Analysis of serum adenosine deaminase (ADA) and ADA1 and ADA2 isoenzyme activities in HIV positive and HIV-HBV co-infected patients

Objectives

To determine adenosine deaminase (ADA) activity as a possible diagnostic marker in HIV and HIV–HBV co-infected patients.

Design and methods

Blood samples were collected from 72 healthy, 33 HIV positive and 30 HIV–HBV co-infected subjects. Blood CD4+ cell count was recorded and serum alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total ADA, and ADA1 and ADA2 isoenzyme activities were determined.

Results

Serum ALT, AST, total ADA and ADA2 isoenzyme activities were significantly higher in HIV positive and HIV–HBV co-infected groups compare to the control (p < 0.05), whereas serum ALP showed no differences between groups. CD4+ cell counts markedly decreased in all patients and showed a significant inverse correlation with ADA activities (R² = 0.589, p < 0.001).

Conclusions

Serum ADA was significantly increased in HIV and HIV–HBV co-infections. Therefore, because of its low cost and simplicity to perform, ADA activity might be considered as a useful diagnostic tool among the other markers in these diseases.     

乳腺癌患者血清ADA及其同工酶的检测分析

目的探讨ADA总活性及其同工酶ADA1和ADA2活性与乳腺癌发生发展的关系。方法应用日立7150全自动生化分析仪，采用酶显色法测定ADA总活性；在反应体系中加入ADA1的抑制剂后，再测定ADA的活性，即为ADA2的活性；通过计算求得ADA1活性。分别检测112例乳腺癌患者和98例对照组ADA、ADA1和ADA2的活性。根据有无绝经、肿瘤大小、淋巴侵袭进行分组，分析不同组别的差异性。结果乳腺癌患者的血清ADA和ADA2的活性明显高于对照，ADA1活性无差异；乳腺癌患者中绝经后的血清ADA和ADA2活性高于未绝经者；肿瘤大小、淋巴浸润组无统计学意义。结论乳腺癌患者的血清中ADA和ADA2的活性增高，可能与年龄和激素水平有关，与乳腺癌的预后无关。     

腺苷脱氨酶同工酶在结核性胸积液和肿瘤性胸积液的诊断价值研究

目的探讨腺苷脱氨酶（ADA）同工酶（ADA1和ADA2）活性检测在结核性胸积液和肿瘤性胸积液的鉴别诊断意义。方法收集36例结核性胸积液和28例肿瘤性胸积液为研究对象,检测结核性胸积液和肿瘸性胸积液的总ADA和ADA2活性,比较两组胸积液的总ADA和ADA2活性区别在鉴别诊断的意义。结果结核性胸积液组的总ADA、ADA2活性显著高于肿瘤性胸积液组（P〈0．01）。在诊断结核性胸膜炎上,总ADA的敏感性和特异性分别为83．3％和92．86％;ADA2的敏感性和特异性分别为83．3％和96．4％。在诊断肿瘤性胸膜炎上,总ADA的敏感性和特异性分别为92．8％和81．2％,ADA2的敏感性和特异性分别为96．4％和81．8％。结论检测胸积液总ADA和ADA2活性可为结核性胸积液和肿瘤性胸积液的鉴别诊断提供有效参考,检测ADA2活性优于总ADA活性。     

血清腺苷脱氨酶测定在涂阴肺结核诊疗中的应用价值

目的：探讨血清腺苷脱氨酶(adenosine deaminase,ADA)在涂阴肺结核诊断及治疗中的应用价值。方法对152例涂阴肺结核、80例涂阳肺结核、63例非结核性肺部疾病及227例健康志愿者进行血清 ADA 测定,并对测定结果进行比较,采用受试者工作特征曲线(receiver operating characteristic curve,ROC)计算敏感性和特异性。所有活动性肺结核患者给予标准方案的抗结核治疗,于治疗的1月末、2月末、6月末测定血清 ADA,与治疗前结果进行比较。结果治疗前涂阴肺结核组 ADA(10.795±4.164)U/L 高于非结核肺部疾病组(9.354±2.401)U/L 和健康对照组(5.971±1.734)U/L,涂阳肺结核组(14.441±6.267)U/L 高于涂阴肺结核组(10.795±4.164)U/L,差异有统计学意义。共有57例涂阴肺结核患者和45例涂阳肺结核患者于抗结核治疗1月末、2月末、6月末 进 行 了 血 清ADA 测定,两组患者治疗2月末、6月末的血清 ADA 值与疗前相比均有下降,差异有统计学意义(P <0.05)。ROC曲线分析显示以血清 ADA=6.95 U/L 为临界值鉴别涂阴肺结核和健康对照的曲线下面积(Area Under Curve, AUC)为0.921(95% CI =0.894~0.947),敏感性为94.0%,特异性为70.7%。以 ADA=18 U/L 为临界值鉴别涂阴肺结核与非结核性肺部疾病的特异性为100%,敏感性为5.9%。结论涂阴肺结核患者的血清 ADA 水平高于健康人群和非结核性肺部疾病患者,血清 ADA 可以在一定程度上协助诊断涂阴肺结核,适时检测可以反映肺结核的治疗疗效。     

Syzygium cumini inhibits adenosine deaminase activity and reduces glucose levels in hyperglycemic patients

Syzigium cumini (L.) Skeels from the Myrtaceae family is among the most common medicinal plants used to treat diabetes in Brazil. Leaves, fruits, and barks of S. cumini have been used for their hypoglycemic activity. Adenosine deaminase (ADA) is an important enzyme that plays a relevant role in purine and DNA metabolism, immune responses, and peptidase activity. ADA is suggested to be an important enzyme for modulating the bioactivity of insulin, but its clinical significance in diabetes mellitus (DM) has not yet been proven. In this study, we examined the effect of aqueous leaf extracts of S. cumini ( L. ) (ASC) on ADA activity of hyperglycemic subjects and the activity of total ADA, and its isoenzymes in serum and erythrocytes. The present study indicates that: (i) the ADA activity in hyperglycemic serum was higher than normoglycemic serum and ADA activity was higher when the blood glucose level was more elevated; (ii) ASC (60–1000 μg/mL) in vitro caused a concentration-dependent inhibition of total ADA activity and a decrease in the blood glucose level in serum; (iii) ADA1 and 2 were reduced both in erythrocytes and in hyperglycemic serum. These results suggest that the decrease of ADA activity provoked by ASC may contribute to control adenosine levels and the antioxidant defense system of red cells and could be related to the complex ADA/DPP-IV-CD26 and the properties of dipeptidyl peptidase IV (DPP-IV) inhibitors which serve as important regulators of blood glucose .     

腺苷脱氨酶及C-反应蛋白检测对胸腔积液鉴别诊断的临床意义

目的探讨腺苷脱氨酶(ADA)及C-反应蛋白(CRP)检测对诊断结核性与癌性胸腔积液的价值。方法对临床确诊的93例结核性和56例癌性患者胸腔积液分别进行ADA及CRP的检测,并对结果进行比较分析。结果结核性患者胸腔积液ADA和CRP的水平含量分别为(51±7)U/L、(27.0±8.4)mg/L;癌性患者胸腔积液ADA和CRP的水平含量分别为(19±4)U/L、(14.0±5.7)mg/L,两者比较差异均有统计学意义(P<0.05)。结论 ADA及CRP检测在鉴别结核性和癌性胸腔积液方面具有较好的实用价值和临床意义。     

LSA、ADA在鼠肝细胞癌变过程中的表达与动态改变

探讨脂质结合唾液酸 (LSA)、腺苷脱氨酶 (ADA)在肝癌诊断中的价值。方法 :以化学致癌剂制作鼠肝癌模型 ,对鼠肝细胞在癌变不同阶段血清中的 LSA、ADA变化进行实验研究。结果 :LSA在鼠肝癌发生过程中 ,呈持续增加趋势 ,其浓度在癌前病变鼠和肝癌鼠中非常明显地高于对照鼠 (P<0 .0 1 ) ;ADA在肝细胞变性鼠和癌前病变鼠中明显异常 (P<0 .0 1 ) ,其活性增加数倍到十几倍 ,但在鼠肝完全发生癌变后 ,ADA活性则趋于正常。结论 :ADA在肝细胞损伤时较敏感 ,L SA则可望作为肝细胞癌变的标志物。     

Serum adenosine deaminase: isoenzymes and diagnostic application.

Human adenosine deaminase (ADA; EC 3.5.4.4) consists of three isoenzymes: ADA1, ADA1+CP, and ADA2. We developed an electrophoretic technique to distinguish between these three isoenzymes. The isoenzyme pattern was studied in tissue and cell homogenates, as well as in serum from normal subjects and from patients with increased serum ADA who had either hepatitis, infectious mononucleosis, tuberculosis, pneumonia, rheumatoid arthritis, or acute lymphoblastic leukemia (ALL). The highest ADA activity was found in lymphocytes and monocytes. ADA2 could be detected only in monocytes (18% of total ADA activity). It was also the predominant isoenzyme in the sera of controls and all disease groups, except for ALL--the only condition evaluated that is not of an inflammatory nature. We conclude that serum ADA reflects monocyte/macrophage activity or turnover in most diseases studied. The exception is ALL, where serum ADA most probably originates from lymphocyte precursors.     

Adenosine deaminase in patients with primary immunodeficiency syndromes: The analysis of serum ADA1 and ADA2 activities

ObjectivesWe aimed to investigate the activity of ADA and its isoenzymes in serum of patients with various primary immunodeficiency (PID) syndromes.Design and methodsTotal ADA (tADA) and its isoenzymes were measured in 76 children with PID syndromes and 30 healthy controls using the Ellis method.ResultsOur results indicated that tADA and ADA2 levels were higher in patients with Chronic Granulomatous Disease (CGD), Leukocyte Adhesion Deficiency (LAD), hyper IgM (HIM) and Wiskott–Aldrich Syndrome (WAS) than those of corresponding controls (P < 0.01). There was a significant elevation of tADA and ADA1 activities in IgA deficiency patients as compared to healthy individuals (P < 0.01).ConclusionsOur results hypothesized that altered ADA activity may be associated with altered immunity. Therefore, serum ADA level could be used as an indicator along with other parameters in follow up of patients with CGD, LAD, IgA deficiency, HIM and WAS.     

Serum adenosine deaminase activity in women with hyperemesis gravidarum

BACKGROUND: Serum adenosine deaminase (ADA) activity increases in diseases where cellular immunity is stimulated. Since hyperemesis gravidarum is characterized by enhanced cell-mediated immunity, serum ADA activity may be altered. The present study evaluated the relation between serum ADA activity and changes in cell-mediated immunity as causes of changes in ADA activity in hyperemesis gravidarum. METHODS: Serum activities of total ADA and its isoenzymes, ADA1 and ADA2, were measured in women with hyperemesis gravidarum (n = 24) and normal pregnancies (n = 24). Peripheral blood lymphocyte and monocyte counts were also measured. RESULTS: In hyperemesis gravidarum, serum total ADA and ADA2 activities averaged 16.8 +/- 0.5 and 13.3 +/- 0.7 U/l, respectively, which were significantly higher than those in normal pregnancies (10.2 +/- 0.5 and 7.8 +/- 0.5 U/l, respectively) (p < 0.05). The mean values for ADA1 activity in women with hyperemesis gravidarum and normal pregnancies were similar. The increase in total ADA activity was accompanied by the increase in lymphocyte and monocyte counts. CONCLUSIONS: These results suggest that increased serum total ADA activity reflects increases in ADA2 activity, which may be at least in part attributed to enhanced cell-mediated immunity in hyperemesis gravidarum.     

Ectonucleotide pyrophosphatase/phosphodiesterase (E-NPP) and adenosine deaminase (ADA) activities in prostate cancer patients: Influence of Gleason score,treatment and bone metastasis

The relation between adenine nucleotides and cancer has already been described in literature. Considering that the enzymes ectonucleotide pyrophosphatase/phosphodiesterase (E-NPP) and adenosine deaminase (ADA) act together to control nucleotide levels, we aimed to investigate the role of these enzymes in prostate cancer (PCa). E-NPP and ADA activities were determined in serum and platelets of PCa patients and controls. We also verified the influence of the Gleason score, bone metastasis and treatment in the enzyme activities. Platelets and serum E-NPP activity increased, whereas ADA activity in serum decreased in PCa patients. In addition, Gleason score, metastasis and treatment influenced E-NPP and ADA activities. We may propose that E-NPP and ADA are involved in the development of PCa. Moreover, E-NPP and ADA activities are modified in PCa patients with distinct Gleason score, with bone metastasis, as well as in patients under treatment.     

吸毒者血清总胆汁酸检测与临床意义

目的通过检测吸毒者戒毒治疗前血清总胆汁酸（total bile acids，TBA）水平，以探讨TBA与吸毒的关系。方法在BECKMAN COULTERCX4PRO全自动生化分析仪上对286例吸毒者及67例正常对照者血清TBA、腺苷脱氨酶（ADA）、丙氨酸氨基转移酶（ALT）进行测定。结果吸毒各组与对照组相比，血清TBA水平差异均具有统计学意义（均P〈0．05）。与对照组相比，吸毒2个月组血清ADA、ALT活性差异均无统计学意义（均P〉0．05），吸毒6个月及以上各组ADA、ALT活性差异均具有统计学意义（均P〈0．05）。在155例吸毒〉12个月者中，注射组与混合组、烟吸组相比，TBA水平差异均有统计学意义（均P〈0．05）；混合组与烟吸组相比，差异无统计学意义（P〉0．05）。结论TBA检测较ADA、ALT更早反映吸毒者肝实质损害；可作为判断吸毒者肝实质损害程度、评估其吸毒时间及吸毒方式的指标之一。     

Plasma adenosine deaminase activity among HIV1 Clade C seropositives: relation to CD4 T cell population and antiretroviral therapy

BACKGROUND: Plasma adenosine deaminase and its isoenzymes(s) activities have been used as diagnostic marker for intracellular parasitism, including HIV infection, and malignancy of immune cells. HIV infection being primarily targeted against CD4 cells, it would be of interest to relate the activity of total plasma ADA and isoenzymes fractions to immune status and antiretroviral therapy. METHODS: In the present study, plasma total ADA activity (ADAT) including ADA1 and ADA2 isoenzyme(s) were assayed among HIV seropositive Clade C (n=90) comprising both asymptomatic (n=71) and symptomatic (n=19) and compared with that of HIV seronegatives (n=35). RESULTS: A significant increase in the activity of ADAT (16.30+/-0.80 v/s 6.18+/-0.30) as well as ADA1 (6.50+/-0.42 v/s 2.34+/-0.16) and ADA2 (9.79+/-0.53 v/s 3.85+/-0.23) isoenzyme(s) among the asymptomatic as well as the symptomatic subjects as compared to respective controls was noted. Increase in plasma ADAT activity, including ADA1 and ADA2 isoenzyme(s), were found to have negative correlation with CD4 counts (r, -0.273; p<0.05). The increased plasma ADAT activity among the asymptomatic HIV seropositive with CD4 counts>500 (13.2+/-1.65; p<0.01) as well as those who were on antiretroviral therapy (19.31+/-1.36; p<0.001) was evident. CONCLUSIONS: These findings suggest that plasma ADA can be a sensitive marker of an ongoing biological insult to host tissues either because of infection and/or side effects of medication. Measurement of plasma ADA activity, along with serological evidence for HIV infection may provide an alternate laboratory tool to monitor intracellular parasitism including secondary infection vis a vis the after effects of therapeutic outcome.     

T-SPOT．TB 和 ADA 在结核性胸膜炎中的诊断价值

目的：评价外周血结核杆菌感染 T 细胞斑点试验（T-SPOT．TB）和胸腔积液腺苷脱氨酶（ADA）检测对结核性胸膜炎的辅助诊断价值。方法前瞻性纳入疑诊结核性胸膜炎患者62例,进行外周血 T-SPOT．TB、胸腔积液 ADA 检测,利用 ROC曲线探讨胸腔积液 ADA 诊断结核性胸膜炎的最佳临界值。结果根据诊断及分组标准,最终诊断结核性胸膜炎24例,非结核性胸膜炎33例,无法确定者5例,外周血 T-SPOT．TB 诊断结核性胸膜炎的灵敏度为91．7％,特异度为81．8％,阳性预测值78．6％,阴性预测值93．1％;结核性胸膜炎组 ADA 活性为（40．5±15．4）IU/L,非结核性胸膜炎组 ADA 活性为（12．4±9．5）IU/L,差异有统计学意义（P ＜0．01）;将 ADA 活性的临界值定为22．5 IU/L,其灵敏度和特异度分别为83．3％和84．8％;联合 T-SPOT．TB 与 ADA 检测灵敏度为95．8％。结论外周血 T-SPOT．TB 联合胸腔积液 ADA 对诊断结核性胸膜炎具有较高的灵敏度,对疑似结核性胸膜炎患者的快速、准确诊断具有重要的辅助诊断价值。     

腺苷脱氨酶自建检测系统及评价

目的比较北京利德曼生化股份有限公司生产的腺苷脱氨酶（ADA）检测试剂盒在Roche ModolarDPP全自动生化分析仪上建立的检测系统与Roche Modolar DPP可溯源的参考系统血清ADA检测结果之间的可比性和临床上可接受性。方法依据临床和实验室标准化协会（CLSI）标准中EP9-A文件对自建检测系统与可溯源参考系统检测门诊患者的40份新鲜血清ADA含量进行线性回归分析。结果自建系统和参考系统血清ADA检测结果具有很好的可比性。回归方程为Y=0.998 7 X＋0.090 2,其相关系数r2=0.998 4。结论自建系统血清ADA检测结果与Roche Modolar DPP可溯源的标准参考检测系统具有很好的可比性,可以代替参考系统检测临床标本,能够被临床所接受。     

检测肿瘤标志物、LDH、ADA对良恶性腹水鉴别诊断价值

目的探讨检测腹水肿瘤标志物、LDH、ADA对良恶性腹水的鉴别诊断价值。方法AFP、CEA、CA199、CA125用电化学方法进行检测,LDH采用酶法,ADA采用酶法。结果原发性肝癌患者腹水AFP、CEA、CA199、CA125明显高于良性腹水(P<0.01,P<0.05),腹腔转移癌患者腹水CEA、CA199、CA125明显高于良性腹水(P<0.01,P<0.05),原发性肝癌患者血清AFP、CEA、CA199明显高于良性腹水患者和正常对照者(P<0.01,P<0.05),原发性肝癌患者腹水和血清AFP明显高于腹腔转移癌(P<0.01),恶性腹水LDH、ADA无变化但是结核性腹水ADA升高。联合检测腹水AFP、CEA、CA199可提高敏感性和准确性。结论检测腹水AFP、CEA、CA199、CA125有助于良恶性腹水的鉴别诊断。     

血清ADA和CRP联合检测对肺结核诊断及鉴别诊断的临床价值

目的　了解血清ADA和CRP检测在肺结核诊断及其与肺部感染、肺癌的鉴别诊断上的临床价值。方法　用东芝MEGA全自动生化分析仪检测血清ADA ,用NycoCardREADERⅡ检测血清CRP ;对照组80例,肺结核组76例,肺部感染组6 2例,肺癌组4 3例。结果　肺结核组、肺癌组ADA明显高于对照组和肺部感染组,P <0 .0 5 ,肺部感染组ADA与对照组无明显差异,P >0 . 0 5 ;肺结核组ADA显著高于肺癌组,P <0 .0 5。各疾病组CRP均明显高于对照组,肺结核组CRP明显高于肺癌组,而低于肺部感染组,P <0. 0 5。ADA对肺结核、肺癌和肺部感染的敏感度分别为83. 2 % ,5 2 . 8%和10 . 9% ,各疾病组之间均有明显差异,P <0. 0 5。CRP对肺结核、肺癌和肺部感染的敏感度分别为88. 9% ,5 5 . 6 %和95 .2 % ,肺癌的敏感度明显低于肺结核、肺部感染,P <0 . 0 5。结论　血清ADA和CRP联合检测在肺结核诊断及其与肺部感染的鉴别诊断上有重要的临床意义。     

ADA、TB-Ab-IgG检测对结核性胸膜炎诊断及鉴别诊断的临床价值

目的探讨胸水和血清腺苷脱氨酶（ADA）、结核抗体（TB—Ab—IgG）检测对结核性胸膜炎的诊断价值。方法采用斑点金免疫渗滤试验（DIGFA）和酶连续监测法对117例患者进行胸水和血清TB_Ab．IgG和ADA检测分析。结果87例结核性胸膜炎患者胸水、血清中TB-Ab-IgG的敏感性分别为62．0％和70．1％,特异性分别为93．1％和86．6％。ADA活性在结核性和癌性胸水中分别为52．51和10．26U／L（P〈0．01）。以胸水ADA≥40U／L做为诊断结核的临界值,其敏感性为79．3％,特异性为86．6％;以胸水ADA／血清ADA〉1．00为临界值,其敏感性为97．7％,特异性为96．6％。结论胸水和血清ADA、TB—Ab—IgG检测对结核性胸膜炎和非结核性胸膜炎具有诊断和鉴别诊断价值。     

腺苷脱氨酶活性检测在胸腔积液诊断中的临床价值

目的探讨腺苷脱氨酶（ADA）活性测定在胸腔积液诊断和抗结核疗效观察中的应用价值。方法采用北京利德曼生物技术有限公司ADA液体试剂盒，对127例胸腔积液患者胸腔积液中ADA活性进行检测，并对44例结核性胸腔积液和83例非结核性胸腔积液进行ADA活性比较及结核性胸腔积液治疗前、后ADA活性变化比较。结果127例患者胸腔积液中ADA活性增高共43例，其中结核组41例，非结核组2例，结核性胸腔积液组ADA活性为（40．67±10．22）U／L，明显高于癌性胸腔积液组[（5．98±5．56）U／L3及炎性胸腔积液组[（6．35±4．65）U／L3，差异有统计学意义（P〈0．05）；ADA诊断结核性胸腔积液的敏感性为93．2％（41／44），特异性为97．6％（81／83）。结核性胸腔积液患者ADA活性治疗前[（40．67±10．22）U／L3与治疗后[（9．12±6．24）U／L3比较，差异有统计学意义（P〈0．05）。结论胸腔积液ADA活性检测可以作为鉴别结核核性与非结核性胸腔积液的指标，并可作为抗结核治疗疗效观察的指标。     

T-SPOT.TB联合ADA活性检测对结核性胸腔积液患者诊断效能的影响

目的:探讨T-SPOT.TB联合ADA活性检测对结核性胸腔积液患者诊断效能的影响。方法:选取2018年1月〜2020年6月我院结核性胸腔积液患者64例作为观察组,同期非结核性胸腔积液患者53例作为对照组。均行T-SPOT.TB、ADA活性检测,对比两组T-SPOT.TB、ADA水平,统计T-SPOT.TB、ADA单独及联合检测结果,分析二者联合检测对结核性胸腔积液诊断效能的影响。结果:观察组T-SPOT.TB阳性率、ADA水平高于对照组,差异有统计学意义(P<0.05);T-SPOT.TB单独检测阳性52例,阴性65例;ADA单独检测阳性55例,阴性62例;T-SPOT.TB联合ADA活,性检测阳性68例,阴性59例,T-SPOT.TB联合ADA活,性检测结核性胸腔积液的敏感度92.19%高于T-SPOT.TB 71.88%、ADA 75.00%单独诊断,漏诊率7.81%低于T-SPOT.TB 28.13%,ADA 25.00%单独诊断,差异有统计学意义(P<0.05);T-SPOT.TB联合ADA活性检测结核性胸腔积液的特异度、准确率、误诊率、阳性预测值、阴性预测值与T-SPOT.TB、ADA活性检测单独诊断对比,差异无统计学意义(P>0.05)。结论:结核性胸腔积液患者T-SPOT.TB、ADA水平升高显著,二者联合检测可进一步提高诊断效能,便于为临床鉴别诊断,制定治疗方案提供参考。