Detection of neopterin as parameter of potential monocyte activation in patients with acute ischemic stroke.

The mechanisms by which inflammation may induce endothelial dysfunction are not fully understood. It was analyzed if neopterin (a by-product of activated macrophage metabolism) is elevated in patients with systemic inflammatory insult at the time of ischemic stroke. There were investigated 86 consecutive patients with mean age 67 +/- 7.8 years who were admitted within 24 h after ischemic stroke. A control group of 37 patients with mean age 58 +/- 4.9 years without ischemic stroke was also tested. Measurements of serum neopterin levels were performed using enzyme linked immunosorbent assay. Patients with acute ischemic stroke had significantly higher serum levels of neopterin (mean value +/- SD) than controls: 9.6 +/- 1.2 vs. 7 +/- 0.8 nmol/L (p < 0.01). Immune mechanisms contribute to cerebral ischemic injury. The finding of higher serum levels of neopterin, which is regarded as a humoral component of the immune-mediated inflammatory response, sustains the hypothesis that patients with ischemic stroke may show higher levels of inflammatory markers like neopterin. Our results indicate increased monocyte activation after ischemic stroke. In patients with stroke it has been shown that neopterin was determinant of endothelium-dependent vascular dysfunction. However, these preliminary results need to be confirmed by controlled studies.