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    CLINICAL SIGNIFICANCE OF INCREASED SERUM NEOPTERIN IN CHRONIC KIDNEY FAILURE AS A BIOMARKER OF CELL-MEDIATED IMMUNITY
    (Sciendo, 2019) Unuvar, Songul; Aslanhan, Hamza
    Background: Neopterin is a pyrazino-pyrimidine compound which is used as a marker of cell-mediated immunity in a variety of diseases. It is known that neopterin levels increase in diseases where interferon-gamma (IFN-gamma) stimulation is present, and also as a result of deficiencies in renal function, given that the primary means of elimination of neopterin is through the kidneys. In this study, we aimed to investigate the role of increased neopterin levels as a prognostic biomarker in patients with impaired renal function. Methods: A total of 90 individuals including 63 patients with chronic kidney failure (CKF) and 27 healthy volunteers were included in the study. Serum neopterin concentrations were measured using the enzyme-linked immunosorbent assay. A Mann-Whitney U test and a Pearson Correlation Test were used in the statistical analysis, with a p value of <0.05 being considered statistically significant. Results: The mean age was 52.21 +/- 0.16 years in the patient group and 56.55 +/- 0.32 years in the control group. In the CKF patients, serum neopterin levels increased to a significantly greater degree than in the control group (p<0.001), while no statistically significant correlation was identified between serum neopterin levels and age (p>0.05). Conclusions: A significant increase was found in the serum neopterin levels in the CKF patients, due to both the triggering of the disease and the reduction of neopterin elimination.
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    POTENTIAL PROGNOSTIC ROLE OF IMMUNE SYSTEM ACTIVATION MARKER NEOPTERIN IN PATIENTS WITH TYPE 2 DIABETES
    (Sciendo, 2018) Unuvar, Songul; Tanriverdi, Zubeyde; Aslanhan, Hamza
    Background: An increase in neopterin concentrations is known in some pathologies due to interferon-gamma (INF-gamma) activation. These include viral and bacterial infections, autoimmune diseases, metabolic diseases, psychiatric disorders, tissue and organ rejections, and different malignancies. The aim of this study was to evaluate the role of neopterin as a prognostic biomarker in type 2 diabetes, which is a metabolic disease with a high worldwide prevalence. Methods: The study included a total of one hundred thirty-nine individuals including one hundred and six patients admitted to a family medicine outpatient clinic and diagnosed with type 2 diabetes and thirty-three healthy volunteers. Serum neopterin concentrations were measured using the enzyme-linked immunosorbent assay. Results: Serum neopterin levels significantly increased in type 2 diabetes patients, compared to the control group (p<0.001). Conclusions: Early diagnosis of diabetes and determination of the appropriate therapeutic options are of utmost importance, as diabetes is also associated with other systemic diseases. The risk of developing secondary diseases is high in untreated patients. Our study results suggest that serum neopterin may be a useful biomarker in patients with type 2 diabetes.
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    The relationship between neopterin and hepatitis B surface antigen positivity
    (De Gruyter Poland Sp Z O O, 2018) Unuvar, Songul; Aslanhan, Hamza; Tanriverdi, Zubeyde; Karakus, Fuat
    Hepatitis B is a life-threatening viral liver infection caused by the hepatitis B virus. Neopterin is regarded as an immunologic biomarker of several diseases related to activation of the cellular immune system. Hepatitis B infection is associated with increased production of cellular immune system markers. We aimed to investigate whether there is a relationship between hepatitis B surface antigen-positivity (HBsAg +) and neopterin to determine the role of neopterin in the early diagnosis of hepatitis B infections. Seventy-two HBsAg (+) patients with normal liver function tests and forty-three controls were included in the study. Neopterin levels were 17.6 +/- 0.13 nmol/L in HBsAg (+) patients; and 9.12 +/- 0.09 nmol/L in infection-free controls, respectively. Compared to the control group, a statistically significant increase (p < 0.001) in the serum neopterin levels of the patients was observed. No significant relationship was determined between neopterin levels and age/sex (both, p > 0.05). With overstimulation of interferon-gamma, the production of neopterin increases by monocytes/macrophages. Likewise with other diseases associated with an activated cellular immune system, this study shows that neopterin can be a predictive biomarker for persistent carriers of hepatitis B infection.