Serum and Pleural Adenosine Deaminase

Baganha, M. Fontes; Pêgo, Alice; Lima, Maria A.; Gaspar, Elsa; Cordeiro, Antonio Robalo

doi:10.1378/chest.97.3.605

Cited by 131 publications

(30 citation statements)

References 14 publications

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“…However, similar cell counts are also reported in malignant effusions where no significantly high ADA activity is usually detected [3, 14, 15, 17]. Furthermore, while some studies show a positive correlation between T cells and ADA in tuberculous effusion, other studies fail to demonstrate such a correlation [18, 19, 20]. Moreover, it is possible that ADA levels are linked to pleural tissue T cell and macrophage infiltration and this has not been examined.…”

Section: Introductionmentioning

confidence: 78%

“…However, results on the correlation between ADA and T cells are conflicting [18, 19]. In an older study [18], no correlation was found between ADA and T cells, while in a more recent one [19]a good correlation was reported. We have examined a fairly large number of patients in whom a significant correlation exists between ADA activity and numbers of CD4+ lymphocytes.…”

Section: Discussionmentioning

confidence: 99%

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Tuberculous Effusion: ADA Activity Correlates with CD4+ Cell Numbers in the Fluid and the Pleura

Gaga

Papamichalis²,

Bakakos

et al. 2005

Respiration

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Background: Adenosine deaminase (ADA) is a commonly used marker in the diagnosis of tuberculous effusion and there is evidence that its production is linked to T cells and monocytes. Data on the correlation between ADA and T cells or macrophages in tuberculous effusions are conflicting. Furthermore, no studies have examined a possible correlation between pleural tissue infiltration and ADA. Objectives: We undertook this study to examine cell subsets in the fluid and the pleura in tuberculous effusion and their correlation to ADA. The use of cell subsets as a marker in the differential diagnosis was also examined. Methods: Pleural fluid from 36 patients with tuberculous and 34 patients with malignant effusion as well as pleural tissue biopsies from 16 patients with tuberculous pleurisy were examined. The APAAP and the avidin-biotin complex immunocytochemical methods were used to examine CD4+ T cells and macrophages (CD68+), while ADA activity was measured by the Giusti colorimetric method. Results: Our results showed that, in pleural fluid, CD4+ cells and ADA were significantly higher in tuberculous compared to malignant effusion (p < 0.001 for all measurements). In pleural tissue biopsies, macrophages were the predominant cells but CD4+ T cells were also abundant. A significant correlation was found between ADA and CD4+ numbers in pleural fluid and tissue (r = 0.45, p < 0.01; r = 0.75, p < 0.001, respectively). ADA had high sensitivity and specificity for differential diagnosis while cell subsets did not. Conclusions: These results indicate that ADA activity correlates to CD4+ T cell infiltration in the pleura and the fluid. Moreover, ADA but no cell subsets may be used as markers of tuberculous effusion.

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Section: Introductionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Tuberculous Effusion: ADA Activity Correlates with CD4+ Cell Numbers in the Fluid and the Pleura

Gaga

Papamichalis²,

Bakakos

et al. 2005

Respiration

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“…However, other studies showed that an elevated level of ADA was seldom found in nontuberculous lymphocytic pleural effusions, and an ADA level <40 IU/l virtually excluded tuberculosis in lymphocytic pleural effusions, although cases of cryptococcosis were not included in these studies [18,19]. In a study about tuberculous and nontuberculous pleuritis, evaluation of pleural ADA levels correlates with a CD4+ T lymphocyte population which is related to cellular immunity [20]. Other reported infectious diseases with high pleural ADA levels (other than tubercuosis) include legionellosis, brucellosis, coxiellosis and cryptococcosis [15,21,22,23].…”

Section: Discussionmentioning

confidence: 99%

Cryptococcal Pleuritis Containing a High Level of Adenosine Deaminase in a Patient with AIDS: A Case Report

Kitazawa¹,

Tatsuno²,

Ota³

et al. 2009

Respiration

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Cryptococcal infection is the 4th most common opportunistic infection in patients with acquired immune deficiency syndrome (AIDS). Although pleural effusion alone is an unusual presentation, we present a case of cryptococcal pleuritis in an AIDS patient which was initially difficult to discriminate from tuberculous pleuritis because of the high level of pleural adenosine deaminase (ADA). Cryptococcus neoformans was detected in the culture of the pleural effusion after the initiation of antituberculous treatment. High levels of ADA in the pleural fluid can be observed in patients with cryptococcal pleuritis, and longer incubation of pleural fluid should be performed in all patients who present with pleuritis associated with a high ADA level as the only significant finding.

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“…Evidence from "natural experiments" (infections caused by micro-organisms that infect Monocytes-Macrophages) and literature data: i) increment of ADA2 during infectious diseases due to intracellular micro-organisms while the parasite is alive inside these cells (17)(18)(19)(20); ii) the Monocytes-Macrophages, especially in an activated state, tolerate high levels of…”

Section: U 46 No 3 1998mentioning

confidence: 99%

Enzymes (Isoenzyme System) as homeostatic mechanisms the isoenzyme (ADA2) of adenosine deaminase of human monocytes‐macrophages as a regulator of the 2′deoxyadenosine

1998

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Summary. Regarding homeostatic mechanisms in the enzyme (isoenzymes) and substrate system we show through a simulation model obtained by STELLA I1 software that: (i) a pair of isoenzymes (Isl and Is2) that have different affinity for the substrate (Is2 affinity < lsl affinity), can constitute an efficient homeostatic mechanism: by varying the relative concentration of the isoenzymes in the system, the levels of the substrate can be controlled; (ii) the isoenzymes ADA1 and ADA2 of adenosine deaminase (ADA) that have different affinity for the substrate 2'deoxyadenosine (ADA2 has very weak affinity for 2'deoxyadenosine) constitute, inside human Monocytes-Macrophages, a homeostatic mechanism that assures an up-regulation of 2'deoxyadenosine and a down-regulation of a second substrate (adenosine) for which the affinity of the two isoenzymes is similar.

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Serum and Pleural Adenosine Deaminase

Cited by 131 publications

References 14 publications

Tuberculous Effusion: ADA Activity Correlates with CD4+ Cell Numbers in the Fluid and the Pleura

Tuberculous Effusion: ADA Activity Correlates with CD4+ Cell Numbers in the Fluid and the Pleura

Cryptococcal Pleuritis Containing a High Level of Adenosine Deaminase in a Patient with AIDS: A Case Report

Enzymes (Isoenzyme System) as homeostatic mechanisms the isoenzyme (ADA2) of adenosine deaminase of human monocytes‐macrophages as a regulator of the 2′deoxyadenosine

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