title: Significance of CSF total neopterin and biopterin in inflammatory neurological diseases.
abstract: Total neopterin (T-N), a by-product in the biopterin biosynthesis and an indicator of activation of the cellular immune system, and total biopterin (T-B) levels in cerebrospinal fluid (CSF), were measured in patients with various inflammatory neurological diseases and Parkinson's disease, and the following results were obtained. (1) In patients with neuro-sarcoidosis, neuro-Behçet's disease and meningitis, CSF T-N levels were markedly elevated in the exacerbation or acute stages of their neurological symptoms and remarkably decreased in the remission or chronic stages. In the neuro-sarcoidosis and neuro-Behçet's disease patients, however, CSF T-B levels showed no substantial change. (2) There was a significant positive correlation between CSF T-N levels and CSF/serum albumin ratios only in the meningitis patients. However, increases of CSF T-N levels were not associated with those of plasma T-N levels. (3) In the Parkinson's disease patients, CSF T-N levels remained normal, although CSF T-B levels significantly decreased. (4) A gradient for the CSF T-N value (lumbar greater than ventricular CSF), being reverse to the CSF T-B value, was observed. These results indicate that the significance of CSF T-N is quite different from CSF T-B, and that CSF T-N appears to be a valuable biochemical marker for evaluating the activity of inflammation within the central nervous system. Its measurement seems useful for therapeutic monitoring, especially of patients showing the chronic exacerbating-remitting course.
authors.affiliation: Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Furukawa
authors.forename: K
authors.initials: K
authors.lastname: Nishi
authors.forename: T
authors.initials: T
authors.lastname: Kondo
authors.forename: K
authors.initials: K
authors.lastname: Tanabe
authors.forename: Y
authors.initials: Y
authors.lastname: Mizuno
mesh_terms: D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D001528:Behcet Syndrome / Q000134:cerebrospinal fluid; D001708:Biopterins / Q000031:analogs & derivatives* / Q000134:cerebrospinal fluid; D005260:Female; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects / Q000276:immunology; D008297:Male; D008581:Meningitis / Q000134:cerebrospinal fluid; D009113:Muramidase / Q000494:pharmacology; D019798:Neopterin; D009422:Nervous System Diseases / Q000134:cerebrospinal fluid*; D012507:Sarcoidosis / Q000134:cerebrospinal fluid
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D001708:Biopterins; D019798:Neopterin; D009113:Muramidase