Increased urine neopterin levels in psoriasis.

Area of Science:

• Immunology
• Dermatology
• Biochemistry

Background:

• Neopterin production correlates with T-lymphocyte-mediated immunity.
• Psoriasis is an inflammatory skin condition with T-cell involvement.
• Cutaneous T-cell malignancies (CTCM) also involve T-lymphocytes.

Purpose of the Study:

• To investigate urine neopterin levels as a marker of disease activity in psoriasis.
• To compare neopterin levels in psoriatic patients, CTCM patients, and healthy controls.
• To assess the impact of psoriasis treatment on urine neopterin levels.

Main Methods:

• Measurement of oxidized and reduced urine neopterin using reversed-phase ion-pair high-performance liquid chromatography.
• Comparison of neopterin levels in 40 psoriasis patients, 14 CTCM patients, and 30 healthy controls.
• Repeated measurements in 12 psoriatic patients after UVB, tar, dithranol, or PUVA therapy.

Main Results:

• Significantly elevated fully oxidized urine neopterin and neopterin/creatinine ratios in psoriatic patients versus controls (P < 0.002, P < 0.05).
• No significant difference in neopterin levels in the CTCM group compared to controls.
• Significant reduction in neopterin and its creatinine ratio after treatment (P < 0.05, P < 0.01).
• Strong correlation between Psoriasis Area and Severity Index (PASI) scores and urine neopterin levels (P < 0.001).

Conclusions:

• Urine neopterin concentrations may serve as a valuable biomarker for psoriatic disease activity.
• Findings reinforce the critical role of activated T lymphocytes in the pathogenesis of psoriasis.
• Neopterin levels decrease with effective psoriasis treatment, indicating its utility in monitoring therapeutic response.