Neopterin belongs to the chemical group known as
pteridines. It is synthesised by human
macrophages upon stimulation with the
cytokineinterferon-gamma and is indicative of a pro-inflammatory immune status. Neopterin serves as a marker of
cellular immune system activation.[1] In humans neopterin follows a circadian and circaseptan rhythm.[2]
Biosynthesis
The biosynthesis of neopterin occurs in two steps from
guanosine triphosphate (GTP). The first being catalyzed by
GTP cyclohydrolase, which opens the ribose group. Phosphatases next catalyze the hydrolysis of the phosphate ester group.[3]
Neopterin as disease marker
Measurement of neopterin concentrations in body fluids like
blood serum,
cerebrospinal fluid or
urine provides information about activation of cellular immune activation in humans under the control of
T helper cells type 1. High neopterin production is associated with increased production of
reactive oxygen species, neopterin concentrations also allow to estimate the extent of
oxidative stress elicited by the
immune system. [4]
Increased neopterin production is found in, but not limited to, the following diseases:
Neopterin concentrations usually correlate with the extent and activity of the disease, and are also useful to monitor during therapy in these patients. Elevated neopterin concentrations are among the best predictors of adverse outcome in patients with HIV infection, in cardiovascular disease and in various types of cancer.
In the laboratory it is measured by
radioimmunoassay (RIA),
ELISA, or high-performance liquid chromatography (HPLC).[7] It has a native
fluorescence of wavelength excitation at 353 nm and emission at 438 nm, rendering it readily detected.
References
Cavaleri et al. Blood concentrations of neopterin and biopterin in subjects with depression: A systematic review and meta-analysis. Progr Neuropsychopharmacol Biol Psychiatry 2023;120:110633.
Murr C, et al. Neopterin as a marker for immune system activation. Curr Drug Metabol 2002;3:175-187.
Fuchs D, et al. The role of neopterin in atherogenesis and cardiovascular risk stratification. Curr Med Chem 2009;16:4644-4653.
Sucher R, et al. Neopterin, a prognostic marker in human malignancies. Cancer Lett 2010;287:13-22.
Zeng B, et al. Serum neopterin for early assessment of severity of severe acute respiratory syndrome. Clin Immunol 2005;116(1):18-26.
Roberston J, et al. Serum neopterin levels in relation to mild and severe COVID-19. BMC Infect Dis 2020;20(1):942.
^ Cavaleri et al. Blood concentrations of neopterin and biopterin in subjects with depression: A systematic review and meta-analysis Progress in Neuro-Psychopharmacology and Biological Psychiatry 2023. 120:110633.
http://dx.doi.org/10.1016/j.pnpbp.2022.110633
^Seizer L, Cornélissen-Guillaume G, Schiepek GK, Chamson E, Bliem HR and Schubert C (2022) About-Weekly Pattern in the Dynamic Complexity of a Healthy Subject’s Cellular Immune Activity: A Biopsychosocial Analysis. Front. Psychiatry 13:799214. doi: 10.3389/fpsyt.2022.799214
^Widner, Bernhard; Laich, Andreas; Sperner-Unterweger, Barbara; Ledochowski, Maximilian; Fuchs, Dietmar (2002). "Neopterin production, tryptophan degradation, and mental depression—What is the link?". Brain, Behavior, and Immunity. 16 (5): 590–595.
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10.1016/s0889-1591(02)00006-5.
PMID12401473.
S2CID35800171.
^ Cavaleri et al. Blood concentrations of neopterin and biopterin in subjects with depression: A systematic review and meta-analysis Progress in Neuro-Psychopharmacology and Biological Psychiatry 2023. 120:110633.
http://dx.doi.org/10.1016/j.pnpbp.2022.110633
^Adam, M. P.; Mirzaa, G. M.; Pagon, R. A.; Wallace, S. E.; Bean LJH; Gripp, K. W.; Amemiya, A.; Crow, Y. J. (1993).
"Aicardi-Goutières Syndrome". GeneReviews. University of Washington, Seattle.
PMID20301648.
^ Cavaleri et al. Blood concentrations of neopterin and biopterin in subjects with depression: A systematic review and meta-analysis Progress in Neuro-Psychopharmacology and Biological Psychiatry 2023. 120:110633.
http://dx.doi.org/10.1016/j.pnpbp.2022.110633
^ Cavaleri et al. Blood concentrations of neopterin and biopterin in subjects with depression: A systematic review and meta-analysis Progress in Neuro-Psychopharmacology and Biological Psychiatry 2023. 120:110633.
http://dx.doi.org/10.1016/j.pnpbp.2022.110633