Evaluation of possible neuroprotective effects of virgin coconut oil on aluminum-induced neurotoxicity in an in vitro Alzheimer's disease model.

Alzheimer's disease (AD) is a progressive neurological disorder that affects various cognitive functions, behavior, and personality. AD is thought to be caused by a combination of genetic and environmental factors, including exposure to aluminum (Al). Virgin coconut oil (VCO) may have potential as a natural neuroprotectant against AD. Aim of this study was to determine neuroprotective effects of VCO on Al-induced neurotoxicity in an in vitro AD model. SH-SY5Y cells were initially cultured in normal growth medium and then differentiated by reducing fetal bovine serum content and adding retinoic acid (RA). Later, brain-derived neurotrophic factor (BDNF) was added along with RA. The differentiation process was completed on the seventh day. Study groups (n = 3) were designed as control group, VCO group, Al group, Al-VCO group, Alzheimer model (AD) group, AD + Al-exposed group (AD+Al), AD + VCO applied group (AD + VCO) and AD + Al-exposed + VCO applied group (AD + Al + VCO). Specific markers of AD (hyperphosphorylated Tau protein, amyloid beta 1-40 peptide, and amyloid precursor protein) were measured in all groups. In addition, oxidative stress parameters (total antioxidant capacity, lipid peroxidase, protein carbonyl, and reactive oxygen species) and neurotransmitter-related parameters (dopamine, dopamine transporter acetylcholine, and synuclein alpha levels, acetylcholinesterase activity) were measured comparatively in the study groups. VCO reduced amyloid beta and hyperphosphorylated Tau protein levels in the study groups. In addition, oxidative stress levels decreased, and neurotransmitter parameters improved with VCO. Our study shows that VCO may have potential therapeutic effects in Alzheimer's disease and further experiments are needed to determine its efficacy.

Verification studies of tryptophan and kynurenine determination using HPLC and evaluation of the kynurenine pathway and neopterin levels in human colostrum samples.

Colostrum, the first breast fluid produced by mammals after giving birth, is followed by breast milk, which serves as the sole source of nutrients for breastfed newborns and infants. Tryptophan, an essential amino acid, plays a crucial role in the development and maturation of the central nervous system in infants. Tryptophan is primarily degraded through the kynurenine pathway. Owing to its sensitivity to dietary intake, immune-mediated tryptophan degradation is assessed by the kynurenine-to-tryptophan ratio, with a focus on one of the rate-limiting enzymes in the pathway. This study involved the validation of the simultaneous determination of tryptophan and kynurenine using HPLC. The validated method was then used to detect levels of tryptophan and kynurenine, as well as to calculate the kynurenine-to-tryptophan ratio in colostrum samples. Simultaneously, these results were compared with colostrum neopterin levels measured using commercial enzyme-linked immunosorbent assay kits. The mean levels for tryptophan, kynurenine, and neopterin were 17.3 ± 62.4 µM, 0.45 ± 0.03 µM, and 28.9 ± 2.6 nM, respectively. This study is among the few that have evaluated these parameters in colostrum samples. Neopterin levels secreted by the mammary gland were found not to be correlated with tryptophan degradation, a process influenced by the mother's nutritional status.

Effects of idebenone and coenzyme Q10 on NLRP3/caspase-1/IL-1ß pathway regulation on ethanol-induced hepatotoxicity in rats.

Chronic and excessive alcohol consumption leads to liver toxicity. There is a need to investigate effective therapeutic strategies to alleviate alcohol-induced liver injury, which remains the leading cause of liver-related morbidity and mortality worldwide. Therefore here, we looked into and evaluated how ethanol-induced hepatotoxicity was affected by coenzyme Q10 (CoQ10) and its analog, idebenone (IDE), on the NLRP3/caspase-1/IL-1 pathway. Hepatotoxicity induced in rats through the oral administration of gradually increasing dosages of ethanol (from 2 to 6 g/kg/day) over 30 days and the effect of CoQ10 (10 or 20 mg/kg) and IDE (50 or 100 mg/kg) were evaluated. Serum hepatotoxicity markers (ALT, AST, GGT, ALP, and TBIL), tissue oxidative stress markers and the mRNA expressions of IL-1ß, IL-18, TGF-ß, NF-κB, NLRP3, and caspase-1 were evaluated. Masson's trichrome staining was also used to visualize fibrosis in the liver tissue. The results indicated that ethanol exposure led to hepatotoxicity as well as considerable NLRP3/caspase-1/IL-1ß pathway activation. Moreover, CoQ10 or IDE treatment reduced measured parameters in a dosage-dependent manner. Thus, by inhibiting the NLRP3/caspase-1/IL-1 pathway, CoQ10 and IDE can prevent the hepatotoxicity caused by ethanol, although CoQ10 is more effective than IDE. This study will provide insight into new therapeutic avenues that take advantage of the anti-inflammatory and antioxidant properties of CoQ10 and IDE in ethanol-induced liver diseases.

Unraveling the neuroprotective mechanisms of naltrexone against aluminum-induced neurotoxicity.

Aluminum (Al) is a known neurotoxic trace element linked to Alzheimer's disease (AD). Naltrexone, an opioid antagonist, has shown promising effects in reducing neuroinflammation at lower doses than those prescribed for addiction. This study aimed to determine the neuroprotective effects of naltrexone on Al-induced neurotoxicity in an in vitro AD model. The SH-SY5Y cells were first cultivated in a standard growth medium. Subsequently, the cells were induced to differentiate by decreasing the concentration of fetal bovine serum and introducing retinoic acid (RA) into the culture media. Subsequently, the inclusion of brain-derived neurotrophic factor (BDNF) was implemented in conjunction with RA. The process of differentiation was concluded on the seventh day. Study groups (n = 3) were designed as the control group, naltrexone group, Al group, Al-Nal group, Alzheimer' model (AD) group, Alzheimer model + Al-exposed group (AD-Al), Alzheimer model + Nal applied group (AD-Nal) and Alzheimer model + Al-exposed + Nal applied group (AD-Al-Nal). Hyperphosphorylated Tau protein as the specific marker of AD was measured in all groups. Glycogen synthase kinase-3 (GSK-3)ß, Protein phosphatase 2A (PP2A), Akt and Wnt signaling pathways were analyzed comparatively. In addition, oxidative stress parameters (total antioxidant capacity, lipid peroxidase, protein carbonyl and reactive oxygen species) were measured comparatively in the study groups. The results showed that naltrexone reduced hyperphosphorylated tau protein levels by regulating GSK-3ß, PP2A, Akt and Wnt signaling. Also, exposure to naltrexone decreased oxidative stress parameters. Based on these results, naltrexone shows promise as a potential therapy for AD, subject to additional clinical assessments.

Antioxidant dihydrolipolic acid protects against in vitro aluminum-induced toxicity.

Dihydrolipoic acid (DHLA) is a natural antioxidant known for its ability to counteract metal toxicity and oxidative stress. It has shown the potential to safeguard cells from harmful environmental substances. It may hold therapeutic benefits in treating neurodegenerative disorders by defending against oxidative damage and chronic inflammation. Thus, this study aimed to explore the potential neuroprotective effects of DHLA against aluminum (Al)-induced toxicity using an Alzheimer's disease (AD) model in vitro. The study focused on two important pathways: GSK-3ß and the Wnt signaling pathways. The SH-SY5Y cell line was differentiated to establish AD, and the study group were as follows: control, Al, DHLA, Al-DHLA, AD, AD-Al, AD-DHLA, and AD-Al-DHLA. The impact of DHLA on parameters related to oxidative stress was assessed. The activity of the GSK-3ß pathway was measured by evaluating the levels of PPP1CA, PP2A, GSK-3ß, and Akt. The Wnt signaling pathway was assessed by measuring Wnt/ß-catenin in the different study groups. Exposure to DHLA significantly reduced oxidative stress by effectively decreasing the levels of reactive oxygen species, thereby protecting against protein oxidation and limiting the production of malonaldehyde. Moreover, the DHLA-treated groups exhibited a remarkable increase in the total antioxidant capacity. Furthermore, the study observed an upregulation of the Wnt signaling pathway and a downregulation of the GSK-3ß pathway in the groups treated with DHLA. In summary, the neuroprotective effects of DHLA, primarily achieved by reducing oxidative stress and modulating critical imbalanced pathways associated with AD, indicate its potential as a promising addition to the treatment regimens of AD patients.

Evaluation of the effects of herpes simplex glycoprotein B on complement system and cytokines in in vitro models of Alzheimer's disease.

Alzheimer's disease (AD) is a neurodegenerative disorder that causes memory loss and dementia and is characterized by a decline in cognitive functions. Brain infections, especially induced by herpes simplex virus type-1 (HSV-1), are suggested to play a key role in the pathogenesis of AD. Within the scope of this study, two different AD models (Tau model and amyloid beta [Aß]) were created in the SH-SY5Y cell line, and HSV glycoprotein B (gB) was applied to the cell line and on the generated AD models. Study groups (n = 3) were designed as (1) control, (2) HSV-gB group, (3) retinoic acid (RA) and brain derived neurotrophic factor (BDNF) induced Alzheimer's model (AD), (4) RA and BDNF induced Alzheimer's model + HSV-gB (ADH), (5) Aß 1-42 peptide-induced Alzheimer's model (Aß), and (6) Aß 1-42 peptide-induced Alzheimer's model + HSV-gB (AßH). Levels of complement proteins and cytokines were determined comparatively. In addition, specific markers of AD (hyperphosphorylated Tau proteins, Aß 1-40 peptide and amyloid precursor protein) were measured in all groups. HSV-gB administration was found to increase Aß and hyperphosphorylated Tau levels, similar to AD models. In addition, our data confirmed that the immune system and chronic inflammation might have a crucial role in AD development and that HSV-1 infection might also be an underlying factor of AD.

Role of aluminum exposure on Alzheimer's disease and related glycogen synthase kinase pathway.

Aluminum (Al) is an environmentally abundant metal that is not essential for life. There is considerable evidence that Al as a neurotoxic xenobiotic may play a role in the pathogenesis of neurodegenerative diseases like Alzheimer's disease (AD). Exposure to aluminum has been shown to cause neuronal damage that resembles the symptoms of AD. In this review, we will summarize recent data about Al as the possible risk of incidence of AD. Then glycogen synthase kinase-3 beta (GSK3ß) contributes to the hyperphosphorylation of Tau protein, the main component of neurofibrillary tangles, one of the hallmarks of AD as one of the mechanisms behind Al neurotoxicity will be covered. Overall, there is still a need for epidemiological studies and more in vivo and in vitro studies to determine the exact mechanisms of its neurotoxicity and the role of GSK3ß in both Al toxic effect and AD.

Aluminium in cosmetics and personal care products.

Usage of inorganic ingredients like aluminium salts in cosmetics and personal care products has been a concern for producers and consumers. Although aluminium is used to treat hyperhidrosis, some worries have been raised about aluminium's role in breast cancer, breast cyst and Alzheimer's disease. The human population is exposed to aluminium from vaccines, diet, and drinking water, but the frequent use of aluminium-based cosmetics might add additional local exposure. This paper reviews literature to determine if aluminium-based products may pose potential harm to the body. The dermal absorption of aluminium is not widely understood. It is not yet known whether aluminium can travel from the skin to brain to cause Alzheimer's disease. Aluminium may cause gene instability, alter gene expression or enhance oxidative stress, but the carcinogenicity of aluminium has not been proved yet. Until now, epidemiological researches were based on oral information, which lacks consistency, and the results are conflicting. Future studies should target real-life-based long-time exposure to antiperspirants and other aluminium-containing cosmetics and personal care products.

The increased neopterin content in turkish pediatric patients with sickle cell anemia.

In the present study, the possible activation of cellular immunity in SCD patients was investigated. As immune activation parameters, neopterin concentrations and kynurenine/tryptophan ratio for tryptophan degradation in 35 pediatric patients with sickle cell disease (31 HbSS and 4 HbSß) were determined. Our results have shown that neopterin levels (both urinary and serum) are increased in pediatric patients with sickle cell disease. The increase in neopterin concentration was accompanied by significantly increased biopterin, kynurenine concentration and kynurenine/tryptophan ratio. The mechanism of immune activation and the effects of inflammatory mediators in sickle cell disease are poorly understood, especially in terms of cell-mediated immunity. Further in-vivo and in-vitro studies are required to illuminate the association between neopterin levels and neutrophil activation in sickle cell disease.

Evaluation of isoindole derivatives: Antioxidant potential and cytotoxicity in the HT-29 colon cancer cells.

Norcantharimides have an isoindole skeleton structure, and some isoindoline derivatives have positive effects on inflammatory pathologies, including cancers. The present study aims to evaluate the antioxidant and cytotoxic potential of four synthesized isoindoline derivatives (NCTD1-4). HT-29 cells exposed to 10, 50, 100, and 200 µM doses of each derivative were incubated for 24 and 48 h, respectively. The cytotoxicity of the new derivatives was analyzed using the cell growth inhibition assay and the cell membrane damage test. In vitro antioxidant activity studies showed that the derivatives have free radical-scavenging effects in a dose-dependent manner. NCTD3 and NCTD4 apparently have antioxidant effects when compared with the control group treated with dimethyl sulfoxide. Furthermore, NCTD4 inhibited the growth of the HT-29 cells due to membrane damage and exhibited a dose-dependent cytotoxic effect on colon adenocarcinoma cells. The findings suggest that NDTD4 has the highest potential for colon cancer treatment and may be interpreted as a candidate anticancer agent.

Nitrite, neopterin levels and tryptophan degradation in allergic conjunctivitis.

PURPOSE: The study aims to evaluate changes in neopterin levels and tryptophan degradation which are induced by Th1-type immune response and nitric oxide metabolism which may be involved in allergic inflammation. METHODS: Serum nitrite, kynurenine, tryptophan and neopterin levels were evaluated in 36 patients with seasonal allergic conjunctivitis, along with these values in 41 healthy subjects. All these parameters have been compared with symptom and sign scores. RESULTS: Tryptophan and kynurenine concentrations were not significantly changed, while serum nitrite concentrations were significantly low, and neopterin levels were significantly increased in patients compared to healthy subjects (p < 0.05). There was a significant relationship between symptom scores and serum nitrite levels in patients. CONCLUSIONS: This preliminary study demonstrates that serum nitric oxide metabolism might have a role in allergic conjunctivitis. Serum neopterin levels but not tryptophan metabolism could serve as a biomarker in patients with seasonal allergic conjunctivitis.

A New Diagnostic and Prognostic Marker in Endometrial Cancer: Neopterin.

OBJECTIVE: In this study, we investigated the correlation between serum and urinary neopterin levels as well as the stage of the disease in women with endometrial cancer.Increased neopterin concentrations are reported in patients with activation of macrophages by interferon-γ, which includes the following: viral infections, autoimmune disorders, allograft rejection, and various malignant tumors. In patients with several types of cancer, high-neopterin concentrations in body fluids like serum/plasma, urine, ascites, and cerebrospinal fluid indicate the course of the disease, and it is associated with poor prognosis. In the light of foregoing, we aimed to investigate the role of neopterin as a prognostic biomarker in endometrial cancer. MATERIALS AND METHODS: Serum neopterin concentrations were determined by enzyme-linked immunosorbent assay and urinary neopterin by high-performance liquid chromatography in 41 patients with endometrial cancer (group 2) and 41 healthy women (group 1). RESULTS: Increased urinary neopterin levels were observed in patients with endometrial cancer (P < 0.001), and the difference in the urinary neopterin levels between low and high stages of endometrial cancer was significant (P < 0.01; stage I-II vs stage III-IV, respectively). Serum neopterin levels did not show a significant difference in each group. CONCLUSIONS: This study suggests that urinary neopterin levels are relevant in evaluating the endometrial cancer stage and follow-up of the disease. As a result, using neopterin and cancer antigen 125 together would be useful in determining the prognosis of endometrial cancer and its posttreatment progression.

Occurrence of multiple mycotoxins and other fungal metabolites in animal feed and maize samples from Egypt using LC-MS/MS.

BACKGROUND: The present study aimed to investigate the occurrence of multiple toxic fungal and bacterial metabolites in 156 animal feed (n = 77) and maize (n = 79) samples collected from three regions in Upper Egypt. The target analytes were quantified using the 'dilute and shoot' approach, followed by a liquid chromatography tandem mass spectrometry analysis. RESULTS: In total, 115 fungal and bacterial metabolites were detected in both matrices, including the regulated mycotoxins in the European Union, in addition to the modified forms such as deoxynivalenol-3-glucosid. Furthermore, some Fusarium, Alternaria, Aspergillus and Penicillum metabolites beside other fungal and bacterial metabolites were detected for the first time in Egypt. All of the samples were contaminated with at least four toxins. On average, 26 different metabolites were detected per sample with a trend of more metabolites in feed than in maize. The maximum number of analytes observed per samples was 54 analytes at maximum concentrations ranging from 0.04 µg kg-1 for tentoxin to 25 040 µg kg-1 for kojic acid. CONCLUSION: According to the international standards, the contamination rates in the investigated regions were not alarming, except for AFB1 in maize. The necessity of further and continuous monitoring is highly recommended to establish a database for mycotoxin occurrence. © 2017 Society of Chemical Industry.

Acrylamide neurotoxicity.

Acrylamide, a food contaminant, belongs to a large class of structurally similar toxic chemicals, 'type-2 alkenes', to which humans are widely exposed. Besides, occupational exposure to acrylamide has received wide attention through the last decades. It is classified as a neurotoxin and there are three important hypothesis considering acrylamide neurotoxicity: inhibition of kinesin-based fast axonal transport, alteration of neurotransmitter levels, and direct inhibition of neurotransmission. While many researchers believe that exposure of humans to relatively low levels of acrylamide in the diet will not result in clinical neuropathy, some neurotoxicologists are concerned about the potential for its cumulative neurotoxicity. It has been shown in several studies that the same neurotoxic effects can be observed at low and high doses of acrylamide, with the low doses simply requiring longer exposures. This review is focused on the neurotoxicity of acrylamide and its possible outcomes.

Walnut oil: a promising nutraceutical in reducing oxidative stress and improving cholinergic activity in an in vitro Alzheimer's disease model.

Improving the quality of life in elderly patients and finding new treatment options for neurological diseases such as Alzheimer's has become one of the priorities in the scientific world. In recent years, the beneficial effects and therapeutic properties of natural foods on neurological health have become a very remarkable issue. Walnut oil (WO) is a promising nutraceutical, with many phytochemicals and polyunsaturated fatty acids and is thought to be promising in the treatment of many neurological diseases and cognitive deficits, such as Alzheimer's disease (AD). Polyphenolic compounds found in WO enhance intraneuronal signaling and neurogenesis and improve the sequestration of insoluble toxic protein aggregates. The objective of this study was to investigate the potential protective and therapeutic effects of WO in a model of AD induced by retinoic acid (RA) and brain-derived neurotrophic factor (BDNF). In order to achieve this, the experimental groups were formed as follows: Control group, WO group, Alzheimer's disease (AD) group, AD + WO applied group (AD + WO). WO supplementation almost significantly reduced oxidative stress in the ad model, providing 2-fold protection against protein oxidation. Additionally, WO showed a significant reduction in tau protein levels (2-fold), increased acetylcholine (ACh) levels (12%), and decreased acetylcholine esterase (AChE) activity (~50%). Since it has been known for centuries that WO does show any adverse effects on human health and has neuroprotective properties, it may be used in the treatment of AD as an additional nutraceutical to drug treatments.

Evaluation of neopterin levels and kynurenine pathway in patients with acute coronary syndrome.

BACKGROUND: Coronary atherosclerosis is the leading cause of coronary artery disease. Several investigations have indicated that tear-sensitive plaques contain macrophages and T cells. Neopterin is an essential cellular immune response biomarker. The main goal of this study was to see if there were any changes in biomarkers like unconjugated pteridines, neopterin, and biopterin, as well as kynurenine pathway enzymes like indoleamine 2,3-dioxygenase (IDO), which catalyzes the rate-limiting step in tryptophan degradation, in patients with the acute coronary syndrome (ACS) caused by angiographic atherosclerosis. METHODS: High-performance liquid chromatography was used to determine the amounts of neopterin, biopterin, and creatinine in urine samples, as well as tryptophan and kynurenine in serum samples. The enzyme-linked immunosorbent assay was used to assess the amounts of neopterin in serum samples. The measured parameters were evaluated between ACS patients and controls. RESULTS: The measured levels of neopterin, biopterin and the kynurenine to tryptophan ratio reflecting IDO activity, and the specifically known biomarkers such as cardiac troponin, creatine kinase, myoglobin, and natriuretic peptides are statistically higher in ACS patients compared to control subjects. On the other hand, the measured parameters are inadequate to classify the conventional kinds of ACS, ST-elevation- and non-ST-elevation- myocardial infarction. CONCLUSIONS: The study found that determining and using neopterin and IDO parameters as biomarkers in individuals with the ACS can support traditional biomarkers. However, it can be concluded that evaluating pteridine biomarkers solely have no privilege to clinical findings in ACS diagnosis and classification.

Dental Implants and Implant Coatings: A Focus on Their Toxicity and Safety.

Dental implants are medical devices that are surgically inserted into the patient's jawbone by an orthodontist to act as roots of missing teeth. After the implantation, the maxilla or mandible integrates with the surface of the dental implant. This process, called "osseointegration," is an important period to ensure the long-term use of dental implants and prevent implant failures. Metal implants are the most used implant materials. However, they have disadvantages such as corrosion, metal ion release from metal implant surfaces and associated toxicity. To avoid these adverse effects and improve osseointegration, alternative dental implant materials such as ceramics, polymers, composites, and novel surface modification technologies have been developed. The safety of these materials are also of concern for toxicologists. This review will give general information about dental implant materials, osseointegration and successful implantation process. Moreover, we will focus on the new surface coatings materials for of dental implants and their toxicity and safety concerns will be discussed.

Oral Care and Maintenance Habits Among Pharmacy Students.

Objective. This study aimed to identify and evaluate oral care habits, awareness, and knowledge of oral dental health among a group of pharmacy students.Methods. An e-questionnaire on oral care habits, awareness, and knowledge was completed by students in a university pharmacy.Results. A total of 484 students with a mean (SD) age of 21.4 (1.6) years participated. Of all participants, 9.3% were not regularly brushing their teeth. The percentage of regular fluoridated toothpaste usage was 44.8%. Three in 5 (64.5%) participants had visited a dentist for a complaint. When answering questions on the possible effects of dental plaque accumulation on teeth, the causative factors for dental decay and signs of periodontal disease, the percentages of students who indicated they "did not know" were 16.3%, 4.8%, and 43.2%, respectively. Among participants, 38.7% were unaware of the cariogenic or erosive effects of pediatric syrups or suspensions. Of all the pharmacy students, 32% stated they have been consulted about some issue related to oral health.Conclusion. The oral care habits, awareness, and oral health knowledge of pharmacy students in one program needs to be improved. Improvement of these measures is a multi-layered issue, not limited only to the quality of life but also to increased awareness associated with public health-related issues related to dental care.

Evaluation of tetrahydrobiopterin pathway in operating room workers: changes in biopterin status and tryptophan metabolism.

The aim of the study was to evaluate the effect of anesthetics as operating room contaminants on tetrahydrobiopterin pathway in 40 operating room personnel and 30 healthy controls by measuring biopterin, dihydrobiopterin reductase, tryptophan, kynurenine and serotonin. Biopterin concentrations were 124 ± 12.3 µmol/mol creatinine in workers and 88 ± 5.7 µmol/mol creatinine in controls whereas kynurenine concentrations were 1.75 ± 0.09 µM and 1.95 ± 0.06 µM, respectively (both, p < 0.05). It can be claimed that enhanced biopterin and diminished kynurenine levels may play a triggering role in disruption of metabolic events in operating room personnel.

Urine neopterin in childhood acute demyelinating diseases: Potential for differential diagnosis.

Inflammatory demyelinating diseases of the central nervous system (CNS) in childhood include clinically and radiologically defined diseases such as acute disseminated encephalomyelitis (ADEM), multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disorder (MOGAD). Differentiation between these phenotypes can be difficult and cases not meeting established diagnostic criteria may remain without any specific diagnosis for months. Laboratory markers can assist in the diagnosis and management of these diseases. Previous studies suggest serum kynurenine-tryptophan pathway products and serum neopterin as biomarkers for CNS autoimmune diseases. Because urine is a reliable and repeatable source for analysis of these products with the additional advantage of easy sampling, we measured neopterin concentrations in serum and urine samples, urinary biopterin and serum kynurenine-tryptophan levels in autoimmune demyelinating diseases of CNS: pediatric multiple sclerosis (pMS, n = 27), MOGAD (n = 10), NMOSD (n = 5) patients and a control group consisting of healthy children or children with non-inflammatory diseases (n = 13), total 55 children. Methods were high performance liquid chromatography (HPLC) for neopterin, biopterin and creatinine in urine and kynurenine and tryptophan in serum; ELISA was used for serum neopterin. Comparison for biomarkers between all diagnostic groups showed urinary neopterin values were significantly higher in the pMS group (p = 0.002). The cut-off point determined by ROC analysis indicated urinary neopterin >167.75 µmol/mol creatinine could distinguish the patients from the controls with a sensitivity of 71% and specificity of 90%. The most significant difference was between the pMS and control groups (p = 0.002) while no difference was observed between pMS patients who were in relapse or stable state. Therefore, urinary neopterin appeared as a potential marker that could differentiate pMS from other demyelinating patient groups MOGAD and NMOSD as well as from controls. The fact that pteridine pathway products had not been studied in urine and serum in children with demyelinating disease before highlights the novelty of this study. If further research in larger samples confirm the present results, these molecules might assist the differential diagnosis of pMS from other demyelinating CNS diseases.