Serum Neopterin Level in Systemic Lupus Erythematosus: Relation toDisease Activity, Organ Affection and Different Therapy Regimens | ||||
| Bulletin of Egyptian Society for Physiological Sciences | ||||
| Article 16, Volume 27, Issue 2, December 2007, Page 233-248 PDF (246.91 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/besps.2007.37375 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Nouran El Ghandour* 1; Hanan Abd El Aziz2; Samar Marzouk2; Marwa Ahmed2 | ||||
| 1Department of Internal Medicine, Faculty of Medicine, Cairo University | ||||
| 2Department of Medical Biochemistry, Faculty of Medicine, Cairo University | ||||
| Abstract | ||||
| Distinguishing patients with active systemic lupus erythematosus (SLE) from those with inactive disease has always been considered a great challenge. Identifying new sensitive markers of activity will be of great value in the clinical management of the disease. Thus the aim of the current study was to investigate the relationship between serum neopterin levels and various parameters of disease activity currently used, in addition, to investigate serum neopterin levels in different patterns of organ disease involvement and during the administration of different therapy regimens used in the management of SLE. The study was conducted on 75 female subjects; 26 patients with active SLE, 24 SLE patients in remission and 25 healthy controls. Patients with SLE were fulfilled four or more of the American Rheumatism Association (ARA) criteria, and disease activity was scoredusing the British Isles Lupus Assessment Group (BILAG) index.Erythrocyte sedimentation rate (ESR), serum urea, serum creatinine, liver function tests, plasma complements C3 and C4, C3 degradation products (C3dg), anti-double stranded DNA antibodies (anti-dsDNA) and serum neopterin were measuredin all groups. Serum neopterin was significantly elevated in the active group as compared to the remission group.Both groups of SLE showed higher levels of neopterin when compared to the control group. Serum neopterin level showed higher sensitivity than other SLE markers (80%) and second highest specificity after anti-dsDNA antibodies (73%). Also, a highly significant positive correlation was found between serum neopterin levels and each of plasma C3dg, anti-dsDNA antibodies, and ESR. Meanwhile, a highly significant negative correlation was detected between serum neopterin levels and both plasma C3 and C4 levels. As regarding various treatment regimens used in the management of active SLE, the current study demonstrated decrease in serum neopterin levels in patients receiving combined treatment of both prednisolone and cytotoxic drugs than those receiving either treatment alone. A significant difference in serum neopterin levels was observed in patients with multiple organ affection in comparison to those with single organ affection regardless the type of organ affected. The present results suggest that the estimation of serum neopterin levels seems beneficial in the assessment of disease activity and progress in SLE patients as well as the assessment of the efficacy of various treatment regimens being used. | ||||
| Keywords | ||||
| Systemic lupus erythematosus; Neopterin; complements; anti-ds DNA antibodies | ||||
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