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Serum neopterin in chronic beryllium disease
Author(s) -
Harris James,
Bartelson Becki Bucher,
Barker Elizabeth,
Balkissoon Ronald,
Kreiss Kathleen,
Newman Lee S.
Publication year - 1997
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/(sici)1097-0274(199707)32:1<21::aid-ajim3>3.0.co;2-u
Subject(s) - medicine , neopterin , beryllium , disease , occupational exposure , immunology , occupational disease , intensive care medicine , environmental health , physics , nuclear physics
We evaluated serum neopterin as a biomarker of chronic beryllium disease (CBD), for use in conjunction with the beryllium lymphocyte proliferation test (BeLPT) in workplace screening. Serum neopterin levels were determined by radioimmunoassay, and we compared levels in three groups: CBD (n = 86), beryllium sensitized (BeS) (n = 22), and normal (Nor) (n = 20). Those in the diseased group underwent pulmonary function tests, bronchoalveolar lavage (BAL), and maximal exercise testing. We correlated neopterin levels with results of these clinical parameters of disease severity. To evaluate the optimum sensitivity, specificity, and neopterin cut‐off value, receiver operator characteristic (ROC) curves were generated. The median serum neopterin level in CBD was significantly higher than in BeS or in Nor [median 1.45, 25 th , 75 th percentiles (1.00, 2.7) ng/ml, 0.82 (0.67, 1.16) ng/ml, and 0.92 (0.86, 1.16) ng/ml, respectively] ( P < 0.05). In CBD, we observed statistically significant associations between neopterin and measures of gas exchange and BAL cellularity. Using a neopterin value of 1.27 ng/ml, test specificity is 88%. In those workers with an abnormal BeLPT, serum neopterin has high positive predictive value (92%), and can identify disease, helping to distiudistinguish it from BeS without the risks of biopsy. Am. J. Ind. Med. 32:21‐26, 1997. © 1997 Wiley‐Liss, Inc.