Serum Adenosine Deaminase In Patients Research Articles

SERUM LEVELS OF ADENOSINE DEAMINASE IN PATIENTS WITH TUBERCULOSIS AND INFLAMMATORY LUNG DISEASE

Introduction: Serum adenosine deaminase (ADA) levels are used to diagnose tuberculosis and to monitor the condition of the patients during hospital treatment. Purpose: The aim of the present study is to establish the diagnostic value of serum ADA in patients with inflammatory lung disease, including pulmonary tuberculosis. Materials and methods: We measured ADA levels in 66 patients with lung disease, of whom 33 were men and 33 were women, all aged 18 to 86 years. Among the patients studied, 12 were diagnosed with tuberculosis, 34 with bacterial pneumonia and 20 with pleural effusion. Results: We found that the serum ADA levels in our patients were higher than 18 U / l, which are the recommended upper limit in healthy people, according to the test performed by our laboratory. ADA levels were also higher than 21 U / l, the value we defined as the mean in healthy individuals in our previous study. Conclusion: Based on our study, we can say that serum ADA levels in the patients we have studied with lung diseases, including pulmonary tuberculosis, have a high diagnostic value.

Correlation between serum adenosine deaminase activity and efficacy of anti-programmed cell death-1 antibody

ObjectiveSerum adenosine deaminase (ADA) activity is a marker of immune reaction to several diseases. We evaluated changes in serum ADA in patients with lung cancer undergoing chemotherapy or anti-programmed cell death-1 (PD-1) therapy to examine the correlation between serum ADA and the therapy efficacy. Materials and methodsWe assessed 50 patients with advanced lung cancer receiving chemotherapy or anti-PD-1 therapy. Serum ADA was measured before and on day 7 of the first treatment cycle and day 0 of subsequent cycles. Correlations between ADA change and efficacy of treatment were evaluated. ResultsOf the 50 patients, 20 were treated with chemotherapy and 30 were treated with anti-PD-1 therapy. Serum ADA decreased significantly between baseline and day 7 of the first cycle in patients undergoing chemotherapy, regardless of response (partial response [PR] or stable disease [SD]: −23% [−38 to +32; p = 0.002]; progressive disease [PD]: −12% [−42 to +6; p = 0.500]). Conversely, in patients undergoing anti-PD-1 therapy, serum ADA increased significantly between baseline and 7 days after the first dose and before subsequent doses in patients who had PR or SD. (day 7 of first cycle: +6% [−10 to +34; p = 0.034], day 0 of second cycle: 8% [−5 to +37; p = 0.002], day 0 of third cycle: 9% [−3 to +55; p = 0.002]). However, serum ADA did not significant change in PD patients undergoing anti-PD-1 therapy. Furthermore, early increases in serum ADA were associated with longer progression-free survival in patients receiving anti-PD-1 therapy (p = 0.006). ConclusionChanges in serum ADA could be used to predict clinical benefit from anti-PD-1 therapy in patients with lung cancer. The association between changes in serum ADA and the efficacy of ant-PD-1 therapy thus remains inconclusive and requires further study.

Study of glycated haemoglobin and serum adenosine deaminase in patients with type II diabetes mellitus with and without diabetic nephropathy or retinopathy

Study of glycated haemoglobin and serum adenosine deaminase in patients with type II diabetes mellitus with and without diabetic nephropathy or retinopathy

Serum Adenosine Deaminase in patients with Type-2 Diabetes Mellitus and its Relation with Blood Glucose and Glycated Haemoglobin levels

Background: Diabetes mellitus is a metabolic characterized bydeficiency of insulin and insulin resistance. Adenosine deaminase (ADA) modulates the bioactivity of insulin and Adenosine receptorsstimulate glucogenolysis and gluconeogenesis . but its role in Type 2 diabetes mellitus is not yet characterized. Aim & Objectives : The present study aimed to evaluate the serum Adenosine Deaminase level and to correlate ADA levels with Blood Glucose and Glycated hemoglobin levels in Type-2 Diabetes Mellitus patients. Material and Method: The study population of 120 patients were divided into 3 groups: Group A which consisted of 40 normal healthy individuals without any complication or history of Diabetes. Group B included 40 patients of Type 2 Diabetes Mellitus both with HbA1c 7% (n=40). Fasting blood sugar, HbA1c, ADA, and body mass Index were estimated in all the subjects under study. Results: The study showed that mean Fasting Blood Sugar, Post prandial Blood sugar and HbA1c concentration was significantly higher in Group C & Group B compared to Group A. Compared with the well-controlled Type-2 Diabetes Mellitus patients (HbA1c 7%) showed significantly increased ADA activity (49.79 18.12 U/L vs. 90.10 32.75; P <0.001). The correlation between Adenosine Deaminase and HbA1c was positive and significant in both Group B (r= 0. 389; p= 0.007) and Group C (r = 0.430; p<0.001). Conclusion: Serum ADA levels may have an important role in determining the glycemic status in Diabetics. A positive correlation between ADA level with glycemic control suggest its important role in glucose and lipid metabolic derangements seen in Type 2 Diabetes Mellitus patients.

Evaluation of Serum Adenosine Deaminase Changes Before and After Treatment in Patients with Systemic Lupus Erythematosus, Henoch-Schonlein Purpura and Juvenile Idiopathic Arthritis

Background: Adenosine deaminase (ADA) is a purine metabolism enzyme that can be used as an indicator of cellular immunity for monitoring of inflammatory diseases. The aim of this study was to investigate the changes of serum adenosine deaminase before and after treatment in patients with systemic lupus erythematosus (SLE), Henoch-Schonlein purpura (HSP) and juvenile idiopathic Arthritis ( JIA). Methods: The study comprised 103 patients with JIA, 17 with SLE and 30 HSP. The serum ADA was measured of all patients before and after treatment or remission. Serum ADA was measured by an ultraviolet kinetic method with NADH as substrate. Normal value for serum ADA level was less than 15 IU/L. Results: Positive serum ADA was found in 38 patients with JIA (38.9%), 9 patients (52.9%) with SLE and 6 patients (20%) with HSP. During the disease activity (before treatment), the mean serum ADA in patients with JRA was 15.1±10.9 IU/l, vs. 12.6±4.5 IU/l in patients with HSP and 18.8±11.95 IU/l in patients with SLE (P=0.097). There was no significant differences in changes of ADA levels between disease activity and after control (p= 0.1) in SLE. In patients with JIA, there was significant differences in changes of ADA levels between disease activity and control (p= 0.01). There was no significant differences in changes of ADA levels between disease activity and control (p= 0.2) in HSP. Conclusion: Determination of ADA serum levels is as noninvasive method, reliable and easy for diagnosis of JIA and can be used as alternative parameters representing disease activity in SLE patients.

Serum adenosine deaminase in patients with rheumatoid arthritis treated with methotrexate.

Objective:Recently, adenosine deaminase (ADA) is introduced as helpful marker in diagnosis, prognosis, and monitoring of treatment in rheumatoid arthritis (RA). The aim of this study was to determine the efficacy of the serum ADA in diagnosis, prognosis, and monitoring of treatment with methotrexate (MTX) in RA.Methods:This was a self-controlled clinical trial conducted in university hospitals of Isfahan, Iran. The serum level of ADA, erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF) were measured for 70 patients with active RA (Disease Activity Score-28 [DAS28] > 3/2). After three months of MTX treatment and disease remission (DAS28 < 2.6) these markers were measured again. ANCOVA multiregression and paired t-test were used to compare and evaluate the mean level and correlation of ADA, ESR, IgM-RF, and DAS before and after RA remission.Findings:The mean value for ADA activity was significantly higher than the normal one compared with other studies. Significant decreases were seen in values of ADA, ESR, RF, visual analogue scale (VAS), and DAS after remission. Also, the correlation coefficient between the values of ADA with ESR and DAS were statistically significant in baseline. Moreover, the statistically significant correlation between ADA and ESR, VAS, and DAS were seen after remission. No correlation was found in the case of the dosage of MTX with the value of ADA.Conclusion:It was concluded that ADA may be considered useful as a marker in diagnosis, prognosis, and monitoring of treatment with Methotrexate in RA.

Serum levels of adenosine deaminase and pregnancy-related hormones in hyperemesis gravidarum

We investigated the correlation between pregnancy-related hormones and serum adenosine deaminase (indicator of cellular immunity) level in women with hyperemesis gravidarum. Twenty patients with hyperemesis gravidarum and 20 normal pregnancies were included in this prospective, case-control study. Serum adenosine deaminase levels, hematological parameters (white blood cells, neutrophil, monocyte and lymphocyte counts) and hormone levels (prolactin, progesterone, thyroid stimulating hormone, human chorionic gonadotropin beta subunit, estradiol (E2)) were measured in all women. Interrelations of blood cell counts and hormone levels with serum adenosine deaminase levels were also investigated. Serum adenosine deaminase, human chorionic gonadotropin beta subunit, thyroid stimulating hormone, E2, progesterone and prolactin levels, and lymphocyte and monocyte counts in women with hyperemesis gravidarum were significantly higher than in controls but white blood cells, neutrophil, T3 and T4 levels were not different. Serum adenosine deaminase level correlated with E2, progesterone, lymphocyte, and monocyte levels for all patients. Elevated serum adenosine deaminase in patients with hyperemesis gravidarum may relate to high levels of E2 and progesterone.

Serum adenosine deaminase activities during acute attacks and attack-free periods of familial Mediterranean fever

Background Familial Mediterranean Fever (FMF) is a systemic relapsing autoinflammatory disorder. Adenosine deaminase (ADA) is an enzyme widely distribute in tissues and body fluids. Circulating levels of ADA have been shown to increase in several inflammatory conditions. This study was designed to evaluate the serum ADA in patients with FMF during acute attacks and attack-free periods. Methods The study groups comprised 23 FMF patients in attack-free period (male/female: 11/12), 30 FMF patients in attack period (male/female: 11/19) and 20 healthy control (male/female:10/10). The groups were similar for age, gender and disease duration. Results The mean age of FMF patients in attack-free period, patient with acute attack were 34.3 ± 11.7 and 29.4 ± 11.1 respectively. The disease durations were 13.1 ± 10.2 and 8.2 ± 7.6 years for patients in attack-free periods and patients with acute FMF attack, respectively. Patients with acute attack had significantly higher ADA levels than both patients with attack-free periods and healthy controls (for each, p < 0.001). Conclusion In this study we demonstrated that FMF patients with acute attacks had higher serum ADA levels than attack-free periods and healthy controls. It is likely that ADA may have a role in the cytokine network of the inflammatory cascade of FMF. Also, elevated ADA levels may be a part of the activated Th1 response in the disease. ADA may be used as a supportive marker to differentiate FMF attacks from attack-free periods. Further larger-scale studies are needed to support this result.

Sequential Evaluation of Serum Adenosine Deaminase in Patients Treated for Tuberculosis

To delineate the course of serum adenosine deaminase (s-ADA) in patients with tuberculosis who are receiving effective therapy. A medical ward and an outpatient clinic in a general hospital. Twenty-five immunocompetent patients with pleural or pulmonary tuberculosis. All patients received standard chemotherapeutic regimens with isoniazid, rifampin, and pyrazinamide. Six measurements of several variables, including s-ADA, were carried out at different periods of time during the 6 months of follow-up. There were no significant differences in s-ADA values between sexes and there was no significant correlation with age or with the other variables analyzed. There was a significant decline in the s-ADA values during the first 2 months in the patients as a whole (p=0.04), followed by a stabilization of the s-ADA activity. This decline was due to a marked decrease in the s-ADA in the 13 patients (52%) who had initial high levels of the enzyme (p=0.03), whereas there were no changes in those patients with normal initial levels (p=0.27). Patients with increased s-ADA activity at the time of the first measurement reported symptoms for a longer period than patients with normal s-ADA (median, 15 vs 10 days; p=0.02). s-ADA levels in patients with tuberculosis decrease during the initial months of effective treatment. Perhaps this decrease might reflect the normalization of the altered lymphocyte turnover induced by tuberculosis. The measurement of s-ADA could be of some help to evaluate the response to therapy, particularly in those patients with increased values of the enzyme.

Adenosine deaminase activity in the aetiological diagnosis of community-acquired pneumonia.

A prospective study was undertaken to assess the usefulness of serum adenosine deaminase (ADA) activity in the aetiological diagnosis of 75 patients (mean age 58 years) with community-acquired pneumonia who required hospitalization. Measurements of ADA were also carried out in 35 healthy subjects (mean age 52 years). The serum ADA activity in patients with typical bacterial pneumonia (TBP) was 21 +/- 7 IU/l and in controls 22 +/- 9 IU/l. In 43 patients with atypical pneumonia (AP), ADA levels (43 +/- 23 IU/l) were significantly higher than in the previously related groups (p < 0.001). Analysis within the group of atypical pneumonia showed significant differences for infections caused by Coxiella burnetii (61 +/- 19 IU/l, p < 0.001), Mycoplasma pneumoniae (44 +/- 26 IU/l, p < 0.001) and Legionella pneumophila (39 +/- 15 IU/l, p < 0.05), as compared with patients with bacterial pneumonia and normal control subjects. We conclude that serum ADA in patients with community-acquired pneumonia requiring hospitalization may provide useful additional diagnostic information on the aetiology of pulmonary infection.