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Changes in serum neopterin and serum beta 2-microglobulin in subjects with lung infections
1Dept of Infectious Diseases, Marselisborg Hospital, Aarhus, Denmark.
Abstract:
Our aim was to investigate whether serum neopterin and beta 2-microglobulin have any value in the distinction between Pneumocystis carinii pneumonia (PCP) and pneumonia due to extracellular bacteria. Also, to study whether neopterin and beta 2-microglobulin would correlate with the clinical course of lung infections in human immunodeficiency virus (HIV)-positive and HIV-negative patients. Thirty HIV-positive subjects with PCP, 9 HIV-positive patients with bacterial pneumonia, and 16 HIV-negative patients with bacterial pneumonia were investigated. Thirty eight asymptomatic HIV-positive subjects and 48 healthy blood donors were used as controls. The HIV-positive patients with PCP and the HIV-positive subjects with bacterial pneumonia had significantly and similarly elevated levels of neopterin and beta 2-microglobulin in the acute stage. In the weeks before the acute stage of PCP, neopterin and beta 2-microglobulin had been increasing. After start of treatment, serum neopterin declined significantly, whilst serum beta 2-microglobulin remained elevated. The HIV-negative patients with bacterial pneumonia had significantly increased serum concentrations of both markers in the acute stage, and had decreasing serum concentrations in the weeks after treatment. We conclude that neither neopterin nor beta 2-microglobulin seem to be of value in distinction between PCP and bacterial pneumonia in HIV-positive subjects. In the HIV-positive patients, neopterin may correlate partly with the clinical activity of PCP, whilst serum beta 2-microglobulin may remain elevated after PCP, despite treatment and recovery. The elevated level may, in part, be due to repeated infections and progression to acquired immune deficiency syndrome (AIDS).(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Serum neopterin and beta 2-microglobulin do not distinguish between Pneumocystis pneumonia and bacterial pneumonia in HIV-positive patients. Neopterin levels correlate with Pneumocystis pneumonia activity, while beta 2-microglobulin remains elevated post-treatment.
Area of Science:
- Infectious Diseases
- Immunology
- Clinical Chemistry
Background:
- Distinguishing Pneumocystis pneumonia (PCP) from bacterial pneumonia is crucial for appropriate treatment, especially in human immunodeficiency virus (HIV)-positive individuals.
- Biomarkers such as neopterin and beta 2-microglobulin are investigated for their diagnostic and prognostic value in lung infections.
Purpose of the Study:
- To evaluate the utility of serum neopterin and beta 2-microglobulin in differentiating PCP from bacterial pneumonia in HIV-positive and HIV-negative patients.
- To assess the correlation of these markers with the clinical course of lung infections in different patient groups.
Main Methods:
- Serum neopterin and beta 2-microglobulin levels were measured in HIV-positive patients with PCP, HIV-positive patients with bacterial pneumonia, HIV-negative patients with bacterial pneumonia, asymptomatic HIV-positive individuals, and healthy controls.
- Levels were analyzed during the acute stage, before PCP onset, and during/after treatment.
Main Results:
- Both neopterin and beta 2-microglobulin were significantly elevated in HIV-positive patients with PCP and bacterial pneumonia during the acute phase.
- Neopterin levels declined significantly after PCP treatment, while beta 2-microglobulin remained elevated.
- HIV-negative patients with bacterial pneumonia showed increased levels during acute infection, which decreased post-treatment.
Conclusions:
- Neopterin and beta 2-microglobulin are not valuable for distinguishing between PCP and bacterial pneumonia in HIV-positive individuals.
- Neopterin may partially correlate with PCP clinical activity in HIV-positive patients.
- Elevated beta 2-microglobulin post-PCP treatment in HIV-positive individuals may indicate ongoing inflammation, repeated infections, or disease progression.