Neumonía adquirida en la comunidad: adenosindesaminasa plasmática como marcador etiológico

Álvarez, Ramón Fernández; Martín, L.; Blanco, José Antonio Gullón; Cuadrado, Gemma Rubinos; Jiménez, Alejandro; González-Río, J. Martínez

doi:10.1016/s0025-7753(02)73468-4

Cited by 2 publications

(3 citation statements)

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“…In such reports patients with atypical pneumonia seemed to have higher ADA levels than patients with bacterial pneumonia and than healthy controls [17][18][19][20] . Regarding ADA levels in typical bacterial pneumonia, some studies did not find differences with healthy controls [17][18][19] , whereas other authors found higher levels in pneumonic patients [20,21] . In this regard, we did not find significant differences between patients with pneumococcal pneumonia and patients with other or unknown etiologies (data not shown).…”

Section: Discussionmentioning

confidence: 94%

“…In this regard, we did not find significant differences between patients with pneumococcal pneumonia and patients with other or unknown etiologies (data not shown). Interestingly, some authors found an independent association of ADA levels with both liver disease and prior use of antibiotics [17] . We also found a statistically significant association of ADA with the use of antibiotics and with ALAT serum levels in the univariate and multivariate analyses.…”

Section: Discussionmentioning

confidence: 99%

“…Adenosine deaminase (ADA), an enzyme responsible for the conversion of adenosine and deoxyadenosine to inosine and deoxyinosine, is involved in the proliferation and differentiation of lymphocytes and monocytes [12,13] . Although serum ADA has been evaluated mainly in patients with tuberculosis [12][13][14][15][16] , it has also been analyzed in a few reports of non-tuberculous lower respiratory tract infections [17][18][19][20][21] . β 2 -microglobulin (β2-M), a membrane protein of low molecular weight, is a component of the class 1 major histocompatibility complex.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Acute-phase Reactants, Immunologic Markers and other Clinical and Laboratory Parameters in Patients with Pneumonia and Non-pneumonic Lower Respiratory Tract Infections

Collazos¹,

MartÃnez²,

Izquierdo³

2007

American J. of Infectious Diseases

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More efficacious tools to distinguish pneumonia from other acute lower respiratory tract infections (OALRTI) in facilities where radiologic studies are not easily or rapidly available are desirable to select the patients who should undergo chest radiographs, to avoid unnecessary visits to the emergency wards of hospitals and to optimize health resources. To this end we analyzed the relevance of many clinical and laboratory parameters, including acute-phase reactants and immune activation markers, in 98 patients with pneumonia and 149 with OALRTI seen at the emergency ward of our hospital. Many clinical and laboratory parameters were associated with the diagnosis of pneumonia in the univariate analysis. Among them, C-reactive protein proved to be the most discriminant for the differentiation between the two conditions (area under the ROC curve 0.83, 95%CI 0.78-0.89, P<0.0001). A multivariate logistic regression analysis revealed that C-reactive protein, presence of suggestive auscultatory findings, lower age, presence of pleuritic pain and lower percent of eosinophils were independently associated with the diagnosis of pneumonia. A formula was derived from this analysis, which, for the most discriminant cut-off level, correctly classified pneumonic and non-pneumonic patients with a sensitivity of 88% and specificity 90%. The area under the ROC curve of this predictive model was 0.93 (95% CI 0.89-0.96, P<0.0001). C-reactive protein, especially if combined with other easily obtained parameters, constitutes a useful adjunct for the differentiation of pneumonia from OALRTI. Routine measurement of these parameters could result in a more adequate utilization of resources.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of Acute-phase Reactants, Immunologic Markers and other Clinical and Laboratory Parameters in Patients with Pneumonia and Non-pneumonic Lower Respiratory Tract Infections

Collazos¹,

MartÃnez²,

Izquierdo³

2007

American J. of Infectious Diseases

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Serum Adenosine Deaminase Activity and Neopterin Levels during Therapy in Patients with Pulmonary Tuberculosis and Community-Acquired Pneumonia

Altunoğlu¹,

Erdenen²,

Gelışgen³

et al. 2014

Istanbul Med J

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Objective: Adenosine deaminase (ADA) and neopterin are increased in disorders that stimulate cells involved in the immune system. We investigated the effect of therapy on serum ADA activity and neopterin levels in patients with pulmonary tuberculosis (TB) and with community-acquired pneumonia (CAP).Methods: Seventeen pulmonary TB, 24 CAP, and a control group of 20 healthy volunteers were included in this study. ADA and neopterin assay was performed colorimetrically and by ELISA, respectively, before and 2 months after therapy (rifampicin+isoniazid+ethambutol and pyrazinamide) of patients with TB and before and 15 days after therapy (ampicillin-sulbactam) of CAP.Results: Serum ADA activity and neopterin levels were significantly higher in patients with TB than those in pneumonia and controls. Serum neopterin levels were significantly higher in patients with CAP than controls. No significant differences were found in ADA levels between pneumonia and control subjects. The ADA and neopterin levels decreased in active tuberculosis at the second month of treatment. No significant differences were found in neopterin levels between CAP and TB after treatment. But, serum neopterin and ADA levels were still significantly higher in patients with tuberculosis than controls despite treatment. Conclusion:Although ADA activity may be useful for diagnosis and monitoring therapy in both specific and nonspecific pulmonary infections, neopterin values may be used in pneumonia patients along with the traditional biomarkers, such as white blood cell (WBC), erythrocyte rate (ESR), C-reactive protein (CRP).Amaç: İmmün sistemi stimüle eden hastalıklarda adenozin deaminaz (ADA) ve neopterin seviyeleri yükselir. Bu çalışmada, toplum kökenli pnömoni (TKP) ve pulmoner tüberkülozlu hastalarda tedavinin neopterin ve ADA seviyelerini nasıl etkilediği araştırılmıştır.Yöntemler: Çalışmaya 24 TKP'li, 17 pulmoner tüberkülozlu ve 20 sağlıklı gönüllü kontrol grubu dahil edilmiştir. ADA spektofotometrik, neopterin ise ELİSA yöntemleriyle, pulmoner tüberkülozlu hastalarda tedavi öncesi ve tedaviden (rifampisin, izoniazid, etambutol ve pirazinamid) 2 ay sonra, TKP'li hastalarda tedavi öncesi ve tedaviden (ampisilin, sülbaktam) 15 gün sonra ölçülmüştür.Bulgular: Serum ADA aktivitesi ve neopterin seviyeleri pulmoner tüberkülozlu hastalarda pnömonili hastalardan ve sağlıklı kontrollerden anlamlı olarak yüksek bulunmuştur. Serum neopterin seviyeleri TKP'li hastalarda sağlıklı kontrollerden anlamlı olarak yüksektir ancak pnömonili hastalar ve sağlıklı kontroller arasında ADA seviyeleri açısından anlamlı bir farklılık bulunamamıştır. Aktif tüberküloz grubunda ADA ve neopterin seviyeleri tedavinin ikinci ayından sonra düşmüştür. Tedavi sonrası pulmoner tüberkülozlu ve TKP'li hastalarda neopterin seviyeleri arasında herhangi bir anlamlı farklılık bulunamamıştır ancak serum neopterin ve ADA seviyeleri tedaviye rağmen tüberkülozlu grupta kontrol grubundan anlamlı olarak daha yüksektir.Sonuç: Hem spesifik hem de non spesifik akciğer infeksiyonları tanısını koymad...

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Neumonía adquirida en la comunidad: adenosindesaminasa plasmática como marcador etiológico

Cited by 2 publications

References 15 publications

Evaluation of Acute-phase Reactants, Immunologic Markers and other Clinical and Laboratory Parameters in Patients with Pneumonia and Non-pneumonic Lower Respiratory Tract Infections

Evaluation of Acute-phase Reactants, Immunologic Markers and other Clinical and Laboratory Parameters in Patients with Pneumonia and Non-pneumonic Lower Respiratory Tract Infections

Serum Adenosine Deaminase Activity and Neopterin Levels during Therapy in Patients with Pulmonary Tuberculosis and Community-Acquired Pneumonia

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