ABSTRACT
Rheumatoid arthritis [RA] is a common disease with widely varying severity. A significant proportion of patients have a chronic course with progressive joint destruction and disability. Anti-rheumatoid drug therapy is potentially toxic and therefore needs to be directed at those most likely to benefit. Measurement of serum levels of products released from macrophages, lymphocytes, polymorphs or plasma cells may supply information about different aspects of the disease process. The aim of this work was to study the monocyte/macrophage activation in rheumatoid patients by measuring neopterin concentrations in patient's sera to reflect the value of this parameter in detecting rheumatoid disease activity. Thirty-six patients [34 females and 2 males] with various grades of rheumatoid arthritis and 20 healthy controls were screened for serum neopterin levels using radioimmunoassay. Our results showed statistically significant elevation [p < 0.05] of serum neopterin of patients with grade III and IV rheumatoid activity, compared to healthy controls. In grade II [mild rheumatoid activity] the difference was insignificant [p > 0.05]. In conclusion neopterin, a new biochemical marker, can be used as a reliable sensitive and reproducible in rheumatoid disease. Its direct relation to the pathogenesis of the disease, correlation with clinical disease activity and its significant elevation when the disease becomes more active, recommend neopterin as an activity marker