Adenosine Deaminase Isoenzymes in the Diagnosis and Monitoring of Rheumatoid Arthritis

Milada Nalesnik,Tatjana Bućma,Jasminka Nikolić

doi:10.2478/v10011-012-0008-z

Abstract

Adenosine Deaminase Isoenzymes in the Diagnosis and Monitoring of Rheumatoid ArthritisThe aim of this study was determination of the catalytic activities of adenosine deaminase (ADA), ADA1 and ADA2 isoenzymes in the serum of patients suffering from rheumatoid arthritis (RA) who were and were not treated with methotrexate (MTX), and identification of the possibilities of using these biochemical parameters in diagnosing and monitoring the treatment effects in RA. Catalytic activities of total ADA (tADA) and ADA2 in serum were determined by a spectrophotometric method. A statistically significant correlation was found between the total ADA and ADA1 values, as well as between tADA and ADA2 in the serum of all patients suffering from RA. Determination of ADA1 and ADA2 isoenzyme catalytic activities in the serum of patients who might be suffering from RA improves the diagnostic value of total ADA catalytic activity determination. ADA2 catalytic activity in serum can be a useful biochemical marker in diagnosing and monitoring RA. Decrease in ADA1 isoenzyme catalytic activities in the serum of patients suffering from RA who were treated with MTX can help in the observation of MTX therapy effects.

Highlights

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory autoimmune disease characterized by pain and swelling of the attacked joints, chronic proliferative synovitis that leads to progressive articular cartilage and subchondral bone destruction and the development of functional disability [1,2,3]
The aim of the study was the determination of catalytic activities of ADA1 and ADA2 isoenzymes in the serum of patients suffering from RA who were and were not treated with MTX, and the identification of the possibilities of using these biochemical parameters in diagnosing RA and monitoring the therapy effects
Impossibility of early diagnosis and the problems in differential diagnosing that would permit to distinguish RA from other autoimmune diseases of connective tissues using only the ACR criteria are the reasons behind the search for some new markers which would make all this possible and at the same time be used for monitoring the disease course after therapy. It is still not completely clear what exactly causes the increase in Adenosine deaminase (ADA) catalytic activities in the serum of patients suffering from RA, but it is supposed that ADA catalytic activity is increased because of its release from the damaged cells and the increased cell proliferation in RA [8]

Summary

Introduction

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory autoimmune disease characterized by pain and swelling of the attacked joints, chronic proliferative synovitis that leads to progressive articular cartilage and subchondral bone destruction and the development of functional disability [1,2,3]. Hitoglou et al [8] and Cordero et al [9] determined the catalytic activities of total adenosine deaminase (tADA) and its isoenzymes (ADA1 and ADA2) in patients suffering from rheumatoid arthritis and systemic lupus erythematosus (SLE). They identified the correlation between RA activities and tADA and its isoenzyme ADA2 catalytic activities, whereby the progress of RA leads to increased activity of the mentioned enzyme and isoenzyme. ADA is a marker of cellular immunity, so it is important to determine its catalytic activity when identifying the seriousness of an inflammatory process, and for the improvement of treatment strategy and better monitoring of the therapy effects in RA [17]

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