Increased neopterin concentrations are common in patients suffering from malignant tumors. Neopterin concentrations correlate with stage of the disease and provide significant predictive information for the disease development.
Neopterin as an indicator of immune activation and prognosis in patients with gynecological malignancies
Melichar B, et al. Departments of Oncology & Radiotherapy, Charles University Medical School & Teaching Hospital, Hradec Kralove, Czech Republic
(Int J Gynecol Cancer 2006;16:240-52.)
Malignant tumors may contribute to host response that involves both the adaptive and innate immune systems. Among other biochemical indicators of systemic immune and inflammatory activity, activation of macrophages by interferon-gamma induces a marked increase in the production of neopterin. Neopterin production by activated macrophages is also associated with tryptophan degradation. In addition to tumors of other primary locations, increased urinary and serum neopterin concentrations have been reported in patients with gynecological cancers, including epithelial ovarian carcinoma, cervical carcinoma, endometrial carcinoma, uterine sarcomas, and vulvar carcinoma, but not in women with benign neoplasms or precancerous disorders. Increased neopterin concentrations have been associated with poor prognosis. Elevated levels of neopterin have also been observed in the tumor microenvironment. Systemic (urinary or serum) or local (ascitic fluid) neopterin concentrations increased after therapeutic administration of cytokines. Elevated neopterin concentrations have been associated with anemia of chronic disease and increased urinary zinc loss in patients with gynecological malignancy. Elevated neopterin has also been connected with depressed function of peripheral blood lymphocytes and a decrease in CD4+ T-cell numbers.
as a marker for activated cell-mediated immunity: application in malignant
Reibnegger G, et al. Institute for Medical Chemistry and Biochemistry, University of Innsbruck, Austria
(Cancer Detect Prev 1991; 15: 483-90)
A review is presented on studies concerning neopterin determination in patients with malignant neoplastic diseases. Neopterin is produced chiefly by human macrophages through their activation by T-cell-derived interferon gamma. In vivo, determination of neopterin in various body fluids provides a convenient way to monitor early events that are involved in cell-mediated immune responses. In malignant neoplasia, elevation of neopterin concentrations in body fluids depends on tumor type. Within a given type of tumor, more advanced stages are generally associated with higher levels than early disease. In a variety of different tumor types and sites, a significantly poorer prognosis was associated with high pretherapeutic neopterin concentrations. This predictive value is independent of several possible confounders such as stage or therapy. During follow-up malignant disease, neopterin elevations may predict deterioration of the clinical status of the patients and thereby provide a valuable additional marker for monitoring such patients. Possible immunobiological implications of the results are discussed.
Increased urinary excretion of neopterin in patients with malignant tumors and with virus diseases
Wachter H, et al. Institute
for Medical Chemistry and Biochemistry, University of Innsbruck, Austria
(Hoppe Seylers Z Physiol Chem 1979; 360: 1957-60)