increased urinary neopterin: creatinine ratio as a marker of activation of cell-mediated immunity and oxidative stress in the iranian patients with multiple sclerosis

neopterin, apyrazinopyrimidine compound, is produced by macrophages after induction by interferon gamma (ifn-y) and serves as a marker of cellular immune system activation followed by oxidative stress. the aim of this study was to determine urinary neopterin to creatinine ratio (uncr) as a surrogate marker of cell-mediated immune activation in multiple sclerosis (ms). three weekly early morning urine samples were collected from 27 patients with ms and 31 age- and sex-matched apparently healthy subjects. urinary neopterin and creatinine were determined using reversed phase high-performance liquid chromatography and jaffe reaction, respectively. uncr was significantly higher in patients than in healthy controls indicating ifn-y-induced cellular immunity activation and oxidative stress in multiple sclerosis. as a non-invasive method, uncr determination may be helpful in monitoring disease progression and the effects of therapies, as well.