title: Plasma neopterin/C-reactive protein ratio as an adjunct to the assessment of infection and cancer cachexia.
abstract: Neopterin (NPT), a pteridine intermediate metabolite in the biopterine synthetic pathway, is synthesized and secreted by monocytes/macrophages upon stimulation, mainly by gamma-interferon produced by activated T cells. C-reactive protein (CRP) is one of the major acute-phase reactants and its release is thought to be mediated by interleukin-6. Plasma concentrations of NPT and CRP were synchronously analyzed in 25 determinations of 5 patients with severe infectious complications and 50 determinations of 10 cancer-burden patients representing cachexia. The mean value of NPT (pmol/ml) was 201.6 in the infection group and 16.5 in the cancer cachexia group. The mean value of CRP (mg/dl) was 12.5 in the infection group and 3.4 in the cancer cachexia group. The number of samples in which NPT alone exceeded the cut-off level were 0/25 (0%) in the infection group and 38/50 (76.0%) in the cancer cachexia group. The number of samples in which both NPT and CRP exceeded the cut-off level was 25/25 (100%) in the infection group and 12/50 (24.0%) in the cancer cachexia group. The mean ratio of NPT to CRP was 11.3 in the infection group and 30.7 in the cancer cachexia group, respectively. These results suggest that gamma-interferon could play the principal role in the pathogenesis of cancer cachexia and that interleukin-6 modified the disease status. Interleukin-6 would be the critical mediator of host responses in infectious complications.
authors.affiliation: First Department of Surgery, Okayama University Medical School, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Iwagaki
authors.forename: A
authors.initials: A
authors.lastname: Hizuta
authors.forename: N
authors.initials: N
authors.lastname: Tanaka
authors.forename: K
authors.initials: K
authors.lastname: Orita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001708:Biopterins / Q000031:analogs & derivatives* / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002100:Cachexia / Q000097:blood* / Q000150:complications / Q000209:etiology; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D019798:Neopterin; D013530:Surgical Wound Infection / Q000097:blood* / Q000150:complications
chemical_list: D015850:Interleukin-6; D001708:Biopterins; D019798:Neopterin; D007371:Interferon-gamma; D002097:C-Reactive Protein