (1.054–1.227)), and CRP (OR: 1.023 (1.002–1.044)) were significantly associated with the presence of postoperative infectious complications. The area under receiver operating characteristic curves for LF, NT, and CRP was 0.709, 0.779, and 0.629, respectively.ConclusionsElevated serum concentrations of LF and NT are associated with early infection after surgery. Compared to CRP, elevated levels of LF and NT are better indicators for predicting postoperative infectious complications in patients with acute traumatic spinal cord injury.

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The Value of Neopterin and Procalcitonin in Patients with Sepsis

Abstract: NT was found to be a prognostic factor in patients with sepsis.

Cited by 24 publications

References 25 publications

Neopterin in Diagnosis and Monitoring of Infectious Diseases

Neopterin in Diagnosis and Monitoring of Infectious Diseases

Neopterin, kynurenine and tryptophan as new biomarkers for early detection of rectal anastomotic leakage

Elevated serum lactoferrin and neopterin are associated with postoperative infectious complications in patients with acute traumatic spinal cord injury

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