Increased Urinary Neopterin Excretion in Vaccinated Adults

Abstract

Serial urinary neopterin :creatinine ratios of 58 healthy adult sub jects were measured from 2 days prior to and up to 12 days post vaccination. An increase in the urinary neopterin of at least twice the baseline was detected in 24/ 46 subjects who received either a Mantoux skin test or a live viral vaccine (cell mediated immune group, median average increase above baseline = 206%(interquartile range 150-338% ), and 'in 5/12 who received non-live vaccines known to stimulate mainly humoral immunity (humoral immune group, median average increase above baseline = 165%((interquartile range 142-412%) ). The peaks in the urinary neopterin in the cell mediated group occurred between days 5 and 10 post-vaccination, with the mode on day 5. In contrast the 5 subjects in the humoral immune group all developed their peaks on day 7 or 8 . Three of these subjects received an influenza vaccine, one a typhoid vaccine and one a tetanus toxoid. No association was found between local or systemic side-effects of vaccination and raised urinary neopterin . In conclusion, the monitoring of urinary neopterin excretion in adults is sensitive enough to detect an immunological response to vaccination with immunogens that induce either cell mediated or humoral immune responses.

Keywords

• neopterin
• vaccination
• purified protein derivative
• skin tests