Plasma level of neopterin as a marker of disease activity in treated rheumatoid arthritis patients: association with gender, disease activity and anti-CCP antibody.
Immune system activation is known to be involved in the progression of rheumatoid arthritis (RA). The pro-inflammatory cytokine interferon-γ in various cells, including monocytes, induces neopterin production. Plasma level of neopterin has been measured in many autoimmune diseases and can be used as a marker of cellular immunity activation. In this study we measured the plasma level of neopterin in 418 treated RA patients and 398 age and sex matched healthy people by high pressure liquid chromatography (HPLC) method. Disease activity score was calculated in all patients by DAS-CRP method. Plasma level of neopterin was compared between RA and control groups. We also determined the association between neopterin level with gender and disease activity score in RA patients. Significantly higher level of neopterin was observed in RA patients compared to healthy controls. Moreover, there was higher neopterin level in male RA patients versus female patients. Plasma neopterin level was increased in patients with active disease and also was correlated with disease activity parameters. There was a significant correlation of plasma level of neopterin with age in both RA and control group and also age of onset and disease duration in RA patients. Anti-CCP positive patients had higher level of neopterin in comparison to anti-CCP negative patients and there was a significant correlation between neopterin level and anti-CCP titer. Our results indicated that neopterin is a sensitive marker for assaying background inflammation and disease activity score in RA patients and may be used as a marker for evaluation of therapy efficacy.
Department of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Pharmacological Research Center of Medicinal Plants, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Delnia
D
Arshadi
Behrouz
B
Nikbin
Yadollah
Y
Shakiba
Amir
A
Kiani
Ahmad Reza
AR
Jamshidi
Mohammad Taher
MT
Boroushaki
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000097:blood*; D010456:Peptides, Cyclic / Q000276:immunology
D015415:Biomarkers; D007074:Immunoglobulin G; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D019798:Neopterin
ACR; American college of rheumatology; Anti citrulinated protein antibody; Anti cyclic citrulinated peptide antibody; Anti-CCP; Anti-CPA; C reactive protein; CRP; DAS-28; Disease activity score-28; EDTA; ESR; Erythrocyte sedimentation rate; Ethylenediamine tetraacetic acid; GTP; Guanosine triphosphate; HPLC; High pressure liquid chromatography; IFN-γ; Inflammation; Neopterin; RA; RF; Rheumatoid Arthritis; Rheumatoid Factor; Rheumatoid arthritis; VAS; Visual analog scale; interferon gamma