Time-course of neopterin levels in patients suffering from severe sepsis treated with and without Drotrecogin-alpha (activated).
Neopterin is secreted by activated monocytes/macrophages upon stimulation with interferon-gamma. The release of this pro-inflammatory mediator permits the activation status of cell-mediated immune system to be examined. We assayed neopterin plasma concentrations in septic patients under treatment with (n=10) and without Drotrecogin-alpha (activated) (n=10) on d 1 and 6 of severe sepsis. In septic patients treated with Drotrecogin-alpha (activated), neopterin levels decreased significantly (p=0.027) from d 1 (baseline) (mean 140.8 nmol/l, +/-standard error of mean (SEM) 106.2) to d 6 (mean 68.9 nmol/l, +/-SEM 46.4). In patients not treated with Drotrecogin-alpha (activated) there was no significant (p=0.96) decrease of neopterin levels from d 1 (mean 147.8 nmol/l, +/-SEM 58.4) to d 6 (mean 139.7 nmol/l, +/-SEM 52.6). Furthermore, neopterin levels showed significant correlations with bilirubin in all patient groups on d 1 of severe sepsis (range of correlation coefficient, r: 0.69-0.88; p<0.05). Neopterin levels correlated significantly with creatinine with regard to all patient groups (range of correlation coefficient, r: 0.73-0.92; p<0.05). In conclusion, Drotrecogin- alpha (activated) was associated with a significant decrease of neopterin plasma levels in septic patients. Neopterin concentrations appear to depend on renal function and enterohepatic circulation.
Behnes
Michael
M
First Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
Brueckmann
Martina
M
Wiessner
Mike
M
Kettenmann
Eva
E
Liebetrau
Claudia
C
Lang
Siegfried
S
Putensen
Christian
C
Borggrefe
Martin
M
Hoffmann
Ursula
U
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001663:Bilirubin / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000097:blood*; D011486:Protein C / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D018805:Sepsis / Q000188:drug therapy* / Q000276:immunology*; D013223:Statistics as Topic; D013997:Time Factors
D000900:Anti-Bacterial Agents; D011486:Protein C; D011994:Recombinant Proteins; D019798:Neopterin; D003404:Creatinine; C421124:drotrecogin alfa activated; D001663:Bilirubin