title: Neopterin as an indicator of immune activation and prognosis in patients with gynecological malignancies.
abstract: 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.
authors.affiliation: Departments of Oncology & Radiotherapy, Charles University Medical School & Teaching Hospital, Building 23, Sokolská 581, 500-05 Hradec Králové, Czech Republic, European Union. melichar@fnhk.cz
authors.forename: B
authors.initials: B
authors.lastname: Melichar
authors.forename: D
authors.initials: D
authors.lastname: Solichová
authors.forename: R S
authors.initials: RS
authors.lastname: Freedman
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D016889:Endometrial Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology; D005260:Female; D005833:Genital Neoplasms, Female / Q000276:immunology* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D019798:Neopterin / Q000032:analysis / Q000378:metabolism*; D010051:Ovarian Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology
chemical_list: D015415:Biomarkers; D019798:Neopterin