Serum Adenosine Deaminase: A Novel Biomarker Tool for the Diagnosis of Tuberculosis

Abstract

Tuberculosis is a major health issues worldwide. Every year more than 9 million new cases are reported worldwide with death rate of around 2 million each year. Rapid and accurate diagnosis of tuberculosis in population is most supportive in proper medication and early recovery. The golden standard method for diagnosis of tuberculosis in patient is formerly culture method which is time consuming and cumbersome. Various other techniques used in the diagnosis of tuberculosis have poor sensitivity and specificity however serum adenosine deaminase (ADA) has emerged as a potent biochemical marker that can be used as tool for the diagnosis of tuberculosis for rapid, easy and better result. Increased level of ADA in blood generally indicates the presence of tuberculosis. In the present study, the serum ADA level was examined in 75 healthy control and 75 tuberculosis patients with positive sputum smear for acid fast bacilli (AFB), having clinical symptoms were diagnosed for pulmonary tuberculosis and radiological impression for extra pulmonary tuberculosis. The selection of cases and control were based on the inclusion and exclusion criteria. Samples were collected at the outpatient department of National Tuberculosis Centre, Nepal after asking simple questionnaires. Modified Guisti and Galanti method was adopted for estimation of serum ADA from pooled and processed blood samples. There was significant difference (p<0.001) in mean rank of level of serum ADA among the TB cases to controls. The P-TB had the highest mean rank (116.52) followed by EP-TB (99.48) and control had significantly less mean rank (40.16). At the cut-off point of 25 U/L; sensitivity, specificity, positive predictive value and negative predictive value were 90.7%, 100%, 90.66% and 100% respectively. It can be concluded from data that there were insignificant difference in mean rank among sex wise distribution with p=0.037 and sputum grading wise distribution with p=0.142.

High-throughput and computational approaches for diagnostic and prognostic host tuberculosis biomarkers

“…Kynurenine is known to correlate with increased expression of indoleamine 2,3-dioxygenase upon contact with M. tuberculosis, while adenosine deaminase, which enzymatically converts adenosine to inosine, has been identified as a potential serum proteomic biomarker for TB. 40 [ 2 9 _ T D $ D I F F ] Zhou et al confirmed some of these findings in a nuclear magnetic resonance (NMR) rather than mass spectrometry based approach. 41 [ 3 0 _ T D $ D I F F ] Another study also showed changes in metabolic profiles upon TB drug treatment; however, the study design did not allow for an unambiguous annotation of the unique molecular features collected.…”

Using Omics to Study Leprosy, Tuberculosis, and Other Mycobacterial Diseases

“…Previously, the culture technique was the gold standard for diagnosing TB patients, although it is time-consuming and labor-intensive and other techniques for diagnosing TB possess low sensitivity and specificity ( Pandey et al., 2016 ). Furthermore, the aforementioned mycobacterial species discovered several strategies to build a viable human habitat, including modulating host immunological response.…”

“…This proteomic approach is utilized to identify appropriate host biomarkers in mycobacterial disease ( De Groote et al., 2013 ). Another research found that serum adenosine deaminase enzymatically converts adenosine to inosine as a possible serum proteomic biomarker for TB that may be utilized to quickly and efficiently diagnose TB ( Pandey et al., 2016 ). Proteome microarray research allowed screening of blood serum from individuals with active TB and latent TB infection and found that RV2031c, RV2421c,and RV1408 were possible serum biomarkers for distinguishing active TB from latent TB infection ( Cao et al., 2018 ).…”

Novel biomarkers for Diagnosis of Pulmonary Tuberculosis and Tuberculous Pleural Effusion

“…ADA seems to be an index for cellular immunity. [5] Nowadays measurement of ADA levels is the gold standard for the diagnosis of tuberculous pleural effusion in developing countries. [6] More recently, WHO endorsed the GeneXpert(1) for the diagnosis of TB.…”