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Hetland G, Fagerhol MK, Mirlashari MR, Nissen-Meyer LSH, Croci S, Lonati PA, Bonacini M, Salvarani C, Marvisi C, Bodio C, Muratore F, Borghi MO, Meroni PL. Elevated NET, Calprotectin, and Neopterin Levels Discriminate between Disease Activity in COVID-19, as Evidenced by Need for Hospitalization among Patients in Northern Italy. Biomedicines 2024; 12:766. [PMID: 38672123 PMCID: PMC11048478 DOI: 10.3390/biomedicines12040766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) displays clinical heterogeneity, but little information is available for patients with mild or very early disease. We aimed to characterize biomarkers that are useful for discriminating the hospitalization risk in a COVID-19 cohort from Northern Italy during the first pandemic wave. We enrolled and followed for four weeks 76 symptomatic SARS-CoV-2 positive patients and age/sex-matched healthy controls. Patients with mild disease were discharged (n.42), and the remaining patients were hospitalized (n.34). Blood was collected before any anti-inflammatory/immunosuppressive therapy and assessed for soluble C5b-9/C5a, H3-neutrophil extracellular traps (NETs), calprotectin, and DNase plasma levels via ELISA and a panel of proinflammatory cytokines via ELLA. Calprotectin and NET levels discriminate between hospitalized and non-hospitalized patients, while DNase negatively correlates with NET levels; there are positive correlations between calprotectin and both NET and neopterin levels. Neopterin levels increase in patients at the beginning of the disease and do so more in hospitalized than non-hospitalized patients. C5a and sC5b-9, and other acute phase proteins, correlate with neopterin, calprotectin, and DNase. Both NET and neopterin levels negatively correlate with platelet count. We show that calprotectin, NETs, and neopterin are important proinflammatory parameters potentially useful for discriminating between COVID-19 patients at risk of hospitalization.
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Affiliation(s)
- Geir Hetland
- Department of Immunology and Transfusion Medicine, Oslo University Hospital Ullevål, 0450 Oslo, Norway; (G.H.); (M.K.F.); (M.R.M.); (L.S.H.N.-M.)
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, 0451 Oslo, Norway
| | - Magne Kristoffer Fagerhol
- Department of Immunology and Transfusion Medicine, Oslo University Hospital Ullevål, 0450 Oslo, Norway; (G.H.); (M.K.F.); (M.R.M.); (L.S.H.N.-M.)
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, 0451 Oslo, Norway
| | - Mohammad Reza Mirlashari
- Department of Immunology and Transfusion Medicine, Oslo University Hospital Ullevål, 0450 Oslo, Norway; (G.H.); (M.K.F.); (M.R.M.); (L.S.H.N.-M.)
| | - Lise Sofie Haug Nissen-Meyer
- Department of Immunology and Transfusion Medicine, Oslo University Hospital Ullevål, 0450 Oslo, Norway; (G.H.); (M.K.F.); (M.R.M.); (L.S.H.N.-M.)
| | - Stefania Croci
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.C.); (M.B.)
| | - Paola Adele Lonati
- Research Laboratory of Immunorheumatology, IRCCS Istituto Auxologico Italiano, 20095 Cusano Milanino, Italy; (P.A.L.); (C.B.); or (M.O.B.)
| | - Martina Bonacini
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (S.C.); (M.B.)
| | - Carlo Salvarani
- Azienda USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia, 42123 Reggio Emilia, Italy; (C.S.); (C.M.); (F.M.)
| | - Chiara Marvisi
- Azienda USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia, 42123 Reggio Emilia, Italy; (C.S.); (C.M.); (F.M.)
| | - Caterina Bodio
- Research Laboratory of Immunorheumatology, IRCCS Istituto Auxologico Italiano, 20095 Cusano Milanino, Italy; (P.A.L.); (C.B.); or (M.O.B.)
| | - Francesco Muratore
- Azienda USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia, 42123 Reggio Emilia, Italy; (C.S.); (C.M.); (F.M.)
| | - Maria Orietta Borghi
- Research Laboratory of Immunorheumatology, IRCCS Istituto Auxologico Italiano, 20095 Cusano Milanino, Italy; (P.A.L.); (C.B.); or (M.O.B.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Pier Luigi Meroni
- Research Laboratory of Immunorheumatology, IRCCS Istituto Auxologico Italiano, 20095 Cusano Milanino, Italy; (P.A.L.); (C.B.); or (M.O.B.)
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Hetland G, Fagerhol MK, Dimova-Svetoslavova VP, Mirlashari MR, Nguyen NT, Lind A, Kolset SO, Søraas AVL, Nissen-Meyer LSH. Inflammatory markers calprotectin, NETs, syndecan-1 and neopterin in COVID-19 convalescent blood donors. Scandinavian Journal of Clinical and Laboratory Investigation 2022; 82:481-485. [PMID: 36151851 DOI: 10.1080/00365513.2022.2123387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Persisting inflammation has been discovered in lungs and other parenchymatous organs of some COVID-19 convalescents. Calprotectin, neutrophil extracellular traps (NETs), syndecan-1 and neopterin are general key inflammatory markers, and systemically enhanced levels of them may remain after the COVID-19 infection. These inflammatory markers were therefore measured in serum samples of 129 COVID-19 convalescent and 27 healthy blood donors or employees at Oslo Blood bank, Norway. Also antibodies against SARS-CoV-2 nucleocapsid antigen were measured, and timing of sampling and severity of infection noted. Whereas neopterin and NETs values remained low and those for syndecan-1 were not raised to statistically significant level, concentrations for calprotectin, as measured by a novel mixed monoclonal assay, were significantly increased in the convalescents. Antibodies against SARS-CoV-2 nucleocapsid antigen were elevated, but did not correlate with levels of inflammatory markers. Difference between the groups in only one biomarker makes evaluation of ongoing or residual inflammation in the convalescents difficult. If there is a low-grade inflammation, it would in that case involve neutrophils.
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Affiliation(s)
- Geir Hetland
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway.,Department of Immunology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | | | | | - Nhan Trung Nguyen
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway
| | - Andreas Lind
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Svein Olav Kolset
- Department of Nutrician, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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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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4
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Ozger HS, Dizbay M, Corbacioglu SK, Aysert P, Demirbas Z, Tunccan OG, Hizel K, Bozdayi G, Caglar K. The prognostic role of neopterin in COVID-19 patients. J Med Virol 2020; 93:1520-1525. [PMID: 32860465 DOI: 10.1002/jmv.26472] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/22/2020] [Accepted: 08/25/2020] [Indexed: 12/15/2022]
Abstract
In Coronavirus disease-2019 (COVID-19) cases, hyper inflammation is associated with the severity of the disease. High levels of circulating cytokines were reported in severe COVID-19 patients. Neopterin produced by macrophages on stimulation with interferon-gamma, which is an important cytokine in the antiviral immune response, hence it can be used to predict the severity of disease in COVID-19 cases. In this study, it was aimed to determine the prognostic value of the neopterin for the prediction of severe disease in patients with COVID-19. This single-center, prospective study was conducted in hospitalized COVID-19 patients and healthy volunteers. Severe and mild COVID-19 cases were compared in terms of clinical and laboratory findings as well as serum neopterin levels on hospital admission. To assess the prognostic utility of neopterin between the severe and mild COVID-19 groups, a receiver-operating characteristic (ROC) curve was generated, and the area under the curve (AUC) was calculated. The median serum neopterin level was four times higher in COVID-19 patients than the healthy controls (46 vs. 12 nmol/L; p < .001). The AUC value of serum neopterin was 0.914 (95% confidence interval, 0.85-0.97). The sensitivity and specificity of serum neopterin for the cut-off value of 90 nmol/L to identify severe COVID-19 cases were 100% and 76%, respectively. Serum neopterin levels on hospitalization were significantly higher in severe COVID-19 disease than mild COVID-19 patients. Neopterin levels can be used as an early prognostic biomarker for COVID-19 on admission.
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Affiliation(s)
- Hasan Selcuk Ozger
- Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey
| | - Murat Dizbay
- Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey
| | | | - Pinar Aysert
- Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey
| | - Zehra Demirbas
- Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey
| | - Ozlem Guzel Tunccan
- Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey.,Emergency Department, Keçiören Training and Research Hospital, Ankara, Turkey.,Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey
| | - Kenan Hizel
- Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey
| | - Gulendam Bozdayi
- Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey
| | - Kayhan Caglar
- Infectious Disease and Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey.,Emergency Department, Keçiören Training and Research Hospital, Ankara, Turkey.,Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey
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5
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Melichar B, Hrůzová K, Krčmová LK, Javorská L, Pešková E, Solichová D, Hyšpler R, Malířová E, Vošmik M, Bartoušková M, Klos D, Študentová H. Association of peripheral blood cell count-derived ratios, biomarkers of inflammatory response and tumor growth with outcome in previously treated metastatic colorectal carcinoma patients receiving cetuximab. Pteridines 2017; 28:221-232. [DOI: 10.1515/pterid-2017-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
Abstract
Abstract
The aim of the present study was to investigate the association of peripheral-blood cell count (PBC)-derived ratios, other biomarkers of inflammation and biomarkers of tumor growth with outcome in a cohort of patients presenting for the next line of therapy after the failure of prior systemic treatment. The data of 51 patients with advanced/metastatic colorectal carcinoma treated with cetuximab in the second or higher line of therapy were retrospectively analyzed. The median duration of cetuximab therapy and the median survival were 5.1 and 12.1 months, respectively. C-reactive protein (CRP), but not urinary neopterin correlated significantly with PBC-derived ratios. Both CRP and urinary neopterin correlated positively with carcinoembryonic antigen (CEA) concentrations and biomarkers of liver dysfunction. Although a number of parameters predicted overall survival in univariate analysis, only hemoglobin, CEA change and serum bilirubin were independent predictors of survival. In conclusion, in patients with metastatic colorectal carcinoma and predominantly liver metastases, the outcome of therapy in the advanced line setting was associated with initial hemoglobin level, a decrease of CEA concentration and initial presence of liver dysfunction. Urinary neopterin did not correlate with PBC-derived ratios, in contrast to CRP, but both urinary neopterin and serum CRP concentrations correlated with laboratory parameters of liver dysfunction.
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Affiliation(s)
- Bohuslav Melichar
- Department of Oncology , Palacký University Medical School and Teaching Hospital , I.P. Pavlova 6 , 779 00 Olomouc , Czech Republic
- Institute of Molecular and Translational Medicine , Palacký University Medical School and Teaching Hospital , I.P. Pavlova 6 , 779 00 Olomouc , Czech Republic
- Department of Oncology and Radiotherapy , Charles University Medical School and Teaching Hospital , Hradec Králové , Czech Republic
- Fourth Department of Medicine , Charles University Medical School and Teaching Hospital , Hradec Králové , Czech Republic
| | - Klára Hrůzová
- Department of Oncology , Palacký University Medical School and Teaching Hospital , I.P. Pavlova 6 , 779 00 Olomouc , Czech Republic
| | - Lenka Kujovská Krčmová
- Third Department of Medicine (Gerontology and Metabolic Care) , Charles University Teaching Hospital , Hradec Králové , Czech Republic
- Department of Analytical Chemistry , Charles University School of Pharmacy , Hradec Králové , Czech Republic
| | - Lenka Javorská
- Third Department of Medicine (Gerontology and Metabolic Care) , Charles University Teaching Hospital , Hradec Králové , Czech Republic
- Department of Analytical Chemistry , Charles University School of Pharmacy , Hradec Králové , Czech Republic
| | - Eliška Pešková
- Fourth Department of Medicine , Charles University Medical School and Teaching Hospital , Hradec Králové , Czech Republic
| | - Dagmar Solichová
- Third Department of Medicine (Gerontology and Metabolic Care) , Charles University Medical School and Teaching Hospital , Hradec Králové , Czech Republic
| | - Radomír Hyšpler
- Third Department of Medicine (Gerontology and Metabolic Care) , Charles University Medical School and Teaching Hospital , Hradec Králové , Czech Republic
- Department of Clinical Biochemistry , Charles University Medical School and Teaching Hospital , Hradec Králové , Czech Republic
| | - Eva Malířová
- Department of Clinical Biochemistry , Charles University Medical School and Teaching Hospital , Hradec Králové , Czech Republic
| | - Milan Vošmik
- Department of Oncology and Radiotherapy , Charles University Medical School and Teaching Hospital , Hradec Králové , Czech Republic
| | - Marie Bartoušková
- Department of Oncology , Palacký University Medical School and Teaching Hospital , I.P. Pavlova 6 , 779 00 Olomouc , Czech Republic
| | - Dušan Klos
- First Department of Surgery , Palacký University Medical School and Teaching Hospital , I.P. Pavlova 6 , 779 00 Olomouc , Czech Republic
| | - Hana Študentová
- Department of Oncology , Palacký University Medical School and Teaching Hospital , I.P. Pavlova 6 , 779 00 Olomouc , Czech Republic
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Sohrabi P, Habip Z, Saribas S, Vatan A, Dinc HO, Altun YM, Ziver T, Caliskan R, Demirci M, Uysal O, Yuksel P, Kocazeybek B. Neopterin and soluble CD14 (sCD14) levels as immunoactivation markers in aHBc-only cases. Future Virol 2017. [DOI: 10.2217/fvl-2017-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: Isolated hepatitis B core antibodies (aHBc)-only pattern complicates the diagnosis of HBV infections. We evaluated neopterin and sCD14 levels in HBV infections. Methods: aHBc-only (n: 102), healthy control (healthy control group [HCG], n: 100), and chronic hepatitis (CHB) groups (n: 70) were investigated. Competitive and sandwich ELISA were used. Results: The mean neopterin levels were significantly lower in the aHBc-only group than those in the CHB group (p = 0.0001). No significant difference was found between the aHBc-only group and the HCG (p = 0.854). The mean sCD14 levels were lower in the aHBc-only group than those in the CHB group (p = 0.0001), but no significant difference was found between the aHBc-only group and HCG (p = 0.402). No significant difference was detected between aHBc-only and HCG for mean sCD14 (p = 0.402) and neopterin levels (p = 0.854). Conclusion: These two biomarkers are not useful for diagnosing the aHBc only pattern.
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Affiliation(s)
- Pari Sohrabi
- Kanuni Sultan Suleyman Research & Training Hospital, Microbiology Laboratory, Istanbul, Turkey
| | - Zafer Habip
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Suat Saribas
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Asli Vatan
- Department of Infectious Disease, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Harika Oyku Dinc
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Yagiz M Altun
- Institue of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Tevhide Ziver
- Nutrition & dietic Department, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, North Cyprus
| | - Reyhan Caliskan
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mehmet Demirci
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Omer Uysal
- Deparment of Biostatistics, Medical School of Bezmialem Vakif University, Istanbul, Turkey
| | - Pelin Yuksel
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Bekir Kocazeybek
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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Melichar B, Spisarová M, Bartoušková M, Krčmová LK, Javorská L, Študentová H. Neopterin as a biomarker of immune response in cancer patients. ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:280. [PMID: 28758106 DOI: 10.21037/atm.2017.06.29] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
With the advent of immunotherapy the topic of biomarkers of immune response is of high interest. Along with the expression of programmed death ligand 1 (PD-L1) or tumor infiltrating lymphocytes (TIL), biomarkers of macrophage activation could be of interest. Neopterin is a biomarker of immune activation increased in different disorders associated with immune activation, including cancer. Neopterin synthesis is induced by interferon-γ that also induces indoleamine 2,3-dioxygenase (IDO), an enzyme catalyzing catabolism of tryptophan to kynurenine. Increased urinary or serum concentrations of neopterin have been associated with poor prognosis across a spectrum of malignant disorders of different primary location. Neopterin concentration in peripheral blood as well as in the tumor microenvironment correlates with phenotypic and functional changes of lymphocytes, indicating immune dysfunction. Increased neopterin concentrations are also accompanied by increased rate of conversion of tryptophan to kynurenine. Increasing neopterin concentrations also accompany side effects of anticancer treatment and could predict subsequent complications. Although almost four decades have elapsed since the discovery of increased neopterin concentrations in cancer patients, the full potential of neopterin as a biomarker in this setting has not been so far realized.
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Affiliation(s)
- Bohuslav Melichar
- Department of Oncology, Palacký University Medical School and Teaching Hospital, Olomouc, Czech Republic.,Department of Oncology and Radiotherapy, Charles University Medical School & Teaching Hospital, Hradec Králové, Czech Republic.,Fourth Department of Medicine, Charles University Medical School & Teaching Hospital, Hradec Králové, Czech Republic
| | - Martina Spisarová
- Department of Oncology, Palacký University Medical School and Teaching Hospital, Olomouc, Czech Republic
| | - Marie Bartoušková
- Department of Oncology, Palacký University Medical School and Teaching Hospital, Olomouc, Czech Republic
| | - Lenka Kujovská Krčmová
- Third Department of Medicine (Gerontology and Metabolic Care), Charles University Medical School & Teaching Hospital, Hradec Králové, Czech Republic.,Department of Analytical Chemistry, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Lenka Javorská
- Third Department of Medicine (Gerontology and Metabolic Care), Charles University Medical School & Teaching Hospital, Hradec Králové, Czech Republic.,Department of Analytical Chemistry, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Hana Študentová
- Department of Oncology, Palacký University Medical School and Teaching Hospital, Olomouc, Czech Republic
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Uysal HK, Sohrabi P, Habip Z, Saribas S, Kocazeybek E, Seyhan F, Calışkan R, Bonabi E, Yuksel P, Birinci I, Uysal O, Kocazeybek B. Neopterin and Soluble CD14 Levels as Indicators of Immune Activation in Cases with Indeterminate Pattern and True Positive HIV-1 Infection. PLoS One 2016; 11:e0152258. [PMID: 27031691 PMCID: PMC4816292 DOI: 10.1371/journal.pone.0152258] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 03/13/2016] [Indexed: 11/18/2022] Open
Abstract
Background We aimed to evaluate the roles of the plasma immune activation biomarkers neopterin and soluble CD14 (sCD14) in the indirect assessment of the immune activation status of patients with the indeterminate HIV-1 (IHIV-1) pattern and a true HIV-1-positive infection (PCG). Methods This cross-sectional and descriptive study included eighty-eight patients with the IHIV-1 pattern, 100 patients in the PCG, and 100 people in a healthy control group (HCG). Neopterin and sCD14 levels were determined by competitive and sandwich ELISA methods, respectively. Results Mean neopterin and sCD14 levels among those with the IHIV-1 pattern were significantly lower than among the PCG (p < 0.001 and p = 0.001, respectively), but they were similiar to those in the HCG (p = 0.57 and p = 0.66, respectively. Mean neopterin and sCD14 levels among the PCG were found to be significantly higher than among those with the IHIV-1 pattern (p < 0.001 and p = 0.001, respectively) and among those in the HCG (p = 0.001, p < 0.001, respectively). Neopterin did not have adequate predictive value for identifying those in the PCG (area under the curve [AUC] = 0.534; 95% CI, 0.463–0.605; p = 0.4256); sCD14 also had poor predictive value but high specificity (100%) for identifying those in the PCG (AUC = 0.627; 95% CI, 0.556–0.694; p = 0.0036). Conclusions While low levels of these two biomarkers were detected among those with the IHIV-1 pattern, they were found in high levels among those in the PCG. These two markers obviously cannot be used as a sceening test because they have low sensitivies. Taken together, we suggest that neopterin and sCD14 may be helpful because they both have high specificity (92%-100%) as indirect non-specific markers for predicting the immune activation status of individuals, whether or not they have true positive HIV-1.
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Affiliation(s)
- Hayriye Kırkoyun Uysal
- Department of Medical Microbiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Pari Sohrabi
- Istanbul Public Health Laboratory, Istanbul, Turkey
| | - Zafer Habip
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Suat Saribas
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
- * E-mail:
| | | | - Fatih Seyhan
- Istanbul Leprosy Dermatology and Venereology Hospital, Istanbul, Turkey
| | - Reyhan Calışkan
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Esad Bonabi
- Istanbul Aydın University - Health Services Vocational School Of Higher Education, Istanbul, Turkey
| | - Pelin Yuksel
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | | | - Omer Uysal
- Deparment of Biostatistics, Medical School of Bezmialem Vakif University, Istanbul, Turkey
| | - Bekir Kocazeybek
- Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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9
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Neopterin in Diagnosis and Monitoring of Infectious Diseases. J Biomark 2013; 2013:196432. [PMID: 26317013 PMCID: PMC4437389 DOI: 10.1155/2013/196432] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 10/28/2013] [Indexed: 12/01/2022] Open
Abstract
Neopterin is produced by activated monocytes, macrophages, and dendritic cells upon stimulation by interferon gamma produced by T-lymphocytes. Quantification of neopterin in body fluids has been achieved by standard high-performance liquid chromatography, radioimmunoassays, and enzyme-linked immunosorbent assays. Neopterin levels predict HIV-related mortality more efficiently than clinical manifestations. Successful highly active antiretroviral therapy is associated with a decrease in neopterin levels. Elevated neopterin levels were associated with hepatitis by hepatitis A, B, and C viruses. Serum neopterin levels were found to be a predictor of response to treatment of chronic HCV infection with pegylated interferon combined with ribavirin. Neopterin levels of patients with pulmonary tuberculosis were found to be higher in patients with more extensive radiological changes. Elimination of blood donors with elevated neopterin levels to reduce risk of transmission of infections with known and unknown viral pathogens has been undertaken. Neopterin measurement is hereby more cost effective but less sensitive than screening using polymerase chain reaction based assays. In conclusion neopterin is a nonspecific marker of activated T-helper cell 1 dominated immune response. It may be a useful marker for monitoring of infectious disease activity during treatment and for more accurate estimation of extent of disease and prognosis.
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Huang L, Guo L, Wan Y, Pan P, Feng L. Simultaneous determination of three potential cancer biomarkers in rat urine by synchronous fluorescence spectroscopy. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2013; 120:595-601. [PMID: 24365397 DOI: 10.1016/j.saa.2013.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Revised: 11/30/2013] [Accepted: 12/01/2013] [Indexed: 06/03/2023]
Abstract
A rapid, simple, sensitive and accurate method for the simultaneous determination of three potential cancer biomarkers [tryptophan (TRP), isoxanthopterin (ISO) and xanthopterin (XAN)] in rat urine with synchronous fluorescence spectroscopy has been developed. In order to eliminate the interference in urine samples, the synchronous fluorescence spectra were obtained with Δλ=70 nm in a KH2PO4-NaOH buffer solution (pH=8.0). The detected wavelengths of quantitative analysis were set at 275 nm for TRP, 325 nm for ISO and 400 nm for XAN, respectively. Under the optimized conditions, the limits of the detection of the three compounds were 2.73 ng/mL, 0.52 ng/mL and 0.94 ng/mL, respectively. The recoveries were in the range of 80.5-98.0%, with the coefficient of variation between 0.62% and 2.48%. The proposed method has been applied to the simultaneous determination of TRP, ISO and XAN in rat urines of bladder cancer group and control group. The determination results showed that the average level of TRP, ISO and XAN had different change trends with the growth of the tumor. The three analytes could be used as potential biomarkers for noninvasive diagnosis of different stage of bladder cancer. However, more data are needed to support this hypothesis.
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Affiliation(s)
- Lingling Huang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, People's Republic of China; Center of Analysis and Testing, Nanchang University, Nanchang, Jiangxi 330047, People's Republic of China
| | - Lan Guo
- Center of Analysis and Testing, Nanchang University, Nanchang, Jiangxi 330047, People's Republic of China.
| | - Yiqun Wan
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, People's Republic of China; Center of Analysis and Testing, Nanchang University, Nanchang, Jiangxi 330047, People's Republic of China.
| | - Pingping Pan
- Center of Analysis and Testing, Nanchang University, Nanchang, Jiangxi 330047, People's Republic of China
| | - Lei Feng
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, People's Republic of China
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D'agostino LE, Ventimiglia F, Verna JA, Colina ADL, Aguirre Y, Arturi A, Capparelli A. Correlation between DAS-28 and neopterin as a biochemical marker of immune system activation in early rheumatoid arthritis. Autoimmunity 2012; 46:44-9. [DOI: 10.3109/08916934.2012.722143] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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12
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Leng SX, Tian X, Matteini A, Li H, Hughes J, Jain A, Walston JD, Fedarko NS. IL-6-independent association of elevated serum neopterin levels with prevalent frailty in community-dwelling older adults. Age Ageing 2011; 40:475-81. [PMID: 21586579 DOI: 10.1093/ageing/afr047] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND neopterin is a monocyte/macrophage-derived immune activation marker and its levels increase with age. Frailty is an important clinical syndrome of old age. Previous studies have shown significant association between elevated interleukin-6 (IL-6) levels and frailty. The objective of this study was to evaluate IL-6-independent association of serum neopterin levels with prevalent frailty. METHODS this is a cross-sectional study in community-dwelling older adults recruited from residential and retirement communities in Baltimore, MD, USA. Frailty was determined using validated screening criteria. Serum neopterin and IL-6 levels were measured using standard enzyme-linked immunosorbent assay. Pearson correlation and multivariate linear regression analysis was performed to assess the relationship between log(neopterin) and log(IL-6). Odds ratios (ORs) for frailty were calculated using log(neopterin) and log(IL-6) as continuous measures and across tertiles of neopterin and IL-6 levels, adjusting for age, race, sex, education and body mass index. RESULTS one hundred and thirty-three individuals with a mean age of 84 years (range 72-97) completed the study. Neopterin levels were significantly higher in frail older adults than those in non-frail controls [median: 8.94 versus 8.35 nM, respectively, P < 0.001 t-test on log(neopterin)]. Log(neopterin) was significantly associated with prevalent frailty, adjusting for log(IL-6). Participants in the top tertile of neopterin had OR of 3.80 [95% confidence interval (CI) = 1.36-10.6, P < 0.01] for frailty. As expected, participants in the top tertile of IL-6 had OR of 3.29 (95% CI = 1.21-7.86, P < 0.05) for frailty. Log(neopterin) correlated with log(IL-6) (correlation coefficient = 0.19, P < 0.05). Moreover, OR for participants in the top neopterin tertile remained significant after adjusting for IL-6 (OR = 3.97, 95% CI = 1.15-13.72, P < 0.05). CONCLUSION elevated neopterin levels had IL-6-independent association with prevalent frailty, suggesting potential monocyte/macrophage-mediated immune activation in the frail elderly.
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Affiliation(s)
- Sean X Leng
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins Asthma and Allergy Center, Baltimore, MD 21224, USA
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Danoprevir monotherapy decreases inflammatory markers in patients with chronic hepatitis C virus infection. Antimicrob Agents Chemother 2011; 55:3125-32. [PMID: 21502634 DOI: 10.1128/aac.00131-11] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Danoprevir is a potent and selective direct-acting antiviral agent that targets the protease activity of hepatitis C virus (HCV) NS3/4A. This agent results in a significant rapid decline in HCV RNA levels when it is used in monotherapy. The present study evaluated whether plasma concentrations of the inflammatory markers gamma interferon-inducible protein 10 (IP-10) and neopterin or the interferon-stimulated gene product 2'-5'-oligoadenylate synthetase (OAS-1) were correlated with the plasma HCV RNA concentration before or during 14-day danoprevir monotherapy. In contrast to pegylated interferon and ribavirin treatment, a higher baseline IP-10 concentration was positively correlated with a greater first-phase HCV RNA decline upon danoprevir administration. Changes in the IP-10 plasma concentration during danoprevir administration were also associated with categorical changes in HCV RNA concentration at days 7 and 14. The neopterin concentration appeared to be moderately decreased during danoprevir administration, although these changes were not statistically significant. However, changes in neopterin concentration showed a statistically significant correlation with changes in IP-10 concentration. Considerable variation in the OAS-1 concentration was observed before and during treatment, including in patients treated with placebo and/or patients with minimal virologic response. Overall, these results suggest that effective treatment with a direct-acting antiviral agent may reduce hepatic inflammation and that first-phase HCV RNA decline during treatment with an NS3/4A protease inhibitor is more robust in patients with high baseline IP-10 concentrations.
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Byrnes AA, Harris DM, Atabani SF, Sabundayo BP, Langan SJ, Margolick JB, Karp CL. Immune activation and IL-12 production during acute/early HIV infection in the absence and presence of highly active, antiretroviral therapy. J Leukoc Biol 2008; 84:1447-53. [PMID: 18806124 DOI: 10.1189/jlb.0708438] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Suppressed IL-12 production and maladaptive immune activation, both of which are ameliorated by successful highly active antiretroviral therapy (HAART), are thought to play important roles in the immunopathogenesis of chronic HIV infection. Despite the important effects of the immunological and virological events of early HIV infection on subsequent disease progression, IL-12 production and immune activation in early infection remain under-defined. To quantify IL-12 production and immune activation during acute/early HIV infection, in the presence and absence of HAART, we performed a prospective, longitudinal study of participants in the Baltimore site of the Acute Infection and Early Disease Research Program, with cross-sectional comparison to healthy control subjects. PBMC cytokine productive capacity and plasma immune activation markers [soluble CD8 (sCD8), sCD4, granzyme B, neopterin, beta2-microglobulin, sIL-2R, sTNFRI, sTNFRII, and IL-12p70] were quantified by ELISA. Notably, PBMC from patients with acute/early HIV infection exhibited in vivo IL-12p70 production along with increased, maximal in vitro IL-12 production. Further, despite evidence from plasma markers of generalized immune activation, no elevation in plasma levels of sCD4 was observed, suggesting relative blunting of in vivo CD4+ T cell activation from the beginning of HIV infection. Finally, despite successful virological responses to HAART, heightened in vivo CD8+ T cell activation, IL-12 production, and IFN activity were sustained for at least 6 months during primary HIV infection. These data underscore the need for comparative mechanistic analysis of the immunobiology of early and chronic HIV infection.
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Affiliation(s)
- Adriana A Byrnes
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Comparative evaluation of postmortem serum concentrations of neopterin and C-reactive protein. Forensic Sci Int 2008; 179:135-43. [DOI: 10.1016/j.forsciint.2008.04.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Revised: 04/30/2008] [Accepted: 04/30/2008] [Indexed: 11/22/2022]
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