Study of neopterin in liver diseases

ABSTRACT

Liver diseases in children represent a major and complicated health problem especially in developing countries. Early detection of liver disease is helpful in arresting the disease progress and anticipating the prognosis and risk of recurrence in the family. Neopterin, which is released from human macrophages, is an indicator for the activation of the cellular immune system. Increased concentrations were reported in viral and bacterial infections, allograft rejection, malignant diseases, HIV and autoimmune disease. In all these cases, enhanced concentrations of neopterin have been shown to have prognostic significance. The objective of this work was to define whether neopterin can be used as a marker to determine differences in liver diseases according to etiology and stages of diseases, and whether neopterin concentrations could be correlated with other laboratory investigations. The present study was conducted at the Pediatric Hepatology Unit, Children Hospital, Cairo University. The study included 60 children [34 males and 26 females] representing a broad etiological spectrum of acute and chronic liver diseases. Their age ranged from 2 months to 10 years with a mean of 5.5 years. Thirty age- and sex-matched healthy children served as controls. Routine as well as specific investigations were done to all studied cases and serum neopterin concentrations were measured by enzyme-linked immunoassay. The results showed that increased serum neopterin concentration were found in 63% of alI patients with various liver diseases [n = 60]. Patients with liver abscess had appreciably the highest neopterin values [mean +/- SD, 150 +/- 3.45 nmol/g and the lowest were found in patients with glycogen storage disease [1.98 2 0.52 nmol/l]. Patients with acute liver disease have significantly higher mean neopterin [25.35 +/- 55.32 nmol/l, p = 0,025] than patients with chronic cirrhotic [3.24 +/- 2.29 nmol/l, p = 0.017] and chronic non- cirrhotic liver diseases [4.28 +/- 2.99 nmol/l, p = 0.003]. Neopterin tended to be higher in patients with non- cirrhotic liver disease in comparison to those with cirrhotic liver disease. However, the difference between the two groups was insignificant [p = 0.222]. In all patients, most of the diagnostic parameters of liver function tests were significantly elevated when compared to controls but they did not correlate with serum neopterin concentrations. Similar insignificant correlations were found between serum neopterin concentrations and blood indices