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Neopterin in tuberculous and neoplastic pleural fluids
M F Baganha1, A Mota-Pinto, M A Pêgo
1Pneumology Service, University Hospital of Coimbra, Portugal.
Insights
Neopterin levels in pleural fluid are significantly higher in tuberculosis than in neoplastic conditions. This finding highlights neopterin
Area of Science:
- Immunology
- Biochemistry
- Clinical Diagnostics
Background:
- Neopterin, derived from guanosine-triphosphate, is produced by stimulated macrophages.
- Gamma interferon influences neopterin production by lymphocytes.
- Neopterin is a potential marker for monocyte/macrophage activation in clinical settings.
Purpose of the Study:
- To evaluate neopterin concentrations in pleural effusions and blood.
- To compare neopterin levels in tuberculous and neoplastic pleurisy.
- To assess neopterin's utility as a marker for immunologic cellular activity in pleurisy.
Main Methods:
- Radioimmunologic assay was used to determine neopterin concentration.
- Neopterin levels were measured in pleural fluid and blood samples.
- Samples were collected from 25 individuals with pleurisy (10 tuberculous, 15 neoplastic) and 99 controls.
Main Results:
- Significantly elevated neopterin levels were observed in tuberculous pleural fluid compared to neoplastic effusions (p < 0.001).
- Blood neopterin levels were comparable to pleural fluid levels, showing significant differences from controls (p < 0.001).
- Control group exhibited normal serum neopterin values (5.11 ± 1.92 nmol/L).
Conclusions:
- Neopterin levels in pleural fluid significantly influence the diagnosis of pleurisy causes.
- Neopterin serves as an important marker of immunologic cellular activity in pleurisy.
- Elevated neopterin is indicative of cellular immune activation, particularly in tuberculous pleurisy.
Abstract:
Neopterin is derived from guanosine-triphosphate, produced by stimulated macrophages under the influence of gamma interferon of lymphocyte origin. It has been suggested as an excellent marker for activation of the monocyte/macrophage axis in some clinical situations. We evaluated its concentration in the pleural effusions of 25 individuals (10 tuberculous and 15 neoplastic) as well as in the blood of 22 of them (8 tuberculous and 14 neoplastic), comparing these levels with those of a control group in 99 normal individuals. The concentration of neopterin was determined by radioimmunologic assay. This showed a significant increase (p less than 0.001) of neopterin levels in the tuberculous pleural fluid, compared to the neoplastic group (42 +/- 23/17 +/- 9 nmol/L). In the blood, values were nearly identical to the pleural fluid (41.3 +/- 25/15.8 +/- 6.9 nmol/L), although with significant differences between them and in relation to the control group (p less than 0.001), which had a normal serum value (5.11 +/- 1.92 nmol/L). We emphasize the influence of the neopterin levels in the pleural fluid on the diagnosis of causes of pleurisy and its importance as a marker of immunologic cellular activity.