RESUMO
To compare between serum neopterin level in rheumatoid arthritis [RA] patients [active and nonactive], patients with some parasitic intestinal nematodes infestation and with normal controls. The patient groups were chosen to represent diseases in which cell mediated immunity is involved in the disease process. Also, to correlate changes in serum neopterin level with status of disease activity in patients with rheumatoid arthritis [RA] and with the load of some intestinal nematodes infestation. This study was done on the following groups. Group I included 20 inactive RA patients [8 males and l2females, 18-50 years old], Group II which included 20 active RA patients [7 males and 13 fema1es, 18-60 years old], Group III included 16 patients with enterobiasis [6 males and 10 females, 5-35 years old], group IV included 12 patients with ascariasis [8 males and 4 females, 4-30 years old], group V included 12 patients with ancylostomiasis [10 males and 2 females, 12-50 years old] and group VI which included 10 normal subjects [5 males and 5 females, 10-35 years old] with no evidence of any rheumatological disorder or parasitic infestation as a control group. RA disease activity was assessed according to the presence or absence of morning stiffness, pain, grip strength, and articular index. Group I, II and VI were subjected to full medical history and clinical examination, CBC and ESR, assay of rheumatoid factor [RF] by Rose-Waaler test, and X-ray on the affected joints and graded by modified Larsen et al. [1977] index .Group III, IV, V, and VI were subjected to full medical history and clinical examination, repeated stool analysis, perianal swab for suspected cases of pinworm infestation, and estimation of parasitic load. Quantitative measurement of serum neopterin was done for all persons included in the study. In RA patients both groups [I and II] were matched regarding age and disease duration. ESR and serum neopterin levels were higher in active disease group [highly significant difference]. In all RA patients there was a positive correlation between ESR and serum neopterin, and between ESR and serum RF levels. In group I, a positive correlation was found between ESR and serum neopterin levels. In group II, a positive correlation was found between age and disease duration, ESR and serum neopterin levels, ESR and serum RF levels, and between serum neopterin and serum RF levels. Also, serum neopterin was significantly elevated in groups III, IV, and V when compared to group VI. A highly significant difference was found on comparing serum neopterin level between patients with active RA and all parasitic patients, active RA and controls, inactive RA and controls, and all parasitic patients and controls [being higher in the former groups], while it was insignificant on comparing inactive RA and all parasitic patients. Furthermore, serum neopterin was significantly increased with increased parasitic load. Serum neopterin is significantly higher in sera of active RA patients and correlates with disease activity and also it is significantly higher in sera of patients with intestinal nematodes infestation and its level progressively rises with the increase in the parasitic load