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Terken Baydar 1 Article
Evaluation of neopterin levels and kynurenine pathway in patients with acute coronary syndrome
Ibrahim Kember, Sonia Sanajou, Bilge Kilicarslan, Gözde Girgin, Terken Baydar
Acute Crit Care. 2023;38(3):325-332.   Published online August 30, 2023
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AbstractAbstract PDF
Coronary atherosclerosis is the leading cause of coronary artery disease. Several investigations have indicated that tear-sensitive plaques contain macrophages and T cells. Neopterin is an essential cellular immune response biomarker. The main goal of this study was to see if there were any changes in biomarkers like unconjugated pteridines, neopterin, and biopterin, as well as kynurenine pathway enzymes like indoleamine 2,3-dioxygenase (IDO), which catalyzes the rate-limiting step in tryptophan degradation, in patients with the acute coronary syndrome (ACS) caused by angiographic atherosclerosis.
High-performance liquid chromatography was used to determine the amounts of neopterin, biopterin, and creatinine in urine samples, as well as tryptophan and kynurenine in serum samples. The enzyme-linked immunosorbent assay was used to assess the amounts of neopterin in serum samples. The measured parameters were evaluated between ACS patients and controls.
The measured levels of neopterin, biopterin and the kynurenine to tryptophan ratio reflecting IDO activity, and the specifically known biomarkers such as cardiac troponin, creatine kinase, myoglobin, and natriuretic peptides are statistically higher in ACS patients compared to control subjects. On the other hand, the measured parameters are inadequate to classify the conventional kinds of ACS, ST-elevation- and non-ST-elevation- myocardial infarction.
The study found that determining and using neopterin and IDO parameters as biomarkers in individuals with the ACS can support traditional biomarkers. However, it can be concluded that evaluating pteridine biomarkers solely have no privilege to clinical findings in ACS diagnosis and classification.


Citations to this article as recorded by  
  • Biomarkers to monitor the prognosis, disease severity, and treatment efficacy in coronary artery disease
    Armand N. Yazdani, Michaela Pletsch, Abraham Chorbajian, David Zitser, Vikrant Rai, Devendra K. Agrawal
    Expert Review of Cardiovascular Therapy.2023; 21(10): 675.     CrossRef
  • Evaluation of Neopterin as a Neuroinflammatory Marker for Peripheral Neuropathy in Type 2 Diabetic Patients
    Israa Abdelmalik Salem, Sura Ahmed Abdulsattar, Haider Fadhil Alrubaye
    Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 ).2023; 5(1S): S183.     CrossRef

ACC : Acute and Critical Care