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Saghazadeh A, Rezaei N. Elevated neopterin in tuberculosis and co-infection with HIV and the effect of treatment: A systematic review, meta-analysis, and meta-regression. Int Immunopharmacol 2022; 111:109147. [PMID: 35973370 DOI: 10.1016/j.intimp.2022.109147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/21/2022] [Accepted: 08/06/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neopterin (NEO) is a marker of immune stimulation. Increased NEO levels have been associated with autoimmune diseases, infections, and malignancies. Studies of NEO alterations in tuberculosis (TB) with or without HIV co-infection show inconsistent results. Moreover, challenges exist regarding TB diagnosis in people with HIV. METHODS We did a systematic review and meta-analysis of studies comparing urinary, pleural, and blood NEO levels between patients with TB or HIV-TB co-infection as the case group and subjects without TB and HIV or subjects with HIV without TB as the control group, respectively. RESULTS Blood NEO levels in patients with active TB were higher than healthy controls, with a large effect size of 1.99. Patients with TB had higher blood NEO levels before anti-tuberculosis therapy (ATT) than after ATT for months or when treatment ended with moderate effect sizes (1.13-1.46). meta-analysis of studies of patients with HIV-TB co-infection yielded similar results, with higher blood NEO levels in patients than controls that remained significant in subgroups of studies on pulmonary TB (PTB) patients and serum NEO and higher blood NEO levels in patients before than after ATT. CONCLUSION Meta-analyses reveal alteration in NEO levels in different specimens, e.g., blood, urine, and pleural fluid, in patients with TB with or HIV-TB co-infection compared to the control groups. Future studies need to investigate the utility of NEO as a diagnostic/prognostic biomarker for TB. Also, cellular and molecular mechanisms linking NEO and TB remain to be addressed.
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Affiliation(s)
- Amene Saghazadeh
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
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2
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Rasmi Y, Heidari N, Kübra Kırboğa K, Hatamkhani S, Tekin B, Alipour S, Naderi R, Farnamian Y, Akca I. The importance of neopterin in COVID-19: The prognostic value and relation with the disease severity. Clin Biochem 2022; 104:1-12. [PMID: 35307400 PMCID: PMC8929545 DOI: 10.1016/j.clinbiochem.2022.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 02/07/2023]
Abstract
Coronavirus Disease 2019 [COVID-19], caused by severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], has rapidly evolved into a global health emergency. Neopterin [NPT], produced by macrophages when stimulated with interferon [IFN-]gamma, is an essential cytokine in the antiviral immune response. NPT has been used as a marker for the early assessment of disease severity in different diseases. The leading cause of NPT production is the pro-inflammatory cytokine IFN-. Macrophage activation has also been revealed to be linked with disease severity in SARS-CoV-2 patients. We demonstrate the importance of NPT in the pathogenesis of SARS-CoV-2 and suggest that targeting NPT in SARS-CoV-2 infection may be critical in the early prediction of disease progression and provision of timely management of infected individuals.
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Affiliation(s)
- Yousef Rasmi
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Institute, Urmia University of Medical Sciences, Urmia, Iran,Department of Biochemistry, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Nadia Heidari
- Department of Biochemistry, School of Medicine, Gorgan University of Medical Sciences, Urmia, Iran
| | | | - Shima Hatamkhani
- Experimental and Applied Pharmaceutical Sciences Research Center, Department of Clinical Pharmacy, School of Pharmacy, Urmia University of Medical Sciences, Urmia, Iran
| | - Burcu Tekin
- Izmir Institute of Technology, Biotechnology Department, Izmir, Turkey
| | - Shahryar Alipour
- Department of Biochemistry and Applied Cell, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Roya Naderi
- Department of Physiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Yeghaneh Farnamian
- Student research Center, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Ilknur Akca
- Mersin University, Faculty of Sciences, Department of Biotechnology, Mersin, Turkey
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Tanrıverdi Z, Meteroglu F, Yüce H, Şenyiğit A, Işcan M, Unüvar S. The usefulness of biomarkers in diagnosis of asbestos-induced malignant pleural mesothelioma. Hum Exp Toxicol 2021; 40:1817-1824. [PMID: 33998299 DOI: 10.1177/09603271211017324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Malignant pleural mesothelioma (MPM) is a malignant tumor that is associated mostly with asbestos exposure. The present study was to evaluates the diagnostic value of neopterin, periostin, YKL-40, Tenascin-C (TNC), and Indolamine 2,3-dioxygenase (IDO) as noninvasive markers of malign pleural mesothelioma. METHODS Included in the study were 30 patients diagnosed with malign pleural mesothelioma, and 25 people as a control group. Biomarker levels were determined using an enzyme immunoassay . A Mann-Whitney U test and Spearman correlation methods were used for the statistical analysis. RESULTS All evaluated biomarkers were found to be significantly higher in the MPM group than in the control group (p < 0.05). There was no effect of such variables as gender, age or MPMsubtype on the parameters (p > 0.05) in the patient group. All biomarkers were positively correlated with each other (p < 0.001). CONCLUSIONS The current non-invasive biomarkers that can be used in the diagnosis of MPM yielded significant results and can make important contributions to the early diagnosis of MPM.
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Affiliation(s)
- Zübeyde Tanrıverdi
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, 37520İnönü University, Malatya, Turkey
| | - Fatih Meteroglu
- Department of Thoracic Surgery, Faculty of Medicine, 37507Dicle University, Diyarbakır, Turkey
| | - Hande Yüce
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, 37520İnönü University, Malatya, Turkey
| | - Abdurrahman Şenyiğit
- Department of Chest Diseases, Faculty of Medicine, 37507Dicle University, Diyarbakır, Turkey
| | - Mümtaz Işcan
- Faculty of Pharmacy, 64188Cyprus International University, Nicosia, Cyprus
| | - Songül Unüvar
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, 37520İnönü University, Malatya, Turkey
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Zafari P, Golpour M, Hafezi N, Bashash D, Esmaeili SA, Tavakolinia N, Rafiei A. Tuberculosis comorbidity with rheumatoid arthritis: Gene signatures, associated biomarkers, and screening. IUBMB Life 2020; 73:26-39. [PMID: 33217772 DOI: 10.1002/iub.2413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/01/2020] [Accepted: 11/04/2020] [Indexed: 12/19/2022]
Abstract
Rheumatoid arthritis (RA) is known to be related to an elevated risk of infections because of its pathobiology and the use of immunosuppressive therapies. Reactivation of latent tuberculosis (TB) infection is a serious issue in patients with RA, especially after receiving anti-TNFs therapy. TNF blocking reinforces the TB granuloma formation and maintenance and the growth of Mycobacterium tuberculosis (Mtb). After intercurrent of TB infection, the standard recommendation is that the treatment with TNF inhibitors to be withheld despite its impressive effect on suppression of inflammation until the infection has resolved. Knowing pathways and mechanisms that are common between two diseases might help to find the mechanistic basis of this comorbidity, as well as provide us a new approach to apply them as therapeutic targets or diagnostic biomarkers. Also, screening for latent TB before initiation of an anti-TNF therapy can minimize complications. This review summarizes the shared gene signature between TB and RA and discusses the biomarkers for early detection of this infection, and screening procedures as well.
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Affiliation(s)
- Parisa Zafari
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Monireh Golpour
- Molecular and Cellular Biology Research Center, Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nasim Hafezi
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Davood Bashash
- Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Alireza Esmaeili
- Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Naeimeh Tavakolinia
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Rafiei
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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5
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Soedarsono S, Dolli P. Comparison of serum neopterin levels in pulmonary tuberculosis patients with positive acid fast bacilli and inactive pulmonary tuberculosis. J Clin Tuberc Other Mycobact Dis 2020; 18:100138. [PMID: 31890901 PMCID: PMC6926297 DOI: 10.1016/j.jctube.2019.100138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) is caused by infection with Mycobacterium tuberculosis. Sometimes it is difficult to distinguish between active and inactive pulmonary TB based on chest X-ray images. TB biomarkers are needed to diagnose active TB when TB bacilli are not detected either through microscopic examination, culture or geneXpert MTB/Rif. Neopterin can be used as an additional diagnosis and therapy monitoring as well as assessing activation of macrophage cells. This study aims to examine and comparing serum neopterin levels in new cases of pulmonary TB with positive AFB and inactive pulmonary TB. METHODS This was an analytic study with Cross-Sectional design conducted in Dr. Soetomo General Hospital Surabaya, Indonesia. The subjects of the study were the new cases of pulmonary TB with positive AFB and inactive pulmonary TB who met the inclusion and exclusion criteria. Blood serum was collected and examined to measure neopterin serum levels in patients by ELISA technique. RESULTS There was a significant difference of mean neopterin serum levels between the new cases of pulmonary TB with positive AFB and inactive pulmonary TB with a p-value <0.001 (74.92 nmol/l vs. 9.84 nmol/l). There was a significant difference in serum neopterin levels in each AFB grading in the new cases of pulmonary TB with positive AFB with a p-value <0.001 (60.10 nmol/l in AFB 1+, 80.81 nmol/l in AFB 2+, and 110.70 nmol/l in AFB 3+). CONCLUSION Serum neopterin levels in the new cases of pulmonary TB with positive AFB were higher than inactive pulmonary TB.
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Affiliation(s)
- Soedarsono Soedarsono
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
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6
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Positive effect of ozonotherapy on serum concentration of soluble interleukin-2 receptor and neopterin in patients with systemic sclerosis. Postepy Dermatol Alergol 2019; 36:158-163. [PMID: 31320847 PMCID: PMC6627265 DOI: 10.5114/ada.2019.83651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 12/13/2017] [Indexed: 12/04/2022] Open
Abstract
Introduction Systemic sclerosis (SSc) is a chronic systemic autoimmune disease of unknown aetiology. No curative therapy exists, thus management includes controlling of symptoms and prevention of complications. Ozonotherapy has multiple beneficial therapeutic effects which can translate into improving prognostic factors for SSc. Aim To evaluate the effect of ozone on selected factors of inflammation: serum concentration of the soluble receptor of interleukin-2 (IL-2 sR), neopterin as well as the peripheral blood smear in patients with SSc. Material and methods Forty-two patients with SSc underwent two series of 10-minute baths in water with a mixture of air and ozone separated by a 10-day period without treatment. Examinations were performed at baseline and 10 days after completing the last treatment. Results The mean concentration of IL-2 sR decreased significantly from 1563.73 to 1249.86 pg/ml. The mean concentration of neopterin decreased significantly from 12.06 to 10.9 nmol/ml. Absolute monocytosis decreased insignificantly from 1.694 to 1.480 G/l. Correlations between the disease duration and concentration of IL-2 sR were weak and negative, while between the disease duration and concentration of neopterin were weak and positive. Conclusions Ozonotherapy had a beneficial influence on the immune response in patients with scleroderma. Balneotherapy may be considered as an additional therapeutic option, but further research is required.
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7
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Khoo WC, Kamaruzaman S, Lim HN, Jamil SNAM, Yahaya N. Synthesis and characterization of graphene oxide-molecularly imprinted polymer for Neopterin adsorption study. JOURNAL OF POLYMER RESEARCH 2019. [DOI: 10.1007/s10965-019-1847-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nishioka A, Tsunoda S, Abe T, Yoshikawa T, Takata M, Kitano M, Matsui K, Nakashima R, Hosono Y, Ohmura K, Mimori T, Sano H. Serum neopterin as well as ferritin, soluble interleukin-2 receptor, KL-6 and anti-MDA5 antibody titer provide markers of the response to therapy in patients with interstitial lung disease complicating anti-MDA5 antibody-positive dermatomyositis. Mod Rheumatol 2019; 29:814-820. [PMID: 30449228 DOI: 10.1080/14397595.2018.1548918] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: This study identified biomarkers that can be used to assess disease activity and response to therapy in patients with interstitial lung disease complicating anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab)-positive clinically amyopathic dermatomyositis (CADM). Methods: In 15 patients with interstitial lung disease complicating anti-MDA5 Ab-positive CADM, anti-MDA5 Ab, neopterin, interleukin (IL)-18, ferritin, and soluble interleukin 2 receptor (sIL-2R) levels were measured in cryopreserved serum specimens before and at multiple times after remission induction therapy, and their correlations were assessed. Results: Anti-MDA5 Ab, neopterin, IL-18, ferritin, and sIL-2R levels did not differ significantly between patients who survived and those who succumbed to the disease. In many cases, serum anti-MDA5 Ab titers were over the upper limit (over 150 index value) before treatment in the usual measuring method, and gradually decreased to the normal range at stable phase. Meanwhile, serum neopterin levels (21.6 [15.3-48.3] nmol/L) were significantly elevated in newly diagnosed patients and fell to 6.8 (5-11.4) nmol/L at 6 months after treatment introduction. Conclusions: Elevated serum neopterin as well as ferritin, sIL-2R, KL-6, and anti-MDA5 Ab titer might help identify patients with interstitial lung disease complicated with DM and might be useful in monitoring response to therapy.
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Affiliation(s)
- Aki Nishioka
- Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine , Hyogo , Japan
| | - Shinichiro Tsunoda
- Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine , Hyogo , Japan
| | - Takeo Abe
- Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine , Hyogo , Japan
| | - Takahiro Yoshikawa
- Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine , Hyogo , Japan
| | - Miki Takata
- Division of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University , Tottori , Japan
| | - Masayasu Kitano
- Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine , Hyogo , Japan
| | - Kiyoshi Matsui
- Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine , Hyogo , Japan
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University , Kyoto , Japan
| | - Yuji Hosono
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University , Kyoto , Japan
| | - Koichiro Ohmura
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University , Kyoto , Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University , Kyoto , Japan
| | - Hajime Sano
- Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine , Hyogo , Japan
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9
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Löhrich T, Behringer V, Wittig RM, Deschner T, Leendertz FH. The Use of Neopterin as a Noninvasive Marker in Monitoring Diseases in Wild Chimpanzees. ECOHEALTH 2018; 15:792-803. [PMID: 30117002 DOI: 10.1007/s10393-018-1357-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 05/28/2023]
Abstract
Pathogen analysis in wild great apes is both time- and resource-consuming. Therefore, we examined the potential use of urinary neopterin, a sensitive marker of cell-mediated immune system activation, as a disease marker and unspecific screening tool to facilitate informed pathogen analysis in great ape health monitoring. To test this, urinary neopterin was correlated to other disease markers such as sickness behaviors, fever, and urine parameters. Seasonal variation in urinary neopterin levels was investigated as well. The study encompassed noninvasively collected longitudinal data of young wild chimpanzees from the Taï National Park, Côte d´Ivoire. Relationships between disease markers were examined using a linear mixed model and a case study approach. Seasonal variation in urinary neopterin was tested using a linear mixed model. While the linear mixed model found no obvious relationship between urinary neopterin levels and other disease markers, the case study approach revealed a pattern resembling those found in humans. Urinary neopterin levels indicated seasonal immune system activation peaking in times of low ambient temperatures. We suggest the use of urinary neopterin as an unspecific screening tool in great ape health monitoring to identify relevant samples, individuals, and time periods for selective pathogen analysis and zoonotic risk assessment.
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Affiliation(s)
- Therese Löhrich
- Epidemiology of Highly Pathogenic Microorganisms, Robert Koch Institute, Seestraße 10, 13353, Berlin, Germany
- Department of Primatology, Max Planck Institute for Evolutionary Anthropology, 04103, Leipzig, Germany
- Institute of Microbiology and Epizootics, Free University, 14163, Berlin, Germany
| | - Verena Behringer
- Department of Primatology, Max Planck Institute for Evolutionary Anthropology, 04103, Leipzig, Germany
| | - Roman M Wittig
- Department of Primatology, Max Planck Institute for Evolutionary Anthropology, 04103, Leipzig, Germany
- Taï Chimpanzee Project, Centre Suisse de Recherches Scientifiques, Abidjan 01, Côte d'Ivoire
| | - Tobias Deschner
- Department of Primatology, Max Planck Institute for Evolutionary Anthropology, 04103, Leipzig, Germany
| | - Fabian H Leendertz
- Epidemiology of Highly Pathogenic Microorganisms, Robert Koch Institute, Seestraße 10, 13353, Berlin, Germany.
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10
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Kip AE, Wasunna M, Alves F, Schellens JHM, Beijnen JH, Musa AM, Khalil EAG, Dorlo TPC. Macrophage Activation Marker Neopterin: A Candidate Biomarker for Treatment Response and Relapse in Visceral Leishmaniasis. Front Cell Infect Microbiol 2018; 8:181. [PMID: 29911074 PMCID: PMC5992270 DOI: 10.3389/fcimb.2018.00181] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/09/2018] [Indexed: 01/15/2023] Open
Abstract
The Leishmania parasite resides and replicates within host macrophages during visceral leishmaniasis (VL). This study aimed to evaluate neopterin, a marker of macrophage activation, as possible pharmacodynamic biomarker to monitor VL treatment response and to predict long-term clinical relapse of VL. Following informed consent, 497 plasma samples were collected from East-African VL patients receiving a 28-day miltefosine monotherapy (48 patients) or 11-day combination therapy of miltefosine and liposomal amphotericin B (L-AMB, 48 patients). Neopterin was quantified with ELISA. Values are reported as median (inter-quartile range). Baseline neopterin concentrations were elevated in all VL patients at 98.8 (63.9–135) nmol/L compared to reported levels for healthy controls (<10 nmol/L). During the first treatment week, concentrations remained stable in monotherapy patients (p = 0.807), but decreased two-fold compared to baseline in the combination therapy patients (p < 0.01). In the combination therapy arm, neopterin concentrations increased significantly 1 day after L-AMB infusion compared to baseline for cured patients [137 (98.5–197) nmol/L, p < 0.01], but not for relapsing patients [84.4 (68.9–106) nmol/L, p = 0.96]. The neopterin parameter with the highest predictive power for VL relapse was a higher than 8% neopterin concentration increase between end of treatment and day 60 follow-up (ROC AUC 0.84), with a 93% sensitivity and 65% specificity. In conclusion, the identified neopterin parameter could be a potentially useful surrogate endpoint to identify patients in clinical trials at risk of relapse earlier during follow-up, possibly in a panel of biomarkers to increase its specificity.
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Affiliation(s)
- Anke E Kip
- Department of Pharmacy & Pharmacology, Antoni van Leeuwenhoek Hospital/the Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - Fabiana Alves
- Drug for Neglected Diseases Initiative, Geneva, Switzerland
| | - Jan H M Schellens
- Division of Pharmacoepidemiology & Clinical Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands.,Department of Clinical Pharmacology, Antoni van Leeuwenhoek Hospital/the Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Jos H Beijnen
- Department of Pharmacy & Pharmacology, Antoni van Leeuwenhoek Hospital/the Netherlands Cancer Institute, Amsterdam, Netherlands.,Division of Pharmacoepidemiology & Clinical Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands.,Department of Clinical Pharmacology, Antoni van Leeuwenhoek Hospital/the Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Ahmed M Musa
- Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | | | - Thomas P C Dorlo
- Department of Pharmacy & Pharmacology, Antoni van Leeuwenhoek Hospital/the Netherlands Cancer Institute, Amsterdam, Netherlands
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Comparative Diagnostic Utility of Neopterin and IFN-γ/IL-2 in Extrapulmonary Tuberculosis. Indian J Clin Biochem 2017; 32:453-458. [PMID: 29062177 DOI: 10.1007/s12291-016-0624-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 11/09/2016] [Indexed: 10/20/2022]
Abstract
Resurgence of TB has emphasized the need for newer methods of diagnosis. Extrapulmonary tuberculosis (EPTB), being paucibacillary, is a diagnostic dilemma. The aim of the present study was to correlate IFN-γ/IL-2 with neopterin in diagnosis of EPTB. Extrapulmonary specimens from 69 clinically diagnosed cases were stained by Ziehl-Neelsen and cultured on Lowenstein-Jensen medium for Mycobacterium tuberculosis. ELISA was used to assess serum IFN-γ, IL-2 and neopterin levels. Median serum levels of IFN-γ/IL-2 and neopterin were 3.22 and 21.6 nmol/L in clinically diagnosed EPTB cases and 0.52 and 4.20 nmol/L in healthy controls respectively (p < 0.001). Both IFN-γ/IL-2 and neopterin were significantly higher in culture positive (14.64 and 49.8 nmol/L) than culture negative cases (3.01 and 17.5 nmol/L) respectively (p < 0.05). IFN-γ/IL-2 was significantly higher in AFB smear positive cases (8.63) than smear negative cases (3.04) (p = 0.003), whereas no significant difference in neopterin levels was seen (p = 0.307). A positive correlation between IFN-γ/IL-2 and neopterin was seen in EPTB cases (spearman's rho = 0.453, p < 0.001), whereas in healthy controls no such correlation existed (spearman's rho = 0.018, p = 0.884). An urgent need for research in the field of biomarkers exists to utilize them as point of care test in the diagnosis of EPTB.
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Chen DY, Li JP, Chen YM, Liao TL, Chen HH, Hsieh CW, Yeh YW, Lan JL. Elevated Neopterin Levels Are Associated with Increased Tuberculosis Risk in Rheumatoid Arthritis Patients with QuantiFERON Conversion during Biologic Therapy. PLoS One 2016; 11:e0166301. [PMID: 27861525 PMCID: PMC5115727 DOI: 10.1371/journal.pone.0166301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 10/26/2016] [Indexed: 11/18/2022] Open
Abstract
QuantiFERON-TB-Gold (QFT-G) conversion is frequently observed in rheumatoid arthritis (RA) patients receiving biologic therapy. However, there have not been any known biomarkers available for detecting tuberculosis (TB) in QFT-G converters. We aimed to evaluate clinical utility of cytokines/chemokines for detecting TB in patients with QFT-G conversion. Among a total of 227 RA patients who underwent QFT-G assay, 187 QFT-G-negative patients received biologic therapy without isoniazid prophylaxis. QFT-G assay was repeated at week 52 of biologic therapy or at the time of TB diagnosis. Levels of cytokines/chemokines were determined by magnetic bead array or ELISA in QFT-G converters and 12 non-RA patients with TB (non-RA TB). QFT-G conversion was found in 54 (28.9%) of 187 baseline QFT-G-negative patients, of which 7 (13.0%) developed active TB during the one-year follow-up period. Among the examined cytokines/chemokines, non-stimulated and TB-antigen-stimulated neopterin levels were significantly higher in RA patients who developed TB (RA-TB) (median, 24.5pg/ml and 23053pg/ml, respectively) and non-RA TB patients (12.2pg/ml and 9633pg/ml, respectively) compared with QFT-G converters without TB (3.0pg/ml and 2720pg/ml, respectively, both p<0.001). Rising levels of neopterin relative to baseline (non-stimulated levels, 4.4pg/ml vs. 24.5pg/ml; TB-antigen-stimulated levels, 1801pg/ml vs. 23053pg/ml) were observed in QFT-G converters who developed TB. A high proportion (85.7%) of QFT-G converters with high plasma neopterin levels developed TB during the one-year follow-up period. In conclusion, RA patients with QFT-G conversion during the period of biologic therapy should be carefully monitored for elevation of neopterin levels, which is associated with TB risk in QFT-G converters, particularly in TB-endemic areas.
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Affiliation(s)
- Der-Yuan Chen
- Division of Allergy, Immunology and Rheumatology, Department of Medical Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Faculty of Medicine, National Yang Ming University, Taipei, Taiwan
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
- Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
| | - Ju-Pi Li
- Division of Immunology and Rheumatology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Yi-Ming Chen
- Division of Allergy, Immunology and Rheumatology, Department of Medical Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Faculty of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Tsai-Ling Liao
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Hsin-Hua Chen
- Division of Allergy, Immunology and Rheumatology, Department of Medical Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chia-Wei Hsieh
- Division of Allergy, Immunology and Rheumatology, Department of Medical Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Faculty of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Yea-Wen Yeh
- Division of Allergy, Immunology and Rheumatology, Department of Medical Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Joung-Liang Lan
- Division of Immunology and Rheumatology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- * E-mail:
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El-Shimy WS, Bediwy AS, Hassan AM, Ismail LR. Serum neopterin level in cases of pulmonary tuberculosis and pneumonia. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2016. [DOI: 10.4103/1687-8426.184360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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