Neopterin and Biochemical Parameters as Indicators of Predicting HIV Disease Progression and Treatment Response: A Cross-sectional Study in Ghana

Background: Surrogate markers have been identified to play significant role in the pathogenesis and prognosis of HIV infection. However, there is limited data on the utility of neopterin estimation in HIV infection. Therefore, the study sought to measure and ascertains the trends of serum neopterin and other biochemical parameters as indicators of predicting HIV disease progression and treatment response among HIV seropositive individuals Methods: A cross-sectional study with 298 HIV seropositive individuals consisting of 165 HIV on highly active antiretroviral treatment and 136 naïve highly active antiretroviral patients. Venous blood was drawn for the assay of neopterin and the other biochemical parameters.Results:Neopterin was significantly lower (P<0.0001) in patients in the highly active antiretroviral therapy than those in the naïve highly active antiretroviral therapy group. Serum neopterin increased as the disease progresses and decreased as the duration of the therapy treatment increased (p=0.0001). At a cut of point of 54.5nmol/L, neopterin gave a sensitivity of 97.5%, specificity of95.9% and an area under the curve of 0.99.Conclusion: Neopterin has shown to be to be good marker in predicting HIV disease progression especially in patients with CD4 counts less than 200mm-3and a useful indicator of patient’s response to therapy treatment.

Neopterin Levels and Indoleamine 2,3-Dioxygenase Activity as Biomarkers of Immune System Activation and Childhood Allergic Diseases

BACKGROUND: Although Th2 immune activation is predominant in allergic diseases, neopterinlevels and indoleamine 2,3-dioxygenase (IDO)-1 activity (kynurenine:tryptophan ratio), which reflect Th1 immune activity, increase with interferon-gamma (IFN-γ) stimulation. We investigated neopterin, tryptophan, and kynurenine levels as biomarkersof the Th1 immune system activation and changes in IDO-1 activityin children with asthma, allergic rhinitis, and atopic dermatitis, as well as the relationship between these biomarkers and the total IgE level, age, and disease severity. METHODS: We divided 205 children (80 girls and 125 boys, four months to 17 years old) into four groups: controls, patients with asthma, patients with allergic rhinitis, and patients with atopic dermatitis. Peripheral venous blood samples were collected. Neopterin levels were determined by an enzyme immunoassay. Tryptophan and kynurenine levels were analyzed using HPLC. IDO-1 enzyme activity was calculated using tryptophan and kynurenine levels. IgE levels were measured. The Mann-Whitney U test, Kruskal-Wallis test, and Conover post-hoc method were used for statistical analysis. RESULTS: Neopterin, tryptophan, and kynurenine levels were higher and IgE levels and IDO-1 enzyme activity were lower in patients with asthma and allergic rhinitis than in controls (P < 0.05). Patients with atopic dermatitis showed higher neopterin, tryptophan, and kynurenine levels, higher IDO-1 activity, and lower IgE levels thancontrols (P < 0.05). CONCLUSIONS: The Th1/Th2 balance is disrupted in children with allergic diseases, concomitant with increased Th1-mediated immune response activation and reduced IgEproduction, which is promoted by Th2-type cytokines.

Biochemical Analysis of Three Biological Fluids and its Response to Non-Surgical Periodontal Therapy in Pre and Postmenopausal Women with Periodontitis

OBJECTIVES: Periodontitis is a common chronic inflammatory disease characterized by the destruction of the supporting structures of the teeth. The stages of menopause also worsen inflammatory condition. Biomarkers from biological fluids can be used as a diagnostic indicator to correlate these two conditions of present and future disease activity. The aim of the present study was to evaluate the neopterin levels in three biological fluids obtained from pre- and postmenopausal women with periodontitis following non-surgical periodontal therapy (NSPT, that is, scaling).METHODS: This was a cross-sectional interventional study. Thirty women, aged 40–60 years, with periodontitis were selected according to their menstrual history. They were divided into the pre- and postmenopausal groups, with each group including 15 participants. The neopterin levels were measured in both groups at baseline and 3 months after NSPT. Intergroup comparison and percentage decrement analysis were performed using the independent sample t test, and intragroup comparison was performed using the paired t test.RESULTS: There were statistically significant reductions in the mean values of saliva, urine, and plasma from baseline to 3 months after NSPT in the groups. Intergroup comparison showed no significant values in the postmenopausal group, and a significant reduction was seen in the mean values was seen in the mean values.CONCLUSIONS: Neopterin levels decreased at 3 months after NSPT in both the groups, suggesting that NSPT can be a gold standard therapy and that the neopterin level could be a indicator to identify periodontal destruction.

The effect of periodontal therapy on neopterin and vascular cell adhesion molecule-1 levels in chronic periodontitis patients with and without acute myocardial infarction: a case-control study

Abstract The presence of neopterin in gingival crevicular fluid (GCF) is a marker for local and acute immune activation, and the presence of vascular cell adhesion molecule (VCAM-1) in GCF is accepted as a marker for chronic vascular inflammation. Objectives This study aimed to evaluate effects of periodontal treatment on GCF levels of neopterin and VCAM-1 in patients with chronic periodontitis (CP) with acute myocardial infarction (AMI) compared with systemically healthy CP patients. Material and methods Sixty subjects (20 CP patients with AMI, 20 healthy CP patients, and 20 healthy controls) were included. GCF samples were analyzed at baseline and after 3 and 6 months, and the probing pocket depth (PD), clinical attachment level (CAL), bleeding on probing, gingival (GI) and plaque (PI) indices were recorded. We determined neopterin and VCAM-1 levels (concentration and total amount) using enzyme-linked immunosorbent assay (ELISA). No significant differences were seen between the AMI+CP and CP groups for PI, GI, GCF levels of neopterin and VCAM-1 at baseline. Results The number of teeth with 5 mm≤CAL<7 mm and CAL≥7 mm were significantly increased in the AMI+CP group at baseline. There were no significant differences between the AMI+CP and CP for PI, CAL, GCF volumes, and the AMI+CP group had the highest clinical improvement in the number of teeth with 5 mm≤CAL<7 mm at the sixth month. There were significant positive correlations between clinical periodontal inflammation and the presence of neopterin and VCAM-1 in GCF prior to and following periodontal treatment, and between the GCF volume and clinical parameters. Conclusions Data suggest that the total amount and concentration of neopterin and VCAM-1 in GCF seemed to be closely associated with periodontal disease severity in CP patients with AMI. Moreover, the results of our study demonstrate that the past periodontal status is potentially correlated between groups, with similar periodontal disease severity.

The value of neopterin used in diagnosis and risk stratification of sepsis / 中华急诊医学杂志

Objective To explore the value of neopterin (Np) in early diagnosis and risk stratification of sepsis.Methods A total of 82 patients admitted to the emergency department from April 2013 to February 2014 were enrolled in the study.They were divided into two groups:sepsis-free group (n =8) and sepsis group (n =74).Patients' APACHE Ⅱ scores were calculated within 24 hours after admission,and then their plasma levels of Np and procalcitonin (PCT) were detected and analysis was carried out to find the correlation between plasma levels of Np,PCT and acute physiology and chronic health evaluation Ⅱ score (APACHE Ⅱ score) in two groups.And 74 patients in sepsis group were further divided into three subgroups according to their APACHE Ⅱ score:Ⅰ subgroup (score ＜ 15,n =27),Ⅱ subgroup (score 15 to 24,n =32),and Ⅲ subgroup (score ＞ 25 or more,n =15).The differences in plasma Np and PCT levels were compared among three subgroups and correlation analysis of Np levels with PCT levels and APACHE Ⅱ scores was carried out.Results The plasma levels of Np,PCT and APACHE Ⅱ scores in sepsis group were higher than those in sepsis-free group (P ＜ 0.05).In sepsis group,the plasma levels of Np and PCT were gradually increased with the increasing severity of sepsis (P ＜ 0.05);In sepsis group,the plasma levels of Np,PCT and APACHE Ⅱ scores were positively correlated (P ＜0.01).The area under receiver operating characteristic curve (ROC) of Np was O.79 and the area under ROC of PCT was 0.75,both of which had high diagnostic accuracy.Conclusions Neopterin has greatly useful value in early diagnosis and risk stratification of sepsis.

Comparative Evaluation of Salivary Neopterin Levels and Its Effects to Periodontal Therapy in Pre- and Post-Menopausal Women

OBJECTIVES: Neopterin is a valuable diagnostic biomarker, which is elevated in inflammatory conditions like periodontitis, that is characterized by destruction of the supporting structures of the teeth. Among the biomarkers, neopterin occurs in body fluids, and acts as a diagnostic marker for present and future disease activity. METHODS: Thirty female subjects with chronic periodontitis, mean age 50 years (40-60 years) were included in this study. Depending upon their menstrual history, subjects were categorized into two groups of fifteen each. Group I 15 pre-menopausal women, and Group II 15 post-menopausal women. Saliva was collected, and neopterin levels were assessed by enzyme-linked immunosorbent assay in both the groups, at base line and after three months of nonsurgical periodontal therapy (NSPT). Periodontal parameters like pocket probing depth (PD) and Russell's periodontal disease index (PDI) were assessed before treatment as well as after three months of scaling and root planning. RESULTS: Intra group analysis showed significant markdown in the mean values of all the parameters from baseline to three months (P < 0.001), for all patients. The intergroup comparison, from baseline to 3 months also showed no significant change in PD and PDI values, but there was a statistically significant difference in the salivary neopterin levels (P = 0.04). CONCLUSIONS: Neopterin levels were found to be reduced in three months after NSPT in both the groups, suggesting that the NSPT is the gold standard therapy, and also that neopterin levels in saliva can be used as an indicator to identify periodontal inflammation and destruction.

Clinical and laboratory features of HTLV-I asymptomatic carriers and patients with HTLV-I-associated myelopathy/tropical spastic paraparesis from the Brazilian Amazon

ABSTRACT Clinical and laboratory parameters including blood and cerebrospinal fluid (CSF) neopterin were investigated in human-T-lymphotropic-virus-type-I associated-myelopathy/tropical-spastic-paraparesis-HAM/TSP and in HTLV-I carriers. HAM/TSP (n = 11, 2 males/9 females, median age = 48 years), recently diagnosed HTLV-I carriers (n = 21, 15 females/6 males, median age = 44 years), healthy individuals (n = 20, 10 males/10 females, median age = 34.6 years) from the Brazilian Amazon (Manaus, Amazonas State) were investigated. Neopterin was measured (IBL ELISA Neopterin, Germany) in serum samples of all the participants, in CSF of 9 HAM/TSP patients as well as in 6 carriers. In HAM/TSP patients, CSF cell counts, protein and glucose were measured, the Osame’s motor-disability-score/OMDS was determined, and brain/spinal cord magnetic-resonance-imaging (MRI) was performed. HAM/TSP patients had normal CSF glucose, leukocyte counts; and normal protein levels predominated. Brain-MRI showed white-matter lesions in 7 out of 11 HAM/TSP patients. OMDS varied from 2-8: 9 were able to walk, 2 were wheel-chair-users. The median serum neopterin concentration in HAM/TSP patients was 6.6 nmol/ L; min. 2.8- max. 12.5 nmol/ L); was lower in carriers (4.3 nmol/L; min. 2.7- max. 7.2 nmol/ L) as well as in healthy participants (4.7 nmol/ L; min. 2.7- max. 8.0 nmol/ L) (p < 0.05). CSF neopterin concentrations in HAM/TSP patients were higher than in serum samples, and higher compared to carriers (p < 0.05). Carriers had similar serum-CSF neopterin concentrations compared to healthy participants. Variable clinical and laboratory profiles were seen in HAM/TSP patients, however our results support the neopterin measurement as a potential biomarker of disease activity.

Clinical diagnostic value of fecal neopterin and calprotectin on the activity of inflammatory bowel disease / 医学研究生学报

Objective Fecal biomarkers have emerged as an important tool for assessing and monitoring disease activity in patients with inflammatory bowel disease ( IBD) .We aimed to investigate the diagnostic value of fecal neopterin and calprotectin in pa-tients with active inflammatory bowel disease and made comparison with that of serum C-reactive protein ( CRP) . Methods A total of 151 consecutive patients with IBD (84 CD and 67 UC) provided 2 gram fecal samples for the measurement of fecal neopterin( FNP) and calprotectin( FCP) concentrations and 2 milliliter blood samples for the serum C-reactive protein measurement before undergoing a colonoscopy.ELISA was applied in the measurement.Clinical disease activities were scored independently according to the Best Crohn′s Disease Activity Index(CDAI) in patients with CD, while the Modi-fied Mayo Scores in patients with UC.Comaprison was made in the relativity of each fecal marker and IBD activity score, the optimum value of diagnosing IBD acitivity as to each fecal marker, as well as sensitivity, specificity, moreover, receiver operating characteristic curve ( ROC) was drawn.50 healthy volunteers who received a normal colonoscopy were also enrolled as the control group and asked to give a 2 gram fresh stool sample. Results The FNP and FCP concentrations in patients with IBD were significantly higher than those in healthy control group(P<0.05).Both FNP and FCP concentrations differed significantly in clinically active IBD when compared with those in patients with inactive disease( P<0.001) .In CD patients, the correlation coefficients of FNP and FCP with CDAI were 0.55 and 0.59, respectively(P<0.001).In UC patients, the correlation coefficients of FNP and FCP with Mayo scores were 0.74 and 0.77, respectively( P<0.001) .The correlation coefficients of serum CRP in CD and UC patients with clinical scores were 0.49 and 0.60, respectively(P<0.001).The area under the ROC curve(AUC) of FNP and FCP for the diagnosis of clinical activity in pa-tients with CD were 0.75 and 0.80, respectively.The AUC of FNP and FCP in UC patients were 0.85 and 0.90, respectively.The AUC of serum CRP in patients with CD and UC were 0.65 and 0.74, respectively.When combined FNP with FCP, the AUC in pa-tients with CD and UC were 0.85 and 0.92, respectively. Conclusion FNP is a novel reliable and non-invasive biomarker to evalu-ate clinical disease activity in patients with IBD as accurate as FCP, It is advisable to combine FNP with FCP to evaluate disease activi-ty in patients with IBD.

Measurement of serum neopterin in patients with nephritis and its significance / 国际检验医学杂志

Objective To evaluate the expression of serum neopterin in nephritic patients and its relationship with the prognosis of acute and chronic nephritis.Methods The levels of serum neopterin were determined in 40 patients with acute nephritis (A1 group)and 30 patients with chronic nephritis (A2 group)by enzyme-linked immunosorbent assay.The contents of serum creatinine and blood urea nitrogen were determined by Hitachi fully automatic biochemical analyzer.50 healthy blood donors were in the con-trol group.Results The levels of serum neopterin in acute nephritis and chronic nephritis were significantly higher than that in the normal group(P <0.05).The levels of serum neopterin in acute nephritis were significantly higher than that in chronic nephritis(P<0.05).The levels of serum creatinine and blood urea nitrogen in two nephritis group were significantly higher than that in the normal group(P <0.05).Conclusion The measurement of the serum neopterin may be a useful sensitive index for early diagnosis. This may be helpful for diagnosis and evaluation of therapy effect.

The clinical significance of serum neopterin and adenosine deaminase in patients with secondary hemophagocytic lymphohistiocytosis / 中华内科杂志

Objective To investigate the significance of plasma neopterin (Npt) and adenosine deaminase (ADA) in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).Methods Serum specimens from 39 patients with newly diagnosed sHLH,10 sHLH patients who had achieved clinical remission after treatment,and 15 healthy controls were collected.Serum Npt level was detected by enzyme linked immunosorbent assay (ELISA) and ADA activity was tested by kinetic method.Results Npt and ADA values in sHLH group were significantly higher than those in control group [Npt:(164.6 ± 90.0) nmol/L vs (7.9 ± 3.6) nmol/L; ADA:(117.2 ± 70.2) U/L vs (11.6 ± 4.0) U/L; all P ＜ 0.001].Among the 10 sHLH patients who obtained effective clinical treatment,posttreatment levels of Npt and ADA were significantly lower than pretreatment data [Npt:(17.5 ± 10.9) nmol/L vs (170.6 ± 117.9) nmol/L ; ADA:(22.5 ± 15.5) U/L vs (98.8 ± 52.6) U/L; all P ＜ 0.05].The Npt level in sHLH patients was positively correlated with the levels of serum soluble interleukin-2 receptor (sCD25) and serum ferritin (r =0.526 and r =0.507) ; while ADA activity had linear relationship with the level of lactate dehydrogenase (r =0.646).Receiver operating characteristic (ROC) curve analysis showed that 148.1 nmol/L was the critical value of serum Npt for the diagnosis of lymphoma associated hemophagocytic syndrome (LAHS) and the sensitivity and specificity were 70.0％ and 78.9％,respectively.As to ADA,103.1 U/L was the critical value for the diagnosis of LAHS and the sensitivity and specificity were 75.0％ and 84.2％,respectively.The sensitivity and specificity of combined parameters of Npt and ADA were 90.0％ and 94.7％,respectively.Conclusions It is concluded that Npt and ADA have great importance in the diagnosis and evaluation of therapeutic effect in patients with sHLH.Npt and ADA provide potential evidence to diagnose patients who are suspected with LAHS.

Estimation of salivary neopterin in chronic periodontitis.

Background: Periodontal diseases are the most common bacterial infection predominantly associated with Gram‑negative microorganisms that exist in the subgingival biofilm. Analysis of saliva provides a noninvasive means of evaluating the role of the host response in periodontal disease. Though salivary enzymes can be used as the biomarkers, neopterin has been recently used as one of the important diagnostic tools in the field of periodontics. Hence, we aimed to identify the neopterin levels in unsimulated saliva from the chronic periodontitis patients and compare them with the periodontally healthy subjects. Materials and Methods: Twenty subjects participated in the study and were categorized as the experimental group (chronic periodontitis patients) and control groups (healthy subjects). Unstimulated saliva samples were collected from both the groups for neopterin estimation. Neopterin in saliva was estimated using Shimadzu High Performance Liquid Chromatography with LC‑20AD pump system, equipped with RF‑10 AXL fluorescence detector. Statistical Analysis Used: Data were expressed as mean ± SD and analyzed using GraphPad Prism version 6.0 (California, USA). Statistical analysis was done by Student’s t‑test Results: The neopterin level in unstimulated saliva was found to be higher in the experimental group than the control group with P ≤ 0.05. Conclusions: The chronic periodontitis patients showed higher neopterin level in unstimulated saliva as compared to control. Hence, neopterin can be used as a potential biomarker for identification of the periodontal disease in its initial stage can help in preventing the disease progression.

The roles of neopterin in patients with coronary atherosclerotic heart disease / 中华检验医学杂志

Objective The study focused on the relationship between neopterin (NP),Gensini score and high-sensitivity C-reactive protein (hs-CRP) to explore the important role of the neopterin in patients with coronary heart disease.Methods Total of 442 patients,admitted to the Department of Cardiology at Renmin Hospital,Wuhan University from January 2012 to September 2012,were enrolled in this study.There were 176 patients in the control group and 266 patients with coroary disease in the experimental group.The Gensini score was used to assess the severity of the coronary lesions in the patients with coronary heart disease.The enzyme-linked immunosorbent assays (ELISAs) were used to measure the serum NP level.The other indicators were assessed by use of fully automatic biochemical and coagulation analyzers.The data were analyzed by using of SPSS19.0.T-test was used for analysis of the results between the control group and the experimental group.One-factor analysis variance (ANOVA) was used for comparisons of the results among the 3 groups,and Spearman correlation analysis was used for the correlation analysis between the NP level and Gensini score as well as hs-CRP level.Results The serum NP level was higher in the experimental group than that in the control group [(1.99 ± 0.37) vs (1.48 ± 0.29) ng/ml,P ＜0.05],and the NP level was positively correlated with the severity of coronary heart disease.Compared with the stable angina (SA) group,the serum NP level was significantly increased in the unstable angina (UA) group (2.00 ± 0.37) ng/ml and the acute myocardial infarction (AMI) group (2.10 ± 0.43) ng/ml (t =2.38,P ＜ 0.05).In addition,the serum NP level was positively correlated with the Gensini score (r =0.687,P＜0.001) as well as with the level of hs-CRP (r=0.190,P＜0.001).Conclusions The serum level of NP was significantly higher in patients with coronary heart disease and was positively correlated with the severity of coronary artery disease.Thus,NP may become a new indicator for the assessment of the inflammatory response in coronary atherosclerosis.

Comparative analysis of gingival crevicular fluid neopterin levels in health and periodontal disease: A biochemical study.

Background: Periodontitis involves intricate interactions of the biofilm with the host immunoinflammatory response and subsequent alterations in bone and connective tissue homeostasis. Neopterin is a marker, belonging to the class of pteridines, which is associated with cell-mediated immunity. It is produced by interferon-γ stimulated macrophages. The levels of neopterin in body fluids are elevated in infections, autoimmune diseases, malignancies and allograft rejections. This investigation was designed to estimate the levels of neopterin in gingival crevicular fluid (GCF) in health, chronic gingivitis and chronic periodontitis. Materials and Methods: Thirty subjects were divided into three groups of ten subjects each as with healthy periodontium (Group 1), chronic gingivitis (Group 2) and chronic periodontitis (Group 3). The GCF samples were obtained from the subjects by placing color-coded calibrated, volumetric, micro-capillary pipettes extracrevicularly. The samples were placed in plastic vials and stored at −70°C until the time of neopterin estimation using enzyme immunoassay. Results: The mean neopterin level in Group 3 (126.28 ± 37.70 nmol/L) is significantly higher than the mean neopterin level in Group 1 (48.66 ± 18.82 nmol/L) and Group 2 (70.68 ± 18.26 nmol/L) (P < 0.05). However, there is no significant relationship between neopterin levels and various clinical parameters in each study group (P > 0.05). Conclusions: The results of our study indicate that the neopterin levels in GCF are positively associated with periodontal disease, which may provide a useful tool in monitoring its progression. Nevertheless, further longitudinal studies are required with larger sample sizes in which neopterin levels are progressively estimated and compared to baseline values.

Proatherogenic or antiatherogenic high density lipoprotein type in acute coronary syndrome and healthy male person.

Aim: To make proatherogenic/antiatherogenic HDL type criteria using Apolipoprotein A-I (ApoA-I), Paraoxonase-1 (PON-1), Neopterin and HDL-cholesterol levels, which may be useful in clinical practice. Methods: This was a case control study recruiting 52 subjects with Acute Coronary Syndrome (ACS) and 30 control healthy subjects. HDL type was classifi ed into antiatherogenic and proatherogenic based on the levels of ApoA-I, PON-1, Neopterin and HDL-cholesterol. Concentrations of ApoA-I was measured by immunoturbidimetry method, PON-1 was measured by colorimetric method, Neopterin was measured by ELISA, and HDL-C was determined by homogenous method. Univariate logistic regression analysis was done using ACS as a dependent variable and levels of ApoA-I, PON-1, Neopterin and HDL-cholesterol as independent variables. Proatherogenic/antiatherogenic HDL type was determined by using ApoA-I, PON-1, Neopterin and HDL-cholesterol cut off and odd ratios. Results: Patient’s age was 50.89 + 12.63 year, HDL-C was 39.82 + 9.84 mg/dL, Apo A-1 was 119.77 + 32.05 mg/ dL, PON-1 was 41.26 + 18.19 kU/L, Neopterin was 16.22 + 38.10 nmol/L. Cut offs of ApoA-I, PON-1 and Neopterin successively were 124.5 mg/dL, 40.8 kU/L, and 7.016 nmol/L. On univariate logistic regression analysis showed that OR of ApoA-I, PON-1 and Neopterin respectively were 29.759 (95% CI : 4.074 – 217.382), 1.647 (95% CI : 0.412 – 6.586), 4.317 (95% CI : 1.098 – 16.977). Using scoring system, we concluded that total score > 18 was proatherogenic HDL type, and total score < 18 was antiatherogenic HDL type. With this scoring we found 78.85% had proatherogenic HDL type in ACS population. Conclusions: Dysfunctional HDL or proatherogenic/antiatherogenic HDL type can be predicted by using ApoA-I – PON-1 – Neopterin – HDL-cholesterol scoring system. Those with score of 18 are supposed to have antiatherogenic HDL type, and those with score of > 18 were having proatherogenic HDL type.

Evaluation of procalcitonin and neopterin level in serum of patients with acute bacterial infection

BACKGROUND: Fever as a common presenting complaint in pediatric patients can be due to various causes. Differentiating bacterial infection from other causes is important because the prompt use of antibiotics is critical in bacterial infection. Traditional markers of infection such as BT and WBC count may be unspecific and culture may be late or absent. CRP and Procalcitonin (PCT) have been considered to evaluate the evolution of infections and sepsis in patients presenting with SIRS. Neopterin has also been proposed to aid in the diagnosis of bacterial infection. In this study, we compared the value of the serum PCT, neopterin level, and WBC count for predicting bacterial infection and outcome in children with fever. METHODS: 158 pediatric (2-120-month-old) patients suspected to have acute bacterial infection, based on clinical judgment in which other causes of SIRS were ruled out were included in the study. WBC count with differential was determined and PCT and neopterin levels were measured. RESULTS: PCT level was higher in bacterial infection and patients who were complicated or expired. CONCLUSION: Rapid PCT test is superior to neopterin and WBC count for anticipating bacterial infection, especially in ED where prompt decision making is critical. ABBREVIATIONS: BT, body temperature; WBC, white blood cell; PCT, procalcitonin; CRP, C-reactive protein; SIRS, systemic inflammatory response syndrome; ED, emergency department.

Incomplete immunological recovery following anti-tuberculosis.

Background & objectives: Mycobacterium tuberculosis infection has been shown to result in increased HIV replication and disease progression in HIV-infected individuals through increased immune activation. The objective of this study was to correlate plasma levels of immune activation markers with the presence of tuberculosis (TB) in HIV-infected and uninfected individuals, and to study the changes following anti-tuberculosis treatment. Methods: Plasma markers of immune activation - neopterin, beta-2-microglobulin (β2M) and soluble tumour necrosis factor alpha receptor type I (sTNFα-RI) were measured by ELISA in 42 HIV positive TB patients (HIV+TB+) undergoing a six-month course of TB chemotherapy. Thirty seven HIV+ persons without active TB, 38 TB patients without HIV infection, and 62 healthy volunteers served as controls. Results: Plasma levels of all three markers were elevated in HIV+ individuals, more so in those with active TB. When HIV+ individuals were further categorized based on CD4+ T cell counts, HIV+TB+ patients with CD4+ T cells counts < 200 cells/μl were found to have the highest levels at baseline with a steep fall in neopterin and sTNFα-RI during treatment, but in most instances the levels did not drop to normal. β2M levels remained persistently high despite completing TB treatment. Interpretation & conclusions: The fi ndings of the study suggest that both HIV and TB act synergistically to activate the host immune system. Although ATT was effective in clearing M. tuberculosis infection, a high proportion of HIV+ TB patients continued to have levels well above the normal range, indicating that underlying immune activation persists despite TB treatment. None of the markers were specific enough to be used to assess cure of TB.

Evaluation of ELISA Method for Detection of Neopterin / 中华医院感染学杂志

OBJECTIVE To evaluate the detect method of neopterin(Npt) by enzyme-linked immunosorbent assay(ELISA) and discuss the application of Npt in the viral encephalitis.METHODS The Npt was detected by ELISA.The methodology was investigated by sensitivity,precision,rate of recovery,interference and reference value.The npt was detected by ELISA assay in peripheral blood of 50 healthy people,30 cases of cerebrospinal fluid in children with viral encephalitis and 12 cases of cerebrospinal fluid in the control group.RESULTS In this method,within-run CVs were 4.94% and 5.55%;between-run CVs were 5.99% and 6.57%.The sensitivity was 1.08 nmol/L;the rate of recovery was 95.8-107.8%.Various indexes of the methodology coincided with the requirements of clinical laboratory.The reference value of serum Npt was 0-7.84 nmol/L.The Npt of cerebrospinal fluid was(34.09 ? 36.34) nmol/L in the viral encephalitis group,and(4.55 ? 2.89)nmol/L in the control group,and the Npt of cerebrospinal fluid in patient was significantly higher than that in control group(P

Clinical value of urinary neopterin in monitoring of pulmonary tuberculosis drug resistance in 112 children / 国际检验医学杂志

Objective To investigate the clinical value of urinary neopterin in monitoring of pulmonary tuberculosis drug resistance in 112 children.Methods Slip diffusion method was applied to performing tuberculosis drug resistance test. According to the detecting results, 112 children with active pulmonary tuberculosis were divided into resistance group(n=48) and non-resistance group(n=64). 50 healthy children were enrolled as healthy control group. ELISA was employed to measure the urinary neopterin level for all subjects.Results There were statistical differences in urinary neopterin levels among resistance group, non-resistance group and healthy control group. The urinary neopterin level was more elevated in patients with pulmonary tuberculosis than that of healthy controls;while, the urinary neopterin level was much higher in resistance group than that of non-resistance group.Conclusion Not only does the measurement of urinary neopterin play a assisted role in diagnosis of pulmonary tuberculosis in children, but also it is of prewarning value in monitoring of children pulmonary tuberculosis drug resistance. As a non-invasive, rapid, simple and sensitive preliminary screening index, urinary neopterin is worthy of spreading and applying in clinic.

The significance of detecting interferon-?,adenosine deaminase and neopterin in the diagnosis of tuberculous pleural effusion / 重庆医科大学学报

Objective:To evaluate the significance of determination of the activity of adenosine deaminase(ADA),and the level of interferon(IFN-?) and neopterin(Npt) in the diagnosis of tuberculous pleuritis.Methods:Enzyme-linked immunosorbent assay(ELISA) and couple velocity assay were used to detect the activity of ADA,and the level of IFN-? and neopterin in 43 patients with tuberculous pleuritis and 38 patients with pleural effusion associated with malignant tumor or other causes and the receiver operating characteristic(ROC) curves were also protracted.Results:The activity of ADA,and the level of IFN-? and neopterin(P

Relationship between Serum Neopterin and D-Dimer Levels and Coronary Artery Dilatation in Kawasaki Disease / 实用儿科临床杂志

Objective To detect the levels of serum neopterin(NP) and D-dimer,and explore whether NP and D-dimer levels respond to coronary artery dilatation(CAD) of Kawasaki disease(KD),and evaluate the risk factors of CAD.Methods This study were conducted on 45 children with KD.Twenty-one children were CAD and 24 cases were not CAD.Active phase serum NP,D-dimer levels were measured by sensitive enzyme-linked immunosorbent assay(ELISA).Multiple regression analysis including platelet(PLT),monocyte(M),creatine kinase-MB(CK-MB),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),cardiac troponin I(cTnI) were studied with CAD.Results Compared with recovery phase,active phase the levels of PLT,M,CK-MB,CRP,ESR,cTnI were significantly higher(Pa