Objective: To determine the levels of serum and salivary neopterin in acute coronary syndrome (ACS) in comparison with established biomarkers like Troponin-I and CK-MB.
Background: Neopterin is the product of activated macrophage which is released by activated monocyte by cytokines during the acute phase response of ACS, can be used as a biomarker for diagnosis of ACS.
Materials and methods: ACS (n = 675) individuals with or without ST-segment elevation myocardial infarction were enrolled for the study, for three years. Serum and saliva neopterin were estimating by HPLC and compared with established biomarkers like Troponin-I and CK-MB.
Results: Increased serum and salivary neopterin levels were observed in patients with STEMI, NSTEMI, and UA of ACS. From the ROC analysis serum and salivary neopterin were found to be more sensitive and specific than the established biomarkers of ACS like Troponin-I and CK-MB, in diagnosing ACS.
Conclusion: Neopterin being more sensitive and specific than troponin and CK-MB, can be a marker of ACS. The collection of saliva being Non-invasive salivary neopterin can be easily estimated than serum neopterin.
Kolansky DM. Acute Coronary Syndromes: Morbidity, Mortality, and Pharmacoeconomic Burden. Am J Manag Care. 2009;15:36-41.
Fox KAA, Cokkinos DV, Deckers J, et al. The ENACT study: a pan- European survey of acute coronary syndromes. European Heart Journal 2000;21:1440-1449.
Becker RC. The investigation of biomarkers in cardiovascular disease: time for a coordinated, international effort. European Heart Journal 2005;26:421-422.
Christenson RH, Duh SH, Sanhai WR, et al. Characteristics of an Albumin Cobalt Binding Test for Assessment of Acute Coronary Syndrome Patients: A Multicenter Study. Clinical Chemistry 2001;47(3):464-470.
Kaski JC, Sanchez LC, Fernandez-Berges DJ, et al. Elevated serum neopterin levels and adverse cardiac events at 6 months follow-up in Mediterranean patients with non-ST-segment elevation acute coronary syndrome. Atherosclerosis 2008;201: 176-183.
XG Moll, Coccolo F, Cole D, et al. Serum neopterin and complex stenosis morphology in patients with unstable angina. J Am Coll Cardiol 2000;35:956-962.
Avanzas P, Espliguero RA, Quiles J, et al. Elevated serum neopterin predicts future adverse cardiac events in patients with chronic stable angina pectoris. Eur H Jou 2005;26:457-463.
Prakova G, Gidikova P, Slavov E, et al. The potential role of neopterin as a biomarker for silicosis. Trakia Journal of Sciences 2005;3(4): 37-41.
Berdowska A, Korczala KZ. Neopterin measurement in clinical diagnosis. Journal of Clinical Pharmacy and Therapeutics 2001;26: 319-329.
Shubhangi KP, Rajani GT, Aruna AJ. Neopterin: Biomarker of cell-mediated immunity and potent usage as biomarker in silicosis and other occupational diseases. Indian J Occup Environ Med 2008;12(3):107-111.
Carru C, Zinellu A, Sotgia S, et al. A new HPLC method for serum neopterin measurement and relationships with plasma thiols levels in healthy subjects. Biomed Chromatogr 2004;18:360-366.
Gurumurthy P, Borra SK, Yeruva RKR, et al. Estimation of serum neopterin in patients with acute coronary syndrome. Asian Cardiovascular & Thoracic Annals 2013;21(4):426-431.
Katoh S, Sueoka T, Matsuura S, et al. Biopterin and Neopterin in human saliva. Life Sciences 1989;45:2561-2568.
Reibnegger G, Fuchs D, Zangerle R, et al. Increased Neopterin Concentration In Saliva of Patients with H1V-1Infection. Clin Chem 1990;36:1379-1380.
Ledjeff E, Artner DE, Witasek A, et al. Neopterin Concentrations in Colon Dialysate. Pteridines 2001;12:155-160.
Sfriso P, Ostuni P, Botsios C, et al. Serum and salivary neopterin and interferon-gamma in primary Sjogren's syndrome. Correlation with clinical, laboratory and histopathologic features. Scand J Rheumatol 2003;32(2):74-78.
Lars H, Paola C, Magnus G, et al. Cerebrospinal fluid neopterin: an informative biomarker of central nervous system immune activation in HIV-1 infection. AIDS Research and Therapy 2010;7(15): 1-12.
Meisel SR, Shapiro H, Radnay J, et al. Increased expression of neutrophil and monocyte adhesion molecules LFA-1 and Mac-1 and Their ligand ICAM-1 and VLA-4 throughout the acute phase of Myocardial Infarction. J Am Coll Cardiol 1998;31:120-125.