Serum Levels of Neopterin during Antimicrobial Treatment for Mycobacterium ulcerans Infection

Janine de Zeeuw Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, The Netherlands; Agogo Presbyterian Hospital, Agogo, Ghana; Nkawie-Toase Governmental Hospital, Nkawie, Ghana

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Sridevi Duggirala Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, The Netherlands; Agogo Presbyterian Hospital, Agogo, Ghana; Nkawie-Toase Governmental Hospital, Nkawie, Ghana

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Willemien A. Nienhuis Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, The Netherlands; Agogo Presbyterian Hospital, Agogo, Ghana; Nkawie-Toase Governmental Hospital, Nkawie, Ghana

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K. Mohammed Abass Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, The Netherlands; Agogo Presbyterian Hospital, Agogo, Ghana; Nkawie-Toase Governmental Hospital, Nkawie, Ghana

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Wilson Tuah Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, The Netherlands; Agogo Presbyterian Hospital, Agogo, Ghana; Nkawie-Toase Governmental Hospital, Nkawie, Ghana

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Till F. Omansen Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, The Netherlands; Agogo Presbyterian Hospital, Agogo, Ghana; Nkawie-Toase Governmental Hospital, Nkawie, Ghana

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Tjip S. van der Werf Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, The Netherlands; Agogo Presbyterian Hospital, Agogo, Ghana; Nkawie-Toase Governmental Hospital, Nkawie, Ghana

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Ymkje Stienstra Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, The Netherlands; Agogo Presbyterian Hospital, Agogo, Ghana; Nkawie-Toase Governmental Hospital, Nkawie, Ghana

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Neopterin is closely associated with activation of the cellular immune system. Neopterin levels differed between controls and patients with Buruli ulcer disease. No differences between patients with or without paradoxical responses were observed. Therefore, neopterin has no value in detecting paradoxical responses among patients with limited Buruli ulcer disease. Neopterin levels were lower in patients receiving clarithromycin. This finding might indicate a slower cellular immune recovery, with possible consequences in future therapy with clarithromycin.

Author Notes

* Address correspondence to Janine de Zeeuw, Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands. E-mail: j.de.zeeuw@umcg.nl

Financial support: This study was supported by the European Union (grants EU FP6 2003-INCO-Dev2-015476 [Burulico]) and FP7 241500 (BuruliVac), the Netherlands Organisation for Scientific Research (VENI grant to Ymkje Stienstra), and the Buruli ulcer Groningen Foundation.

Disclosure: None of the authors have any conflicts of interest.

Authors' addresses: Janine de Zeeuw, Sridevi Duggirala, Willemien A. Nienhuis, Till F. Omansen, Tjip S. van der Werf, and Ymkje Stienstra, Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, E-mails: j.de.zeeuw@umcg.nl, duggirala.sri@gmail.com, wiannix@hotmail.com, till.frederik@gmail.com, t.s.van.der.werf@umcg.nl, and y.stienstra@umcg.nl. K. Mohammed Abass, Buruli Ulcer Service, Agogo Presbyterian Hospital, Agogo, Ghana, E-mail: abass@agogopresbyhospital.org. Wilson Tuah, Buruli Ulcer Service, Nkawie-Toase Governmental Hospital, Nkawie, Ghana, E-mail: tuah_wilson@yahoo.com.

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