Neopterin
metaboliteNeopterin is released by activated macrophages and monocytes, serving as a marker of immune activation and inflammation within destabilized atherosclerotic plaques.
Pathway placement
Cascade stepPlaque inflammation
Confidencehigh
RationaleAnchor molecule; product of macrophage/monocyte activation and IFN-γ signaling; direct marker of immune activation in atherosclerotic plaque.
Druggability
Not assessed (no mapped human gene target).
Type I vs Type II discrimination
ScoresLow-confidence (proxy)
R — rupture / Type-I47
C — confounder / Type-II80
A — assay feasibility42
E — evidence strength29
T1DI (composite)4
Specificity differential (R−C)-32.4
Confounder panel (Type-II drivers)
No confounder evidence retrieved.
Tier: light (literature co-occurrence proxy — lower confidence). See the discrimination table for all markers.
Assay & specimen
Class-level default (no specific cleared assay)— generic method inferred from analyte class; confirm against a specific product insert before use.
Specimen
Serum, plasma or urine
Collection tube
Serum separator (gold/red-top, SST) · Lithium heparin (green-top) · Sterile urine container
Method / principle
LC-MS/MS (targeted metabolomics) or enzymatic colorimetric where available
Reagent / substrate
Stable-isotope-labeled internal standard (MS); or enzyme-coupled Trinder reagent
Platform
LC-MS/MS; some automated chemistry
Turnaround · availability
Send-out / research · Specialized / research
Literature evidence(3)
- Prognostic utility of neopterin and risk of heart failure hospitalization after an acute coronary syndrome.European heart journal · 2011 · PMID 21345849 · doi
- Inflammatory systemic biomarkers in setting acute coronary syndromes--effects of the diurnal variation.Current drug targets · 2009 · PMID 19860643 · doi
- Non-traditional biomarkers of atherosclerosis in stable and unstable coronary artery disease, do they differ?Acute cardiac care · 2007 · PMID 17924231 · doi