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Alkan AA, Arslan B, Özcan D, Tekin K. Serum neopterin and orexin-A levels in different stages of diabetic retinopathy. Clin Exp Optom 2024:1-7. [PMID: 39009974 DOI: 10.1080/08164622.2024.2374875] [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: 05/24/2023] [Accepted: 06/25/2024] [Indexed: 07/17/2024] Open
Abstract
CLINICAL RELEVANCE Retinopathy is one of the most common microvascular complications of diabetes mellitus and is the leading cause of vision loss in the working middle-aged population. BACKGROUND This study aimed to investigate the value of neopterin and orexin-A levels in patients with diabetes mellitus with different stages of diabetic retinopathy and without diabetic retinopathy and to compare those findings with results from healthy individuals without diabetes mellitus. METHODS In total, 65 patients with type 2 diabetes mellitus and 22 healthy individuals without diabetes mellitus were enrolled in this prospective study. The participants were separated into four subgroups. The first subgroup included 25 patients without diabetic retinopathy, the second subgroup included 20 patients non-proliferative diabetic retinopathy, the third subgroup included 20 patients with proliferative diabetic retinopathy, and the fourth subgroup included 22 healthy individuals without diabetes mellitus as controls. Serum neopterin and orexin-A levels were analysed and compared among the groups. RESULTS The age and gender of the participants between the four subgroups were not statistically significantly different (p > 0.05). The mean neopterin levels were significantly higher in patients included in the diabetes mellitus subgroups compared with the controls (p < 0.001). Neopterin levels significantly increased as diabetic retinopathy progressed within the diabetes mellitus subgroups. Mean orexin-A levels were significantly lower in the diabetes mellitus subgroups compared with the controls (p < 0.001); however, orexin-A levels were not significantly different within the diabetes mellitus subgroups (p > 0.05). CONCLUSION Patients with diabetes mellitus have higher serum neopterin and lower serum orexin-A levels compared with healthy individuals without diabetes mellitus. Moreover, serum neopterin levels increase with progression of diabetic retinopathy.
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Affiliation(s)
| | - Burak Arslan
- Department of Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - Delil Özcan
- Ophthalmology Department, Seyrantepe Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Kemal Tekin
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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Metri NJ, Butt AS, Murali A, Steiner-Lim GZ, Lim CK. Normative Data on Serum and Plasma Tryptophan and Kynurenine Concentrations from 8089 Individuals Across 120 Studies: A Systematic Review and Meta-Analysis. Int J Tryptophan Res 2023; 16:11786469231211184. [PMID: 38034059 PMCID: PMC10687991 DOI: 10.1177/11786469231211184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/15/2023] [Indexed: 12/02/2023] Open
Abstract
In this systematic review and meta-analysis, a normative dataset is generated from the published literature on the kynurenine pathway in control participants extracted from case-control and methodological validation studies. Study characteristics were mapped, and studies were evaluated in terms of analytical rigour and methodological validation. Meta-analyses of variance between types of instruments, sample matrices and metabolites were conducted. Regression analyses were applied to determine the relationship between metabolite, sample matrix, biological sex, participant age and study age. The grand mean concentrations of tryptophan in the serum and plasma were 60.52 ± 15.38 μM and 51.45 ± 10.47 μM, respectively. The grand mean concentrations of kynurenine in the serum and plasma were 1.96 ± 0.51 μM and 1.82 ± 0.54 μM, respectively. Regional differences in metabolite concentrations were observed across America, Asia, Australia, Europe and the Middle East. Of the total variance within the data, mode of detection (MOD) accounted for up to 2.96%, sample matrix up to 3.23%, and their interaction explained up to 1.53%; the latter of which was determined to be negligible. This review was intended to inform future empirical research and method development studies and successfully synthesised pilot data. The pilot data reported in this study will inform future precision medicine initiatives aimed at targeting the kynurenine pathway by improving the availability and quality of normative data.
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Affiliation(s)
- Najwa-Joelle Metri
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Ali S Butt
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Ava Murali
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, NSW, Australia
| | - Genevieve Z Steiner-Lim
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
| | - Chai K Lim
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, NSW, Australia
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Venema WJ, Hiddingh S, Janssen GMC, Ossewaarde-van Norel J, van Loon ND, de Boer JH, van Veelen PA, Kuiper JJW. Retina-arrestin specific CD8+ T cells are not implicated in HLA-A29-positive birdshot chorioretinitis. Clin Immunol 2023; 247:109219. [PMID: 36581221 DOI: 10.1016/j.clim.2022.109219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND HLA-A29-positive birdshot chorioretinitis (BCR) is an inflammatory eye disorder that is generally assumed to be caused by an autoimmune response to HLA-A29-presented peptides from retinal arrestin (SAG), yet the epitopes recognized by CD8+ T cells from patients remain to be identified. OBJECTIVES The identification of natural ligands of SAG presented by HLA-A29. To quantify CD8+ T cells reactive to antigenic SAG peptides presented by HLA-A29 in patients and controls. METHODS We performed mass-spectrometry based immunopeptidomics of HLA-A29 of antigen-presenting cell lines from patients engineered to express SAG. MHC-I Dextramer technology was utilised to determine expansion of antigen-specific CD8+ T cells reactive to SAG peptides in complex with HLA-A29 in a cohort of BCR patients, HLA-A29-positive controls, and HLA-A29-negative controls. RESULTS We report on the naturally presented antigenic SAG peptides identified by sequencing the HLA-A29 immunopeptidome of antigen-presenting cells of patients. We show that the N-terminally extended SAG peptide precursors can be trimmed in vitro by the antigen-processing aminopeptidases ERAP1 and ERAP2. Unexpectedly, no enhanced antigen engagement by CD8+ T cells upon stimulation with SAG peptides was observed in patients or HLA-A29-positive controls. Multiplexed HLA-A29-peptide dextramer profiling of a case-control cohort revealed that CD8+ T cells specific for these SAG peptides were neither detectable in peripheral blood nor in eye biopsies of patients. CONCLUSIONS Collectively, these findings demonstrate that SAG is not a CD8+ T cell autoantigen and sharply contrast the paradigm in the pathogenesis of BCR. Therefore, the mechanism by which HLA-A29 is associated with BCR does not involve SAG.
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Affiliation(s)
- W J Venema
- Department of Ophthalmology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands; Center for Translational Immunology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - S Hiddingh
- Department of Ophthalmology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands; Center for Translational Immunology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - G M C Janssen
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, the Netherlands
| | - J Ossewaarde-van Norel
- Department of Ophthalmology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - N Dam van Loon
- Department of Ophthalmology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - J H de Boer
- Department of Ophthalmology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - P A van Veelen
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, the Netherlands
| | - J J W Kuiper
- Department of Ophthalmology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands; Center for Translational Immunology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands.
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Increased Expression of Indoleamine 2,3-Dioxygenase (IDO) in Vogt-Koyanagi-Harada (VKH) Disease May Lead to a Shift of T Cell Responses Toward a Treg Population. Inflammation 2021; 43:1780-1788. [PMID: 32435912 DOI: 10.1007/s10753-020-01252-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Previous studies have pointed out that indoleamine 2,3-dioxygenase (IDO), the rate-limiting enzyme initiating tryptophan metabolism, plays a role in the regulation of the immune system. This project was designed to investigate the potential role of IDO in monocyte-derived dendritic cells (moDCs) obtained from active Vogt-Koyanagi-Harada (VKH) disease patients. In this study, we found that the IDO mRNA expression and enzyme activity were increased in active VKH patients as compared with healthy controls and patients in remission. To investigate the role of IDO in immune regulation, an effective inhibitor 1-methyl-L-tryptophan (1-MT) was used to suppress its activity in DCs. The results showed that inhibition of IDO with 1-MT significantly decreased the expression of DC marker CD86. IDO inhibition did not affect the cytokine production of IL-6, IL-1β, TNF-α, IL-10, and TGF-β in DCs. Downregulation of IDO in DCs also led to the reduction of regulatory T (Treg) cells and an increased CD4+ T cell proliferation. Treatment with 1-MT did not affect the phosphorylation of the MAPK pathway in DCs. In general, our study suggests that IDO may play an important role in the pathogenesis of VKH disease by regulating DC and CD4+ T cell function. Tryptophan deficiency and kynurenine accumulation may account for the complicated effects of IDO. Further research is needed to study the precise tryptophan metabolites that may limit immune responses in VKH disease.
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Gürcü S, Girgin G, Yorulmaz G, Kılıçarslan B, Efe B, Baydar T. Neopterin and biopterin levels and tryptophan degradation in patients with diabetes. Sci Rep 2020; 10:17025. [PMID: 33046801 PMCID: PMC7552423 DOI: 10.1038/s41598-020-74183-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/28/2020] [Indexed: 12/23/2022] Open
Abstract
This study aimed to evaluate the possible changes of neopterin, biopterin levels and tryptophan degradation in diabetes and to compare the results within diabetes groups and with healthy subjects. Diabetes mellitus patients and healthy controls were recruited the study. Patients were further subgrouped according to their drug therapy. Serum neopterin concentrations were detected by ELISA. Urinary neopterin, biopterin, serum tryptophan (Trp) and kynurenine (Kyn) levels were detected by HPLC. There was no difference between controls and diabetes patients in serum neopterin, urinary neopterin and biopterin levels (p > 0.05, all). Serum Trp and Kyn levels were significantly different in type 1 diabetes (T1DM) patients compared to controls (p < 0.05, both). Serum neopterin levels were significantly higher in type 2 diabetes patients (T2DM) compared to T1DM (p < 0.05). Urinary biopterin levels of T2DM patients using both metformin and vildagliptin were significantly higher than T1DM patients (p < 0.05). The correlations between serum neopterin and urinary neopterin, Kyn and Kyn/Trp were statistically significant in control and patient groups (p < 0.05, all). The study showed that Kyn/Trp was altered in diabetes patients due to immune modulation. On the other hand, although xenobiotic exposure may change pteridine levels, metformin and/or vildagliptin use in T2DM patients did not have any effect on the measured parameters.
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Affiliation(s)
- Sinem Gürcü
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, 90-06230, Ankara, Turkey
- Eskisehir City Hospital, Hospital Pharmacy, Eskişehir, Turkey
| | - Gözde Girgin
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, 90-06230, Ankara, Turkey
| | - Göknur Yorulmaz
- Faculty of Medicine, Department of Endocrinology, Osmangazi University, Eskişehir, Turkey
| | - Bilge Kılıçarslan
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, 90-06230, Ankara, Turkey
| | - Belgin Efe
- Faculty of Medicine, Department of Endocrinology, Osmangazi University, Eskişehir, Turkey
| | - Terken Baydar
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, 90-06230, Ankara, Turkey.
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Kilicarslan B, Cardak A, Girgin G, Kemer OE, Baydar T. An exploratory study of neopterin and kynurenine pathway in pterygium. Pteridines 2019. [DOI: 10.1515/pteridines-2019-0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Pterygium is an inflammatory, vascular and degenerative disorder with unknown aetiology. The aim of this study was to evaluate the changes in neopterin levels, reflecting T-cell immunity, and the kynurenine pathway, the main degradation process of tryptophan, in pterygium. For this purpose, neopterin concentrations were measured in serum and tear samples by enzyme-linked immunosorbent assay (ELISA) in pterygium patients (n=31) and control group (n=32). Kynurenine (KYN) and tryptophan (TRP) serum levels were simultaneously determined by high-performance liquid chromatography (HPLC) for evaluation of the kynurenine pathway. Serum neopterin concentrations and kynurenine to tryptophan ratio (KYN/TRP) as an index of tryptophan breakdown were found increased in pterygium compared to controls (p<0.05). Although there was a 3-fold difference observed between serum and tear neopterin levels, no significant relationship was found. It can be concluded that neopterin may be used as a nonspecific biomarker that reflects immunological activity in pterygium and has clinical potential for evaluation of pterygium pathogenesis. These immune- or inflammatory-mediated changes were also supported by an increased KYN/TRP ratio in pterygium patients.
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Affiliation(s)
- Bilge Kilicarslan
- Department of Toxicology, Faculty of Pharmacy , Hacettepe University , 90-06100 , Ankara , Turkey
| | - Aziz Cardak
- Ophthalmology Clinic, Numune Research and Education Hospital , 90-06230 , Ankara , Turkey
| | - Gozde Girgin
- Department of Toxicology, Faculty of Pharmacy , Hacettepe University , 90-06100 , Ankara , Turkey
| | - Ozlem Evren Kemer
- Ophthalmology Clinic, Numune Research and Education Hospital , 90-06230 , Ankara , Turkey
| | - Terken Baydar
- Department of Toxicology, Faculty of Pharmacy , Hacettepe University , 90-06100 , Ankara , Turkey
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Elevated serum neopterin levels in children with functional constipation: association with systemic proinflammatory cytokines. World J Pediatr 2018; 14:448-453. [PMID: 29549607 DOI: 10.1007/s12519-018-0144-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 09/21/2017] [Accepted: 10/13/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Functional constipation is a clinical problem with an incompletely understood etiology. Functional bowel diseases have been shown to be related to inflammation in many studies in adults. In this study, we aimed to evaluate leukocytes, C-reactive protein, proinflammatory and anti-inflammatory cytokines, and neopterin levels in children with functional constipation. METHODS Seventy-six children with constipation and 71 healthy controls (mean age 7.12 ± 3.46 years and 7.32 ± 4.33 years, respectively, P = 0.991) were included in the study. Leukocytes, C-reactive protein, interleukin (IL)-1β, IL-6, IL-10, IL-12, tumor necrosis factor-alpha (TNF-α) and neopterin levels were assessed in patients and healthy controls. Parameters were measured in the serum using enzyme-linked immunosorbent assay methods. RESULTS Mean IL-6 (20.31 ± 12.05 vs. 16.2 ± 10.25 pg/mL, respectively, P = 0.003), IL-12 (181.42 ± 133.45 vs. 135.6 ± 83.67 pg/mL, respectively, P = 0.018) and neopterin levels (2.08 ± 1.12 vs. 1.52 ± 1.02 pg/mL, respectively, P = 0.001) were significantly higher in constipated children than healthy controls. Leukocyte and thrombocyte counts, C-reactive protein, and IL-1β, IL-10 and TNF-α levels did not show any difference between the two groups. CONCLUSIONS In this study, IL-6, IL-12 and neopterin levels of constipated patients were found to be higher than those of controls. These results indicate the presence of subclinical inflammation in children with functional constipation.
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Ünüvar SÜ, Aslanhan H, Tanrıverdi Z, Karakuş F. The relationship between neopterin and hepatitis B surface antigen positivity. Pteridines 2018. [DOI: 10.1515/pteridines-2018-0001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Hepatitis B is a life-threatening viral liver infection caused by the hepatitis B virus. Neopterin is regarded as an immunologic biomarker of several diseases related to activation of the cellular immune system. Hepatitis B infection is associated with increased production of cellular immune system markers. We aimed to investigate whether there is a relationship between hepatitis B surface antigen-positivity (HBsAg +) and neopterin to determine the role of neopterin in the early diagnosis of hepatitis B infections. Seventy-two HBsAg (+) patients with normal liver function tests and forty-three controls were included in the study. Neopterin levels were 17.6 ± 0.13 nmol/L in HBsAg (+) patients; and 9.12 ± 0.09 nmol/L in infection-free controls, respectively. Compared to the control group, a statistically significant increase (p < 0.001) in the serum neopterin levels of the patients was observed. No significant relationship was determined between neopterin levels and age/sex (both, p > 0.05). With overstimulation of interferon-gamma, the production of neopterin increases by monocytes/macrophages. Likewise with other diseases associated with an activated cellular immune system, this study shows that neopterin can be a predictive biomarker for persistent carriers of hepatitis B infection.
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Affiliation(s)
- Songül Ü Ünüvar
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, İnönü University, Malatya , Turkey
| | - Hamza Aslanhan
- Department of Family Medicine, Faculty of Medicine, Dicle University, Diyarbakır , Turkey
| | - Zübeyde Tanrıverdi
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, İnönü University, Malatya , Turkey
| | - Fuat Karakuş
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, İnönü University, Malatya , Turkey
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Ege University, İzmir , Turkey
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Cinici E, Palabiyik SS, Sipahi H, Baydar T. Nitrite, neopterin levels and tryptophan degradation in allergic conjunctivitis. Int Ophthalmol 2017; 38:1871-1878. [PMID: 28779270 DOI: 10.1007/s10792-017-0669-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 07/28/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE The study aims to evaluate changes in neopterin levels and tryptophan degradation which are induced by Th1-type immune response and nitric oxide metabolism which may be involved in allergic inflammation. METHODS Serum nitrite, kynurenine, tryptophan and neopterin levels were evaluated in 36 patients with seasonal allergic conjunctivitis, along with these values in 41 healthy subjects. All these parameters have been compared with symptom and sign scores. RESULTS Tryptophan and kynurenine concentrations were not significantly changed, while serum nitrite concentrations were significantly low, and neopterin levels were significantly increased in patients compared to healthy subjects (p < 0.05). There was a significant relationship between symptom scores and serum nitrite levels in patients. CONCLUSIONS This preliminary study demonstrates that serum nitric oxide metabolism might have a role in allergic conjunctivitis. Serum neopterin levels but not tryptophan metabolism could serve as a biomarker in patients with seasonal allergic conjunctivitis.
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Affiliation(s)
- Emine Cinici
- Department of Ophthalmology, Regional Training and Research Hospital, Erzurum, Turkey.,Department of Ophthalmology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Saziye Sezin Palabiyik
- Department of Toxicology, Faculty of Pharmacy, Atatürk University, 90-25240, Erzurum, Turkey.
| | - Hande Sipahi
- Department of Toxicology, Faculty of Pharmacy, Yeditepe University, Istanbul, Turkey
| | - Terken Baydar
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
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Baydar T, Kemer OE, Kilicarslan B, Cardak A, Girgin G. Detection of neopterin in tear samples. Pteridines 2016. [DOI: 10.1515/pterid-2015-0020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
The main goal of the present study was to detect neopterin concentrations in human tear samples and to evaluate its potential correlation with serum neopterin levels. For this purpose, 20 systemically healthy volunteers were recruited, and both tear and serum samples were synchronically collected from each individual. Enzyme-linked immunoassay (ELISA) was carried out to detect the quantity of neopterin in the samples. Mean human tear neopterin levels were observed as 3±0.56 nM while mean serum neopterin was 9±1.25 nM. Additionally, a significant positive correlation between tear neopterin and serum neopterin concentrations was observed. This is the first report to show neopterin concentration in human tears as a biological sample. Collecting tears from the individuals is a non-invasive sampling method, and as an analytical aspect detection of neopterin by ELISA in tear samples construct a valuable, practical and cheap procedure for the diagnosis and monitoring of intraocular inflammation and systemic immune-mediated diseases.
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Affiliation(s)
- Terken Baydar
- Faculty of Pharmacy, Department of Toxicology, Hacettepe University, 90-06100 Ankara, Turkey
| | - Ozlem Evren Kemer
- Ophthalmology Clinic, Numune Research and Education Hospital, Ankara, Turkey
| | - Bilge Kilicarslan
- Faculty of Pharmacy, Department of Toxicology, Hacettepe University, 90-06100 Ankara, Turkey
| | - Aziz Cardak
- Ophthalmology Clinic, Numune Research and Education Hospital, Ankara, Turkey
| | - Gözde Girgin
- Faculty of Pharmacy, Department of Toxicology, Hacettepe University, 90-06100 Ankara, Turkey
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