Received: 23.09.2025
Accepted: 25.12.2025
Published online: 20.03.2026
UDC: 616.24-002.5’036.87-07-08
DOI: 10.26212/2227-1937.2026.83.87.009
NEOPTERIN IN THE DIAGNOSIS AND TREATMENT MONITORING OF TUBERCULOSIS RELAPSES (LITERATURE REVIEW)
Tanzharykova G.N. ¹, Dilmagambetov D.S. ¹, Morozova T.I.², Ilyassov E.N. ³
¹ NJSC “West Kazakhstan Marat Ospanov Medical University”, Aktobe, Kazakhstan
² FSBEI of HE «Saratov State Medical University named after V.I. Razumovsky»
of the Ministry of Health of the Russian Federation, Saratov, Russia
³ SCE on REM «Aktobe Regional Phthisiopulmonology Center», Aktobe, Kazakhstan
Introduction: Tuberculosis remains one of the global public health challenges today. Despite the implementation of modern diagnostic and treatment methods, tuberculosis is still characterized by the spread of drug-resistant forms and disease relapses. In this regard, there is growing interest in identifying biomarkers that can improve diagnostic accuracy and the effectiveness of treatment monitoring. Neopterin is considered one of the promising markers, as it reflects the activation of cellular immunity and can serve as an important diagnostic and prognostic indicator in pulmonary
tuberculosis.
Objective: To investigate the diagnostic and prognostic role of neopterin in the detection and treatment monitoring of tuberculosis relapses.
Materials and Methods. A literature search was conducted in international and regional databases (Web of Science, Scopus, PubMed, Google Scholar, eLIBRARY, CyberLeninka) covering the period from 2013 to 2025. The analysis included original research studies, systematic reviews, meta-analyses, and clinical trials containing data on neopterin levels in adult patients with tuberculosis.
Results. The results indicate that neopterin levels are significantly higher in cases of tuberculosis relapse compared to newly diagnosed forms of the disease, reflecting enhanced activation of the cellular immune response and correlating with the severity of the clinical course. This biomarker has demonstrated promising potential for assessing the risk of adverse outcomes, predicting relapses and monitoring the effectiveness of tuberculosis treatment.
Discussion. Neopterin demonstrates high diagnostic and prognostic value in tuberculosis relapses, reflecting the activity of the cellular immune response. Changes in neopterin levels during treatment are associated with clinical outcomes and the risk of relapse, indicating the potential usefulness of neopterin as an additional indicator in clinical assessment.
Conclusion. Neopterin reflects the activation of cellular immunity and correlates with active tuberculosis, including relapses and disease severity. Neopterin is a valuable additional biomarker that can enhance the effectiveness of tuberculosis diagnosis and treatment monitoring. The obtained data support the feasibility of further multicenter studies for method standardization and the implementation of neopterin into clinical practice.
Keywords: tuberculosis relapse, recurrent case, pulmonary tuberculosis, neopterin, biomarker, tuberculosis diagnosis, monitoring of tuberculosis treatment.
