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Serum neopterin after lung transplantation
M Humbert1, R M Delattre, J Cerrina
1Laboratoire d'Immunopathologie et d'Immunologie Virale, Inserm U131, Clamart, France.
Chest
|February 1, 1993
Summary
Serum neopterin/creatinine (N/C) ratio can indicate immune activation after lung transplant. Early post-transplant, N/C rises with rejection or infection, but later, it specifically signals infection, particularly CMV pneumonia.
Area of Science:
- Immunology
- Transplant Medicine
- Biomarker Discovery
Background:
- Neopterin (N) is a marker for activated cell-mediated immunity.
- Monitoring immune status post-lung transplantation is crucial for patient outcomes.
- Soluble interleukin 2 receptor (sIL-2R) is a marker of T-cell activation.
Purpose of the Study:
- To evaluate the dynamics of the serum neopterin/creatinine (N/C) ratio in lung recipients.
- To correlate N/C ratio changes with rejection or infection episodes.
- To assess the N/C ratio's value in noninvasive long-term follow-up.
Main Methods:
- Prospective, blind clinical trial involving 44 lung recipients.
- Daily or every-other-day serum collection for the first 3 weeks post-transplant.
- Neopterin and sIL-2R levels measured by radioimmunoassay and enzyme immunoassay, respectively.
Main Results:
- Serum N/C ratio is an early, sensitive marker of immune activation within 21 days post-transplant.
- Elevated N/C ratios observed during early rejection and infection episodes.
- Post-3 weeks, increased N/C ratio specifically correlated with infections, especially CMV pneumonia (p < 0.001).
Conclusions:
- Post-transplant, the serum N/C ratio is a reliable indicator of infection, particularly CMV pneumonia.
- Both rejection and infection are associated with increased neopterin production in the early postoperative period.
- The serum N/C ratio holds potential for noninvasive monitoring of lung transplant recipients.