Abstract

BackgroundAdult-onset Still's disease (AOSD) is a systemic inflammatory disease of unknown etiology, lacking specific diagnosis and disease activity evaluation indicators. This study will analyze the activity and clinical significance of Adenosine deaminase (ADA) in AOSD patients.MethodsTotally 53 AOSD patients, 60 patients with other autoimmune diseases including systemic lupus erythematosus (SLE), sjogren syndrome (SS) and rheumatoid arthritis (RA), as well as 60 healthy subjects were included in this study. AOSD activity was determined by Pouchot score. We analyzed the correlation between ADA activity and clinical parameters. In addition, the correlation between ADA activity and disease activity score was also analyzed.ResultsThis study showed that the activity of ADA in AOSD patients was significantly higher than that of healthy controls, SLE, SS and RA patient groups (p < 0.0001). The ADA activity of AOSD patients decreased significantly after systemic treatment (p < 0.0001). Correlation analysis showed that ADA activity was positively correlated with ALT(r = 0.54, p < 0.0001), AST (r = 0.82, p < 0.0001) and serum ferritin (r = 0.67, p < 0.001). ADA activity was negatively correlated with white blood cell (r = − 0.42, p = 0.002) and platelet counts (r = − 0.44, p = 0.001). We also found a significant positive correlation between the activity of ADA and Pouchot score in AOSD patients (r = 0.51, p = 0.001). Receiver operating characteristic (ROC) curve analysis showed that ADA activity had a sensitivity of 93.3%, and a specificity of 83% for the diagnosis of AOSD, with an area under the curve of 0.93.ConclusionThis study showed that serum ADA activity can be used as a potential biomarker for AOSD diagnosis and disease activity assessment.

Highlights

  • Adult-onset Still’s disease (AOSD) is a systemic inflammatory disease with low incidence rate and unclear etiology

  • Serum adenosine deaminase is significantly elevated in patients with adult‐onset still’s disease We first analyzed the differences in serum adenosine deaminase activity in AOSD patients, systemic lupus erythematosus (SLE) patients, rheumatoid arthritis (RA) patients, sjogren syndrome (SS) patients and healthy controls

  • The results showed that the serum Adenosine deaminase (ADA) activity in AOSD

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Summary

Introduction

Adult-onset Still’s disease (AOSD) is a systemic inflammatory disease with low incidence rate and unclear etiology. ADA activity is an indicator of hepatocyte function and can be used as one of the routine items in liver function tests. ADA is essential for development and maturation of lymphocytes, independent of enzyme activity, and plays an important regulatory role in proliferation, differentiation, and immune regulation [12]. ADA activity can be elevated in serum and pleural fluid of tuberculosis patients. Systemic JIA and AOSD patients share similar clinical manifestations, pathogenesis, and treatment response, little is known about the level and biology of ADA activity in AOSD patients. Adult-onset Still’s disease (AOSD) is a systemic inflammatory disease of unknown etiology, lacking specific diagnosis and disease activity evaluation indicators. This study will analyze the activity and clinical significance of Adenosine deaminase (ADA) in AOSD patients

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