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Neopterin is bioactive substance released by the activated monocyte/macrophage,and an early and sensitive marker used for reflection of cellular immune activation status induced by the lymphocyte macrophage system.Observation of neopterin levels is conducive to the diagnosis and prognosis of various diseases. This article reviews the existing evidence that neopterin has an important role in cardiovascular risk,infectious diseases,malignancy,autoimmune diseases and transplantaiton.