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Mark London said: " However, there are lab tests available that can

confirm macrophage activation. Macrophage activation is required for

TH1 vitamin D production. But this activation also produces a

substance called neopterin. Elevated levels are present in many

inflammatory and infectious diseases, including sarcoidosis. In

sarcoidosis, neopterin levels has been found to be coorelated with

the severity of the disease, while ACE levels have not been. The lab

test for neopterin is simple and inexpensive. "

So, have any of you had this test?

- Kate

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> So, have any of you had this test?

>

> - Kate

>

I just read a little about it... pubmed search = [neopterin marker].

One paper on Behcets:

The results of the serum neopterin levels, ESR and CRP values ESR

(mm/h) CRP (g/L) Neopterin (nmol/L)

Behçet's disease

Active 34.27 ± 19.24 36.06 ± 46.68 8.28 ± 4.31

Inactive 21.53 ± 16.50 8.76 ± 9.17 6.10 ± 1.60

Control 7.2 ± 5.7 4.1 ± 2.3 4.56 ± 0.45

PMID: 16600572

Another paper: http://www.clinchem.org/cgi/content/full/51/10/1902

says

Robust ELISAs are available for the assessment of neopterin with

excellent agreement reported, particularly between the two most

widely used assays (10)(11)(12). Intraassay CVs range from 1.5% to

9.1%, and interassay CVs from 3.0% to 10.8%. Assay detection limits

range from 2 nmol/L to 50 nmol/L. In a study of 76 587 blood donors,

the mean neopterin concentration was 5.4 nmol/L and the 95th

percentile was 8.7 nmol/L. Of importance, 98.4% of the blood donors

in the study had neopterin concentrations <10 nmol/L, and there was

no sex or age (age range, 17–64 years) dependency regarding neopterin

concentrations (13).

Regarding TB:

Int J Tuberc Lung Dis. 2005 Sep;9(9):1040-5.

The diagnostic values of serum, pleural fluid and urine neopterin

measurements in tuberculous pleurisy.

[...] Pleural fluid neopterin > or =30 mol/l gave the best diagnostic

yield, with 85% sensitivity, 93% specificity, 94% positive predictive

value, 84% negative predictive value and 89% diagnostic accuracy,

although it is not superior to pleural fluid adenosine deaminase

determination. CONCLUSION: We have suggested that elevated serum,

pleural fluid and urinary neopterin levels in TP [tuberculous

pleurisy] with respect to pleural effusions of non-tuberculous origin

may reflect activation of cell-mediated immunity and that pleural

fluid neopterin measurement may be of value in the differential

diagnosis of TP.

PMID: 16158898 [PubMed - indexed for MEDLINE]

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