Adenosine deaminase activity in serum and pleural effusions of tuberculous and non‐tuberculous patients

Al-Shammary, Fahad J.

doi:10.1080/15216549700204581

Cited by 14 publications

(10 citation statements)

References 16 publications

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“…Kuyucu et al [19] reported a serum ADA level of greater/equal to 53.76 U/L, a sensitivity of 100%, and a specificity of 90.7%, while indicating a positive predictive value of 58.8%, and a negative predictive value of 100% in children with TB. Bhargave et al [20] and Al-Shammary et al [21] reported the cut-off value of serum ADA levels in tuberculosis patients as 78.12 IU/L and 32.8 U/L, respectively…”

Section: Discussionmentioning

confidence: 99%

Validity of serum Adenosine deaminase in diagnosis of tuberculosis

Farazi¹,

Moharamkhani²,

Sofian³

2013

Pan Afr Med J

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IntroductionTuberculosis is one of the most important infectious causes of death worldwide. Ziehl-Neelsen staining of sputum has high specificity in tuberculosis endemic countries, but modest sensitivity which varies among laboratories. This study was set up to investigate the diagnostic value of serum Adenosine deaminase in diagnosis of tuberculosis.MethodsIn a cross sectional and prospective study Serums of 200 patients of positive sputum smear, negative sputum smear, extra-pulmonary tuberculosis and bacterial community acquired pneumonia collected from March 2011 to May 2012 were evaluated. The data were analyzed using SPSS software and P-value of <0.05 was considered significant.ResultsA total of 200 subjects were included in the study designed in four groups. In cut-off value of ≥24 U/l for ADA in smear positive patients defined the sensitivity, specificity and positive predictive value 12%, 98% and 86% respectively. In smear negative patients defined the 6%, 98% and 75%, and in extra-pulmonary tuberculosis patients defined the sensitivity 14%, 98% and 88% respectively.ConclusionThis study indicated that measurement of serum ADA level do not have enough sensitivity to assist in the diagnoses of tuberculosis patients from other respiratory diseases and not evaluated perform well enough to replace sputum smear microscopy. Thus, this tests have little role in the diagnosis of pulmonary tuberculosis.

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Section: Discussionmentioning

confidence: 99%

Validity of serum Adenosine deaminase in diagnosis of tuberculosis

Farazi¹,

Moharamkhani²,

Sofian³

2013

Pan Afr Med J

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“…Several groups found significantly higher ADA activity in pleural fluid, serum or bronchoalveolar lavage of patients with tuberculosis as compared to healthy people [78,79]. ADA activity in BAL or in pleural fluid might be helpful diagnostic tool to differentiate miliar tuberculosis (providing better sensitivity than other methods) [80] or tuberculotic pleuritis (sensitivity 87 to 100%, specificity 81 to 97%) [81] from carcinoma or other diseases.…”

Section: Tuberculosismentioning

confidence: 99%

Adenosine and Adenosine Receptors in the Pathomechanism and Treatment of Respiratory Diseases

Vass¹,

Horváth²

2008

CMC

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It has been known for a long time that inhaled adenosine-monophosphate (AMP) induces airway obstruction in asthmatic patients, but not in healthy subjects. The mechanism of AMP is indirect and occurs via its decay product, adenosine. It stimulates mast cells through its low-affinity receptor A2B to release histamine, which ultimately leads to smooth muscle contraction. This feature of adenosine reveals its pro-inflammatory function, which may play important role in asthma. Indeed, mice lacking adenosine deaminase (ADA), an enzyme which decomposes adenosine, develop asthma-like disorder with elevated IgE, eosinophilia and airway hyperresponsiveness. Human studies showed elevated adenosine levels in bronchoalveolar lavage and exhaled breath condensate of asthmatics as compared to healthy people. Furthermore, certain human ADA phenotypes are associated with prevalence of asthma. These data suggest a protective role for ADA and a pro-inflammatory function for adenosine in asthma. The role of adenosine in inflammatory processes, however, is not unequivocal. Some in vitro studies showed that adenosine binding to its high-affinity receptor A2A results in inhibition of leukotriene synthesis or function of adhesion molecules. It is possible that the concentration of adenosine in lung tissues determines whether it promotes or reduces inflammation. Adenosine has also been associated with other respiratory diseases such as fibrosis, sarcoidosis, cystic fibrosis or tuberculosis. Identification of adenosine receptor subtypes and their role in the pathomechanism of respiratory diseases may provide new therapeutical targets. This review aims to summarize the role of adenosine and adenosine receptors in asthma and other pulmonary disorders.

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“…Previous studies have reported that the diagnostic value of serum ADA for pulmonary tuberculosis is associated with controversial results. In studies of Al-shammary from Saudi Arabia ( 10 ), Afrasiabian and colleagues from Iran ( 13 ) and Dilmac and colleagues from Turkey ( 14 ) serum levels of ADA in patients with pulmonary tuberculosis were significantly higher than in other patients with lung cancer and bacterial pneumonia. Agarwal and colleagues in India also showed that serum levels of ADA in patients with sputum smear-negative pulmonary tuberculosis (culture positive) was significantly different from non-tuberculosis patients with other lung diseases such as lung cancer, pneumonia, pulmonary abscess and bronchiectasis ( 15 ).…”

Section: Discussionmentioning

confidence: 98%

“…The ADA plays an important role in proliferation and differentiation of lymphocytes, particularly T lymphocytes ( 9 ). Increased serum ADA activity can be seen in diseases associated with cellular system stimulation, such as typhoid fever, infectious mononucleosis, liver disease, sarcoidosis, leukemia, brucellosis, acute pneumonia, rheumatoid arthritis, malignancies and tuberculosis ( 10 , 11 ). Although, serum ADA level in pulmonary TB patients is higher than in normal individuals, ADA should not be considered as a suitable marker for differentiating between pulmonary TB and other pulmonary infections ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Serum Adenosine Deaminase (ADA) Level for Pulmonary Tuberculosis

Salmanzadeh

Tavakkol

Bavieh

et al. 2015

Jundishapur J Microbiol

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Background:Diagnosis of tuberculosis (TB) is not always easy, thus employing methods with a short duration and acceptable sensitivity and specificity is necessary to diagnose TB.Objectives:The aim of this study was to investigate the diagnostic value of serum adenosine deaminase (ADA) level for diagnosis of pulmonary tuberculosis.Patients and Methods:A total of 160 sex and age-matched subjects were included in this study, and were divided to four groups; forty patients with pulmonary tuberculosis (PTB) diagnosed based on the national TB program (NTP), forty patients with non-tuberculosis bacterial pneumonia, forty patients with lung cancer and forty people who were healthy in every respect. Serum adenosine deaminase activity in patients of each group was measured by the Giusti and Galanti calorimetry method using a commercial kit (Diazyme, USA). The ANOVA analysis was used to compare groups for quantitative variables.Results:Mean serum ADA level in the PTB group was clearly higher than the mean serum ADA in the other three groups. Mean serum ADA was 26 IU/L in PTB patients, 19.48 IU/L in patients with pneumonia, 15.8 IU/L in patients with lung cancer, and 10.7 IU/L in the control group (P < 0.05). In regard to the cut off value of 26 IU/L for ADA in patients with PTB sensitivity and specificity was defined as 35% and 91%, respectively.Conclusions:Serum ADA activity with high specificity percentage may be a useful alternative test in restricted resource areas to rule out diagnosis of PTB. However, serum ADA activity is not a useful tool for TB diagnosis.

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Adenosine deaminase activity in serum and pleural effusions of tuberculous and non‐tuberculous patients

Cited by 14 publications

References 16 publications

Validity of serum Adenosine deaminase in diagnosis of tuberculosis

Validity of serum Adenosine deaminase in diagnosis of tuberculosis

Adenosine and Adenosine Receptors in the Pathomechanism and Treatment of Respiratory Diseases

Diagnostic Value of Serum Adenosine Deaminase (ADA) Level for Pulmonary Tuberculosis

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