Macrophage activation marker neopterin: A candidate biomarker for treatment response and relapse in visceral leishmaniasis

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.

Click here to read the article / PDF