Neopterin in pulmonary tuberculosis and lung cancer patients

ABSTRACT

Neopterin is produced and released by human macrophages in response to stimulation with interferon-gamma, and changes in neopterin concentrations indicate cellular immune activation. To assess the usefulness of serum, urine and pleural fluid neopterin levels as an index of disease activity in patients with pulmonary tuberculosis and lung cancer. Serum, urine and pleural fluid neopterin levels were evaluated in 30 patients with pulmonary tuberculosis and 30 patients with lung cancer while serum and urine neopterin levels were evaluated in 20 healthy controls by enzyme linked imunosorbent assay [ELISA] technique. The neopterin levels [mean +/- SD] in the serum and urine of 30 tuberculous patients [54 +/- 13.9 n mol/L, 675 +/- 230.7 n mol/mol criatinine respectively] were significantly higher when compared with those in lung cancer patients [29 +/- 5 n moUL, 312 +/- 74.5 n mol/ mol criatnine respectively, P < 0.001] and when compared with those in control subjects [6 +/- 2 n mol/L, 128 +/- 39.8 u mol/mol criatinine respectively]. In tuberculosis patients with faradvanced disease pleural fluid, serum and urine neopterin levels were significantly higher when compared with those in patients with moderately and minimally advanced disease [p < 0.001]. In lung cancer group serum and urine neopterin levels were significantly higher [p < 0.001] in adenocarcinoma, squanous cell carcinoma, and small cell carcinoma than that in the control group. But there was no significant difference between the serum, urine and pleural fluid neopterin from one cell type to another. Serum urine and pleural fluid neopterin levels may reflect the degree of activity in pulmonary tuberculosis before exact diagnosis of the disease by culture results. In addition serum, urine and pleural fluid neopterin levels are elevated in patients with lung cancer whatever the cell type