Lindsay Angus, Baxter-Parker Gregory, Gieseg Steven P
Institution for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
School of Biological Sciences, University of Canterbury, Christchurch 8140, New Zealand.
J Clin Med. 2019 Sep 3;8(9):1383. doi: 10.3390/jcm8091383.
We performed a systematic review of the literature to evaluate pterins as biomarkers of mechanical and impact-induced trauma. MEDLINE and Scopus were searched in March 2019. We included in vivo human studies that measured a pterin in response to mechanical or impact-induced trauma with no underlying prior disease or complication. We included 40 studies with a total of 3829 subjects. Seventy-seven percent of studies measured a significant increase in a pterin, primarily neopterin or total neopterin (neopterin + 7,8-dihydroneopterin). Fifty-one percent of studies measured an increase within 24 h or trauma, while 46% measured increases beyond 48 h. Pterins also showed promise as predictors of post-trauma complications such as sepsis, multi-organ failure and mortality. Exercise-induced trauma and traumatic brain injury caused an immediate increase in neopterin or total neopterin, while patients of multiple trauma had elevated pterin levels that remained above baseline for several days. Pterin concentration changes in response to surgery were variable with patients undergoing cardiac surgery having immediate and sustained pterin increases, while hysterectomy, liver resection or hysterectomy showed no change. This review provides systematic evidence that pterins, in particular neopterin and total neopterin, increase in response to multiple forms of mechanical or impact-induced trauma.
我们对文献进行了系统综述，以评估蝶呤作为机械性和冲击性创伤生物标志物的情况。2019年3月检索了MEDLINE和Scopus数据库。我们纳入了针对无潜在既往疾病或并发症的机械性或冲击性创伤测量蝶呤的人体体内研究。我们纳入了40项研究，共3829名受试者。77%的研究测量到蝶呤显著增加，主要是新蝶呤或总新蝶呤（新蝶呤 + 7,8 - 二氢新蝶呤）。51%的研究在创伤后24小时内测量到增加，而46%的研究测量到在48小时后增加。蝶呤也有望作为创伤后并发症（如败血症、多器官功能衰竭和死亡率）的预测指标。运动引起的创伤和创伤性脑损伤导致新蝶呤或总新蝶呤立即增加，而多发伤患者的蝶呤水平升高，并在数天内维持在基线以上。手术引起的蝶呤浓度变化各不相同，心脏手术患者的蝶呤立即且持续增加，而子宫切除术、肝切除术或子宫切除术患者则无变化。本综述提供了系统证据，表明蝶呤，尤其是新蝶呤和总新蝶呤，会因多种形式的机械性或冲击性创伤而增加。
