• Bianca Thomas, Priyesh Bipath, and Margaretha Viljoen.
• Department of Human Anatomy and Physiology, Faculty of Health Sciences, University of Johannesburg, South Africa.
• Afr Health Sci. 2019 Sep 1; 19 (3): 2407-2413.

BackgroundNeopterin, a product of cell-mediated immunity, is a non-specific biomarker of inflammation. Plasma/serum is generally the body fluid of choice for neopterin assessment, but urine is often used as it does away with venepuncture. Analysis of urine neopterin is based on collection of a single urine sample and expressed as µmol neopterin/mol creatinine.ObjectivesTo examine published correlations between plasma neopterin levels and urine neopterin:creatinine ratios and to determine whether they are in diagnostic agreement.MethodsLiterature search was performed by databases and by hand. Databases included Academic Search Complete; Africa-Wide Information; AHFS Consumer Medication Information; eBook Collection (EBSCOhost); Family & Society Studies Worldwide; MasterFILE Premier; MEDLINE; TOC Premier.ResultsPositive correlations of varying statistical significance generally exist between plasma neopterin and urine neopterin: creatinine ratios. With a decline in renal clearance, plasma neopterin over-estimates inflammatory activity. With immune-complex renal disease, urine neopterin:creatinine ratios over-estimate systemic inflammation. The two biomarkers can differ in diagnostic validity.ConclusionCorrelations between plasma neopterin and urine neopterin:creatinine ratios suggest both as suitable biomarkers. However, since correlations reflect equality of means and not individual values, significant correlations, do not necessarily imply diagnostic agreement. Therefore, plasma and urine cannot summarily be assumed interchangeable for diagnostic/prognostic purposes.© 2019 Thomas et al.

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