The effect of periodontal therapy on neopterin and vascular cell adhesion molecule-1 levels in chronic periodontitis patients with and without acute myocardial infarction: a case-control study

Abstract The presence of neopterin in gingival crevicular fluid (GCF) is a marker for local and acute immune activation, and the presence of vascular cell adhesion molecule (VCAM-1) in GCF is accepted as a marker for chronic vascular inflammation. Objectives This study aimed to evaluate effects of periodontal treatment on GCF levels of neopterin and VCAM-1 in patients with chronic periodontitis (CP) with acute myocardial infarction (AMI) compared with systemically healthy CP patients. Material and methods Sixty subjects (20 CP patients with AMI, 20 healthy CP patients, and 20 healthy controls) were included. GCF samples were analyzed at baseline and after 3 and 6 months, and the probing pocket depth (PD), clinical attachment level (CAL), bleeding on probing, gingival (GI) and plaque (PI) indices were recorded. We determined neopterin and VCAM-1 levels (concentration and total amount) using enzyme-linked immunosorbent assay (ELISA). No significant differences were seen between the AMI+CP and CP groups for PI, GI, GCF levels of neopterin and VCAM-1 at baseline. Results The number of teeth with 5 mm≤CAL<7 mm and CAL≥7 mm were significantly increased in the AMI+CP group at baseline. There were no significant differences between the AMI+CP and CP for PI, CAL, GCF volumes, and the AMI+CP group had the highest clinical improvement in the number of teeth with 5 mm≤CAL<7 mm at the sixth month. There were significant positive correlations between clinical periodontal inflammation and the presence of neopterin and VCAM-1 in GCF prior to and following periodontal treatment, and between the GCF volume and clinical parameters. Conclusions Data suggest that the total amount and concentration of neopterin and VCAM-1 in GCF seemed to be closely associated with periodontal disease severity in CP patients with AMI. Moreover, the results of our study demonstrate that the past periodontal status is potentially correlated between groups, with similar periodontal disease severity.

Clinical and laboratory features of HTLV-I asymptomatic carriers and patients with HTLV-I-associated myelopathy/tropical spastic paraparesis from the Brazilian Amazon

ABSTRACT Clinical and laboratory parameters including blood and cerebrospinal fluid (CSF) neopterin were investigated in human-T-lymphotropic-virus-type-I associated-myelopathy/tropical-spastic-paraparesis-HAM/TSP and in HTLV-I carriers. HAM/TSP (n = 11, 2 males/9 females, median age = 48 years), recently diagnosed HTLV-I carriers (n = 21, 15 females/6 males, median age = 44 years), healthy individuals (n = 20, 10 males/10 females, median age = 34.6 years) from the Brazilian Amazon (Manaus, Amazonas State) were investigated. Neopterin was measured (IBL ELISA Neopterin, Germany) in serum samples of all the participants, in CSF of 9 HAM/TSP patients as well as in 6 carriers. In HAM/TSP patients, CSF cell counts, protein and glucose were measured, the Osame’s motor-disability-score/OMDS was determined, and brain/spinal cord magnetic-resonance-imaging (MRI) was performed. HAM/TSP patients had normal CSF glucose, leukocyte counts; and normal protein levels predominated. Brain-MRI showed white-matter lesions in 7 out of 11 HAM/TSP patients. OMDS varied from 2-8: 9 were able to walk, 2 were wheel-chair-users. The median serum neopterin concentration in HAM/TSP patients was 6.6 nmol/ L; min. 2.8- max. 12.5 nmol/ L); was lower in carriers (4.3 nmol/L; min. 2.7- max. 7.2 nmol/ L) as well as in healthy participants (4.7 nmol/ L; min. 2.7- max. 8.0 nmol/ L) (p < 0.05). CSF neopterin concentrations in HAM/TSP patients were higher than in serum samples, and higher compared to carriers (p < 0.05). Carriers had similar serum-CSF neopterin concentrations compared to healthy participants. Variable clinical and laboratory profiles were seen in HAM/TSP patients, however our results support the neopterin measurement as a potential biomarker of disease activity.

Association of neopterin as a marker of immune system activation and juvenile rheumatoid arthritis activity / Associação de neopterina como marcador de ativação do sistema imunológico e atividade da artrite reumatoide juvenil

OBJECTIVE: To evaluate neopterin plasma concentrations in patients with active juvenile idiopathic arthritis (JIA) and correlate them with disease activity.METHODS: Sixty patients diagnosed as active JIA, as well as another 60 apparently healthy age- and gender-matched children as controls, were recruited from the Pediatrics Allergy and Immunology Clinic, Ain Shams University. Disease activity was assessed by the Juvenile Arthritis Disease Activity Score 27 (JADAS-27). Laboratory investigations were performed for all patients, including determination of hemoglobin concentration (Hgb), erythrocyte sedimentation rate (ESR), and C-reactive protein. Serum concentrations of tumor necrosis factor-alpha (TNF-a), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and neopterin were measured.RESULTS: Significant differences were found between JIA patients and controls with regard to the mean levels of Hgb, ESR, TNF-a, IL-6, and MCP-1 (p < 0.05). A statistically significant higher mean level serum neopterin concentration (p < 0.05) was found in JIA patients (20.43 ± 8.73 nmol/L) than in controls (6.88 ± 2.87 nmol/L) (p < 0.05). Positive significant correlations were detected between serum neopterin and ESR, TNF-a, IL-6, MCP-1, and JADAS-27 (p < 0.05). No correlation was found between serum neopterin and CRP (p > 0.05). Multiple linear regression analysis showed that JADAS- 27 and ESR were the main variables associated with serum neopterin in JIA patients (p < 0.05).CONCLUSION: The elevation of plasma neopterin concentrations in early JIA patients may indicate stimulation of immune response. Serum neopterin can be used as a sensitive marker for assaying background inflammation and disease activity score in JIA patients.

OBJETIVO: Avaliar as concentrações plasmáticas de neopterina em pacientes com artrite idiopática juvenil (AIJ) ativa e correlacioná-las com a atividade da doença.MÉTODOS: Foram recrutados da clínica de Alergia e Imunologia Infantil da Universidade Ain Shams 60 pacientes diagnosticados com AIJ ativa, bem como 60 crianças aparentemente saudáveis com a mesma idade e o mesmo sexo no grupo de controle. A atividade da doença foi avaliada pelo Escore de Atividade da Doença da Artrite Juvenil em 27 Articulações (JADAS-27). Foram feitas investigações laboratoriais em todos os pacientes, incluindo a determinação da concentração de hemoglobinas, a taxa de sedimentação de eritrócitos e a proteína C-reativa. Foram mensuradas as concentrações séricas do fator de necrose tumoral alfa, interleucina-6 e proteína quimiotática de monócitos-1 e neopterina.RESULTADOS: Foi encontrada uma diferença significativa entre os pacientes com AIJ e os controles quanto às médias de Hb, TSE, FNT-a, IL-6 e MCP-1 (p < 0,05). Foi encontrado um nível estatística e significativamente maior de concentração média de neopterina sérica (p < 0,05) em pacientes com AIJ (valor médio de 20,43 ± 8,73 nmol/L) do que em controles (valor médio de 6,88 ± 2,87 nmol/L) (p < 0,05). Foram detectadas correlações positivas significativas entre a neopterina sérica e TSE, FNT-a, IL-6, MCP-1 e JADAS-27 (p < 0,05). Não foi encontrada correlação entre a neopterina sérica e a PCR (p > 0,05). A análise de regressão linear múltipla mostrou que o JADAS-27 e a TSE foram as principais variáveis associadas à neopterina sérica em pacientes com AIJ (p < 0,05).CONCLUSÃO: A elevação das concentrações plasmáticas de neopterina em pacientes com AIJ precoce pode indicar um estímulo de resposta imune. A neopterina sérica pode ser usada como um indicador sensível para analisar o histórico de inflamações e o escore de atividade da doença em pacientes com AIJ.

Evaluation of procalcitonin and neopterin level in serum of patients with acute bacterial infection

BACKGROUND: Fever as a common presenting complaint in pediatric patients can be due to various causes. Differentiating bacterial infection from other causes is important because the prompt use of antibiotics is critical in bacterial infection. Traditional markers of infection such as BT and WBC count may be unspecific and culture may be late or absent. CRP and Procalcitonin (PCT) have been considered to evaluate the evolution of infections and sepsis in patients presenting with SIRS. Neopterin has also been proposed to aid in the diagnosis of bacterial infection. In this study, we compared the value of the serum PCT, neopterin level, and WBC count for predicting bacterial infection and outcome in children with fever. METHODS: 158 pediatric (2-120-month-old) patients suspected to have acute bacterial infection, based on clinical judgment in which other causes of SIRS were ruled out were included in the study. WBC count with differential was determined and PCT and neopterin levels were measured. RESULTS: PCT level was higher in bacterial infection and patients who were complicated or expired. CONCLUSION: Rapid PCT test is superior to neopterin and WBC count for anticipating bacterial infection, especially in ED where prompt decision making is critical. ABBREVIATIONS: BT, body temperature; WBC, white blood cell; PCT, procalcitonin; CRP, C-reactive protein; SIRS, systemic inflammatory response syndrome; ED, emergency department.

Quantificação dos niveis sericos de anticorpos anti-PGL-I, neopterina e proteina C reativa em pacientes com hanseniase durante a poliquimioterapia / ?

A hanseniase e doença infecciosa, causada pelo Mycobacterium leprae, um parasita intracelular obrigatorio nao cultivavel em meios artificiais. Esta doença pode se manifestar sob amplo espectro clinico, correspondendo a distintos padroes da resposta imunologica do hospedeiro ao M. leprae. Em um polo deste espectro, esta a forma de resistencia ao bacilo, a hanseniase tuberculoide (HT), na qual se desenvolve acentuada resposta imune celular especifica com efetivo controle da mutilaçao bacilar. O outro polo do espectro esta representado pela hanseniase virchoviana (HV), forma de baixa resistencia, em que a resposta imune celular seletivamente falha em eliminar o bacilo do organismo, resultando na disseminaçao da doença. O grupo dimorfo (HD) apresenta manifestaçoes intermediarias variaveis entre HT e HV, de acordo com o grau de resposta imune ao M. leprae. Considerando que na hanseniase existem poucos estudos avaliando os niveis sericos de anticorpos anti-PGL-I, neopterina e proteina C reativa (CRP) no momento do diagnostico e durante o tratamento poliquimioterapico, realizamos este estudo com os sguintes objetivos: A. Avaliar a resposta imune e inflamatoria de pacientes com hanseniase no momento do diagnostico e aos 2, 4, 6 e 12 meses de tratamento com poliquimioterapia (PQT) e nos estados reacionais, mediante a determinaçao dos niveis sericos de anti-PGL-I, de neopterina e de CRP....

Caracterização da resposta inflamatória após implante de stent em pacientes com angina estável: Papel do Ultrassom intracoronário / Characterization of the inflammatory response following coronary stent implantation in stable angina patients: role of intravascular ultrasound

Para avaliar a correlação entre a resposta inflamatória (RI) pós-implante de "stent" coronário (SC) e a composição de placa, 30 pacientes com angina estável (PAE) realizaram ultrassom intracoronário (UIC) antes do SC. As placas foram classificadas em calcificadas, fibrocalcificadas (FC), fibrolipídicas (FL) ou lipídicas. As lesões angiográficas também foram analisadas. Sangue do seio coronário foi coletado antes e 15 minutos depois do SC para a dosagem dos marcadores inflamatórios (MI): interleucina-6 (IL-6), fator de necrose tumoral-a, interferon-g (IFN) e neopterina. Todos os MI se modificaram significativamente apenas para as placas FC e FL. Apenas IL-6 e IFN aumentaram para as lesões B1 e B2. Assim, UIC foi capaz de identificar placas propensas a uma RI aguda de maior grau após SC em PAE.In order to access the correlation between the inflammatory response (IR) post-coronary stenting (CS) and plaque composition, 30 stable angina patients (SAP) underwent intravascular ultrasound (IVUS) before CS. Plaques were classified as calcified, fibrocalcified (FC), fibrolipidic (FL) or lipid. Angiographic lesion types were also analyzed. Coronary sinus blood was collected before and 15 minutes after CS for the measurement of inflammatory markers (IM): interleukin-6 (IL-6), tumoral necrosis factor-a, interferon-g (IFN) and neopterin. All IM changed markedly only for FC and FL plaques. Only lesions B1 and B2 resulted changes for IL-6 and IFN. Thus, IVUS is able to identify plaques prone to a greater acute IR following CS in SAP...

Neopterina: um marcador da resposta imune mediana por células no líquido céfalo-raquidiano? / Neopterin: a marker of the cell-mediated immune response in the cerebrospinal fluid?

A neopterina é sintetizada por macrófagos ou monócitos sob o estímulo de fatores derivados de infócitos T ativada e tem sido utilizada como importante marcador de rejeição de órgãos em pacientes submetidos a transplante, no monitoramento de pacientes com tumores, doenças autoimunes e como triagem para doenças infecciosas em doadores de sangue. Estudamos o comportamento da neopterina em líquido céfalo-raquidiano e soro de pacientes pediátricos normais e com meningites, antes e durante o tratamento. Os resultados obtidos mostraram boa correlação dos níveis de neopterina no soro x LCR e estreita correlação do aumento da neopterina no LCR com a presença ou não de doença infecciosa a nível de meninges.