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Neopterin as an indicator of immune activation and prognosis in patients with gynecological malignancies
  1. B. Melichar*,,
  2. D. SolichovÁ and
  3. R. S. Freedman§
  1. *Department of Oncology& Radiotherapy, Charles University Medical School& Teaching Hospital, Hradec Králové, Czech Republic, European Union
  2. Department of Medicine, Charles University Medical School & Teaching Hospital, Hradec Králové, Czech Republic, European Union
  3. Department of Gerontology & Metabolic Care, Charles University Medical School & Teaching Hospital, Hradec Králové, Czech Republic, European Union
  4. §Department of Gynecologic Oncology, University of Texas, M.D. Anderson Cancer Center, Houston, Texas
  1. Address correspondence and reprint requests to: Bohuslav Melichar MD, PhD, Department of Oncology & Radiotherapy, Charles University Medical School & Teaching Hospital, Building 23, Sokolská 581, 500 05 Hradec Králové, Czech Republic, European Union. Email: melichar{at}fnhk.cz

Abstract

Malignant tumors may contribute to host response that involves both the adaptive and innate immune systems. Among other biochemical indicators of systemic immune and inflammatory activity, activation of macrophages by interferon-γ induces a marked increase in the production of neopterin. Neopterin production by activated macrophages is also associated with tryptophan degradation. In addition to tumors of other primary locations, increased urinary and serum neopterin concentrations have been reported in patients with gynecological cancers, including epithelial ovarian carcinoma, cervical carcinoma, endometrial carcinoma, uterine sarcomas, and vulvar carcinoma, but not in women with benign neoplasms or precancerous disorders. Increased neopterin concentrations have been associated with poor prognosis. Elevated levels of neopterin have also been observed in the tumor microenvironment. Systemic (urinary or serum) or local (ascitic fluid) neopterin concentrations increased after therapeutic administration of cytokines. Elevated neopterin concentrations have been associated with anemia of chronic disease and increased urinary zinc loss in patients with gynecological malignancy. Elevated neopterin has also been connected with depressed function of peripheral blood lymphocytes and a decrease in CD4+ T-cell numbers.

  • cervical carcinoma
  • endometrial carcinoma
  • epithelial ovarian carcinoma
  • immunotherapy
  • neopterin

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