Abstract
Neopterin has been measured in many autoimmune diseases and was reported as a marker of cellular immunity activation in rheumatoid asthritis (RA). The aim of this work was to assess serum neopterin as a marker of disease activity in treated RA patients. We measured serum level of neopterin in 120 treated RA patients and 100 age- and sex-matched controls by high-performance liquid chromatography (HPLC) method, and disease activity score was calculated in all patients by DAS28-CRP score. Significantly higher levels of neopterin were observed in RA patients (11.46 ± 3.56 nmol/L) compared to healthy controls (4.74 ± 1.98 nmol/L), P < 0.0001. Significantly higher neopterin levels were observed among male RA patients [median (IQR), 13.44 (12.65–16.21)] than female RA patients [median (IQR), 11.86 (7.91–13.44)], P <0.0001. No significant correlations between neopterin and age, age of disease onset, disease duration, or any of the disease activity parameters were found. Moreover, no significant difference regarding neopterin levels in different disease activity phases was identified. Our results indicated that neopterin is a marker of RA but not a marker of disease activity in treated RA patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Neumann E, Lefèvre S, Zimmermann B, Gay S, Müller-Ladner U (2010) Rheumatoid arthritis progression mediated by activated synovial fibroblasts. Trends Mol Med 16(10):458–468
Liao KP, Solomon DH (2013) Traditional cardiovascular risk factors, inflammation and cardiovascular risk in rheumatoid arthritis. Rheumatology (Oxford) 52(1):45–52
Steiner G (2007) Auto-antibodies and autoreactive T-cells in rheumatoid arthritis: pathogenetic players and diagnostic tools. Clin Rev Allergy Immunol 32(1):23–36
Firestein GS (2005) Immunologicmechanisms in the pathogenesis of rheumatoid arthritis. J Clin Rheumatol 11(3 Suppl):S39–S44
Van Venrooij WJ, van Beers JJ, Pruijn GJ (2011) Anti-CCP antibodies: the past, the present and the future. Nat Rev Rheumatol 7(7):391–398
Hoffmann G, Wirleitner B, Fuchs D (2003) Potential role of immune system activation-associated production of neopterin derivatives in humans. Inflamm Res 52:313–321
Schroecksnadel K, Frick B, Kaser S, Wirleitner B, Ledochowski M, Mur E et al (2003) Moderate hyper homocysteinaemia and immune activation in patients with rheumatoid arthritis. Clin Chim Acta 338:157–164
Arshadi D, Nikbin B, Shakiba Y, Kiani A, Jamshidi AR, Boroushaki MT (2013) Plasma level of neopterin as a marker of disease activity in treated rheumatoid arthritis patients: association with gender, disease activity and anti-CCP antibody. Int Immunopharmacol 17(3):763–767
Murr C, Widner B, Wirleitner B, Fuchs D (2002) Neopterin as a marker for immune system activation. Curr Drug Metab 3(2):175–187
Rho YH, Solus J, Raggi P, Oeser A, Gebretsadik T, Shintani A et al (2011) Macrophage activation and coronary atherosclerosis in systemic lupus erythematosus and rheumatoid arthritis. Arthritis Care Res (Hoboken) 3(4):535–541
Ray KK, Morrow DA, Sabatine MS, Shui A, Rifai N, Cannon CP et al (2007) Long-term prognostic value of neopterin: a novel marker of monocyte activation in patients with acute coronary syndrome. Circulation 115(24):3071–3078
Sugioka K, Naruko T, Hozumi T, Nakagawa M, Kitabayashi C, Ikura Y et al (2010) Elevated levels of neopterin are associated with carotid plaques with complex morphology in patients with stable angina pectoris. Atherosclerosis 208(2):524–530
Kay J, Katherine S (2012) Upchurch. ACR/EULAR 2010 rheumatoid arthritis classification criteria. Rheumatology 51(suppl 6):vi5–vi9
Inoue E, Yamanaka H, Hara M, Tomatsu T, Kamatani N (2007) Comparison of disease activity score (DAS)28-erythrocyte sedimentation rate and DAS28-C-reactive protein threshold values. Ann Rheum Dis 66(3):407–409
Schroecksnadel K, Kaser S, Ledochowski M, Neurauter G, Mur E, Herold M et al (2003) Increased degradation of tryptophan in blood of patients with rheumatoid arthritis. J Rheumatol 30(9):1935–1939
D’agostino LE, Ventimiglia F, Verna JA, Colina Ade L, Aguirre Y, Arturi A et al (2013) Correlation between DAS-28 and neopterin as a biochemical marker of immune system activation in early rheumatoid arthritis. Autoimmunity 46(1):44–49
Ozkan Y, Mete G, Sepici-Dincel A, Sepici V, Simsek B (2012) Tryptophan degradation and neopterin levels in treated rheumatoid arthritis patients. Clin Rheumatol 31(1):29–34
Schroecksnadel K, Winkler C, Duftner C, Wirleitner B, Schirmer M, Fuchs D (2006) Tryptophan degradation increases with stage in patients with rheumatoid arthritis. Clin Rheumatol 25(3):334–337
Forrest CM, Kennedy A, Stone TW, Stoy N, Darlington LG (2003) Kynurenine and neopterin levels in patients with rheumatoid arthritis and osteoporosis during drug treatment. Adv Exp Med Biol 527:287–295
Beckham JC, Caldwell DS, Peterson BL, Pippen AM, Currie MS, Keefe FJ et al (1992) Disease severity in rheumatoid arthritis: relationships of plasma tumor necrosis factor-alpha, solubleinterleukin2-receptor, soluble CD4/CD8 ratio, neopterin, and fibrin D-dimer to traditional severity and functional measures. J Clin Immunol 12:353–361
Nasonov EL, Samsonov MI, Tilz G, Fuchs D (2000) Neopterin: new immunological marker of autoimmune rheumatic disease. Klin Med (Mosk) 78:43–6.15
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
The study was approved by the local ethics committee. All subjects were informed by the nature of the study and written consents were obtained. All procedures were in accordance with the ethical standards of the Helsinki Declaration of 1975, as revised in 2000 and 2008.
Disclosures
None.
Rights and permissions
About this article
Cite this article
El-Lebedy, D., Hussein, J., Ashmawy, I. et al. Serum level of neopterin is not a marker of disease activity in treated rheumatoid arthritis patients. Clin Rheumatol 36, 1975–1979 (2017). https://doi.org/10.1007/s10067-016-3433-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-016-3433-4