Increased urinary neopterin excretion in vaccinated adults
Giovannoni G., Bell J., Feldmann M., Thompson EJ.
Serial urinary neopterin:creatinine ratios of 58 healthy adult subjects 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.