World Journal of Pediatrics

, Volume 14, Issue 5, pp 448–453 | Cite as

Elevated serum neopterin levels in children with functional constipation: association with systemic proinflammatory cytokines

  • Ceren Cıralı
  • Emel Ulusoy
  • Tuncay Kume
  • Nur ArslanEmail author
Original Article



Functional constipation is a clinical problem with an incompletely understood etiology. Functional bowel diseases have been shown to be related to inflammation in many studies in adults. In this study, we aimed to evaluate leukocytes, C-reactive protein, proinflammatory and anti-inflammatory cytokines, and neopterin levels in children with functional constipation.


Seventy-six children with constipation and 71 healthy controls (mean age 7.12 ± 3.46 years and 7.32 ± 4.33 years, respectively, P = 0.991) were included in the study. Leukocytes, C-reactive protein, interleukin (IL)-1β, IL-6, IL-10, IL-12, tumor necrosis factor-alpha (TNF-α) and neopterin levels were assessed in patients and healthy controls. Parameters were measured in the serum using enzyme-linked immunosorbent assay methods.


Mean IL-6 (20.31 ± 12.05 vs. 16.2 ± 10.25 pg/mL, respectively, P = 0.003), IL-12 (181.42 ± 133.45 vs. 135.6 ± 83.67 pg/mL, respectively, P = 0.018) and neopterin levels (2.08 ± 1.12 vs. 1.52 ± 1.02 pg/mL, respectively, P = 0.001) were significantly higher in constipated children than healthy controls. Leukocyte and thrombocyte counts, C-reactive protein, and IL-1β, IL-10 and TNF-α levels did not show any difference between the two groups.


In this study, IL-6, IL-12 and neopterin levels of constipated patients were found to be higher than those of controls. These results indicate the presence of subclinical inflammation in children with functional constipation.


Children Constipation Cytokine Inflammation Neopterin 


Author contributions

CC contributed to concept and design, and acquisition of data. EU contributed to acquisition of data and drafting the article. TK contributed to acquisition of data, analysis and interpretation of data. NA contributed to concept and design, acquisition of data, analysis and interpretation of data, revising it critically for important intellectual content and final approval of the version to be published.


This study was funded by a grant (grant number: 2013.KB.SAG.001) from Dokuz Eylul University Funding Committee for Scientific Research, Izmir, Turkey.

Compliance with ethical standards

Ethical approval

All procedures performed in study involving the patients were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was started after the approval of the Ethics Committee of Dokuz Eylul University Faculty of Medicine (number of ethical approval: 2012/30-01). Written informed consent was obtained from parents of all patients included in the study.

Conflict of interest

All authors declared that they have no conflict of interest.


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Copyright information

© Children's Hospital, Zhejiang University School of Medicine 2018

Authors and Affiliations

  • Ceren Cıralı
    • 1
  • Emel Ulusoy
    • 1
  • Tuncay Kume
    • 2
  • Nur Arslan
    • 3
    Email author
  1. 1.Department of PediatricsDokuz Eylul UniversityIzmirTurkey
  2. 2.Department of Medical BiochemistryDokuz Eylul UniversityIzmirTurkey
  3. 3.Division of Pediatric Gastroenterology, Metabolism and Nutrition, Department of PediatricsDokuz Eylul University Faculty of MedicineIzmirTurkey

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