by Kip AE, Wasunna M, Alves F, Schellens JHM, Beijnen JH, Musa AM, Khalil EAG, and Dorlo TPC. Frontiers in Cellular and Infection Microbiology 2018, 8:181, doi: 10.3389/fcimb.2018.00181.
Summary: The authors evaluated neopterin, a marker of macrophage activation, as a possible pharmacodynamic biomarker to monitor VL treatment response and predict long-term clinical relapse of VL, since the Leishmania parasite resides and replicates within host macrophages during visceral leishmaniasis (VL). Plasma samples (497) were collected from East-African VL patients receiving miltefosine as monotherapy or in combination with liposomal amphotericin B. Neopterin concentrations were measured by ELISA. A higher than 8% increase in neopterin concentration between end of treatment and day 60 follow-up gave the highest predictive power for VL relapse, with 93% sensitivity and 65% speciﬁcity. The authors conclude that this parameter could be a potentially useful surrogate endpoint to identify patients in clinical trials at risk of relapse earlier during follow-up, possibly in a panel of biomarkers to increase its speciﬁcity.