hujpharm Hacettepe University Journal of the Faculty of Pharmacy 2458-8806 Hacettepe University 10.52794/hujpharm.1261037 Pharmacology and Pharmaceutical Sciences Eczacılık ve İlaç Bilimleri Evaluation of Neopterin Levels and Kynurenine Pathway in Acute Coronary Syndrome Patients Neopterin Düzeylerinin ve Kinürenin Yolağının Akut Koroner Sendrom Hastalarında Değerlendirilmesi https://orcid.org/0000-0002-8440-4242 Kember İbrahim HACETTEPE ÜNİVERSİTESİ, ECZACILIK FAKÜLTESİ https://orcid.org/0000-0002-7051-0490 Girgin Gözde HACETTEPE ÜNİVERSİTESİ, ECZACILIK FAKÜLTESİ https://orcid.org/0000-0002-5497-9600 Baydar Terken HACETTEPE UNIVERSITY 12 01 2023 43 4 340 351 03 06 2023 06 20 2023 Copyright © 1981, Hacettepe University Journal of the Faculty of Pharmacy 1981 Hacettepe University Journal of the Faculty of Pharmacy

The leading cause of coronary artery disease is coronary atherosclerosis. Intracoronary thrombus caused by rupture of atherosclerotic plaque is the main cause of acute coronary syndrome. It has been shown in various studies that tear-sensitive plaques contain more macrophages and T lymphocytes. Neopterin is an important biomarker of cellular immune response. It is considered an important biomarker of early diagnosis and prognosis in a wide variety of pathologies, including inflammation, infections and malignancies. In addition to the release of neopterin in cellular immune activation, indolamine 2,3-dioxygenase (IDO), which catalyzes the rate limiting step in tryptophan degradation, is also induced. It has been reported that the IDO activity, shown by kynurenine (Kyn) to tryptophan (Trp) ratio, can be used as an important indicator in the regulation of cellular immunity, supported by immune variables. In this review, it is aimed to evaluate the possible changes in the diagnosis of coronary artery disease (CAD), mortality and morbidity determination of biochemical indicators such as neopterin, C-reactive protein (CRP), IDO in patients with acute coronary syndrome that develop angiographically on the basis of atherosclerosis. Determination and use of neopterin levels and kynurenine pathway parameters as biomarkers in acute coronary syndrome patients are meaningful and valuable.

Neopterin Düzeylerinin ve Kinürenin Yolağının Akut Koroner Sendrom Hastalarında DeğerlendirilmesiKoroner arter hastalığının en önemli nedeni koroner aterosklerozdur. Aterosklerotik plağın yırtılması ile oluşan intrakoroner trombüs ise akut koroner sendomun temel nedenidir. Yırtılmaya hassas plakların daha fazla sayıda maktofaj ve T lenfosit içerdiği çeşitli çalışmalarda gösterilmiştir. Neopterin hücresel immün yanıtın önemli bir biyogöstergesidir. İnflamasyon, çeşitli enfeksiyonlar ve maligniteler de dahil olmak üzere çok çeşitli patolojilerde erken tanı ve prognoz için önemli bir biyomarkör olarak kabul edilir. Hücresel immün aktivasyonda neopterin salınımına ilave olarak triptofan yıkımında hız kısıtlayıcı basamağı katalizleyen indolamin 2,3-dioksijenaz (İDO) enzimi de aynı anda indüklenir. Kinürenin (Kyn) in triptofan (Trp) ’a oranlanmasıyla ifade edilebilien İDO aktivitesinin, immün değişkenlerle desteklenerek hücresel immünitenin düzenlenmesinde önemli bir gösterge olarak kullanılabileceği rapor edilmiştir. Bu derleme makalesinde, anjiyografik olarak ateroskleroz zemininde gelişen akut koroner sendrom (AKS) hastalarında, neopterin, C reaktif protein (CRP), İDO gibi biyokimyasal göstergelerin koroner arter hastalığı (KAH) tanısı, mortalite ve morbidite süreçlerindeki olası değişimlerin değerlendirilmesi hedeflenmiştir. Akut koroner sendrom hastalarında, neopterin düzeyleri ile kinürenin yolağı parametlerinin belirlenmesi ve biyomarkör olarak kullanılmaları anlamlı ve değerlidir.

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