JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

eISSN: 2717-7505
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Evaluation of serum neopterin levels in patients with Graves disease
Abstract
Aims: Graves’ disease is a disease with an autoimmune basis in which the synthesis and release of thyroid hormone from the thyroid gland increases. Interferon-gamma (IFN-?) released from activated T lymphocytes causes macrophages to produce neopterin (NPT), increasing its concentration in serum and other body fluids. There is a relationship between NPT and the production of free oxygen radicals by these cells. In this study, it was aimed to measure serum NPT levels in individuals with Graves’ disease.
Methods: The study included 13 newly diagnosed Graves’ patients (neopterin levels were measured at the time of first diagnosis and at the 3rd month of treatment) and 16 Graves’ patients who were followed up in endocrinology outpatient clinics for at least one year. NPT levels of 23 healthy individuals without any disease were taken as the control group. Free triiodothyronine (T3), free thyroxine (T4), thyroglobulin, and thyroid stimulating hormone (TSH) levels were measured in the blood samples of the participants.
Results: Serum NPT levels were found to be higher in Graves’ patients compared to the control group (6.66 nmol/L in newly diagnosed patients, 9.24 nmol/L in patients at the 3rd month of treatment, 10.68 nmol/L in patients followed for one year or more, 1.44 nmol/L in the control group, respectively, p <0.05).
Conclusion: Monitoring NPT levels in serum and other body fluids can be used to evaluate the diagnosis, prognosis, and treatment efficacy of autoimmune diseases. In addition, NPT can be suggested as a potential biomarker to determine disease stage, treatment efficacy, and immunological remission status, as well as the diagnosis of Graves’ disease.

Keywords : Neopterin, Graves disease, hyperthyroidism, cellular immunity, T helper cells

Download Article


1. Kahaly GJ, Bartalena L, Heged&uuml;s L, Leenhardt L, Poppe K,Pearce SH. 2018 European Thyroid Association Guideline forthe management of Graves&rsquo; hyperthyroidism. Eur Thyroid J.2018;7(4):167-186.
2. Taylor PN, Albrech D, Scholz A, et al. Global epidemiologyof hyperthyroidism and hypothyroidism. Nat Rev Endocrinol.2018;14(5):301-316.
3. Sj&ouml;lin G, Holmberg M, T&ouml;rring O, et al. The long-termoutcome of treatment for Graves&rsquo; hyperthyroidism. Thyroid.2019;29(11):1545-1557.
4. Li Q, Wang B, Mu K, Zhang JA. The pathogenesis of thyroidautoimmune diseases: new T lymphocytes-cytokines circuits beyondthe Th1-Th2 paradigm. J Cell Physiol. 2019;234(3):2204-2216.
5. Nanba T, Watanabe M, Inoue N, Iwatan Y. Increases of theTh1=Th2 cell ratio in severe Hashimoto&rsquo;s disease and in theproportion of Th17 cells in intractable Graves&rsquo; disease. Thyroid.2009;19(5):495-501.
6. Horiya M, Anno T, Kawasaki F, et al. Basedow&rsquo;s diseasewith associated features of Hashimoto&rsquo;s thyroiditis based onhistopathological findings. BMC Endocr Disord. 2020;20(1):120.
7. Ekin S, Sivrikaya A, Akdağ T, Yilmaz S, G&uuml;lcemal S. Elevatedlevels of neopterin and pentraxin 3 in patients with rheumatoidarthritis. Horm Mol Biol Clin Investig. 2021;42(4):419-423.
8. G&uuml;rc&uuml; S, Girgin G, Yorulmaz G, Kılı&ccedil;arslan B, Efe B, Baydar T.Neopterin and biopterin levels and tryptophan degradation inpatients with diabetes. Sci Rep. 2020;10(1):1-8.
9. Wagner R, Hayatghebi S, Rosenkranz M, Reinwein D. Increasedserum neopterin levels in patients with Graves&rsquo; disease. Exp ClinEndocrinol. 1993;101(4):249-254.
10. Sj&ouml;lin G, Watt T, Bystr&ouml;m K, et al. Long term outcome after toxicnodular goitre. Thyroid Res. 2022;15(1):20.
11. Sahin Tekin M, Kocaturk E, Gurcu S, Kayadibi H, DibekliogluB, Yorulmaz G. Cellular immunity in subacute thyroiditis:a new perspective through neopterin. Clin Exp Immunol.2022;209(1):109-114.
12. Krause A, Protz H, Goebel K. Correlation between synovialneopterin and inflammatory activity in rheumatoid arthritis. AnnRheum Dis. 1989;48(8):636-640.
13. Hagihara M, Nagats T, Ohhashi M, Miura T. Concentrations ofneopterin andbiopterin in serum from patients with rheumatoidarthritis or systemiclupus erythematosus and in synoviai fluidfrom patients with rheumatoid orosteoarthritis. Clin Chem.1990;36(4):705-706.
14. Arshadi D, Nikbin B, Shakiba Y, Kiani A, Jamshidi AR, BoroushakiMT. Plasma level of neopterin as a marker of disease activity intreated rheumatoid arthritis patients: association with gender,disease activity and anti-CCP antibody. Int Immunopharmacol.2013;17(3):763-767.
15. Schroecksnadel K, Frick B, Kaser S, et al. Moderatehyperhomocysteinaemia and immune activation in patients withrheumatoid arthritis. Clinica Chimica Acta. 2003;338(1-2):157-164.
16. Beckham JC, Caldwell DS, Peterson BL, et al. Disease severityin rheumatoid arthritis: relationships of plasma tumor necrosisfactor-&alpha;, soluble interleukin 2-receptor, soluble CD4/CD8ratio, neopterin, and fibrin D-dimer to traditional severity andfunctional measures. J Clin Immunol. 1992;12(5):353-361.
17. Hanafusa T, Pujol-Borrell R, Chiovato L, Russell RC, DoniachD, Bottazzo GF. Aberrant expression of HLA-DR antigen onthyrocytes in Graves&rsquo; disease: relevance for autoimmunity. Lancet.1983;2(8359):1111-1115.
18. Schomburg A, Gr&uuml;nwald F, Schultes B, Hotze A, Bender H,Biersack HJ. Are serum neopterin concentrations superior toother parameters in the differential diagnosis and prognosticassessment of Graves&rsquo; disease? Exp Clin Endocrinol Diabetes.1996;104(2):123-129.
19. Zantut-Wittmann DE, Tambascia MA, da Silva Trevisan MA,Pinto GA, Vassallo J. Antithyroid drugs inhibit in vivo HLA-DRexpression in thyroid follicular cells in Graves&rsquo; disease. Thyroid.2001;11(6):575-580.
20. Stasiak M, Lewinski A. New aspects in the pathogenesis andmanagement of subacute thyroiditis. Rev Endocr Metab Disord.2021;22(4):1027-1039.
Article available in :
Volume 4, Issue 5, 2023
Page : 418-422
https://doi.org/10.47582/jompac.1345829
Article Information
Received : 18 Ağu 2023
Accepted : 08 Eyl 2023
Published : 27 Eki 2023
Corresponding Author :

Melisa Şahin Tekin: Eskisehir Osmangazi University, Faculty of Medicine, Department of Internal Medicine, Eskisehir, Turkey

[email protected]
Citation : Gürcü S, Yorulmaz G, Kocatürk E, et al. Evaluation of serum neopterin levels in patients with Graves disease. J Med Palliat Care. 2023;4(5):418-422.

Read: 50
Cited: 0
Download : 47
_Footer