Serum and synovial fluid adenosine deaminase activity in patients with rheumatoid arthritis, osteoarthritis, and reactive arthritis.

Abstract

SUMMARY Adenosine deaminase activity was determined in paired samples of serum and synovial fluid taken from patients with rheumatoid arthritis (n=12), reactive arthritis (n=13), and osteoarthritis (n=7), and the value of this investigation in the diagnosis of synovial swellings was assessed. Increased activity was found in the synovial fluid taken from patients with rheumatoid disease and reactive arthritis, though values were less raised in the latter. Synovial fluid taken from patients with osteoarthritis did not show significantly raised adenosine deaminase activity as compared with that of normal controls (n=3).Key words: rheumatoid effusions.Adenosine deaminase (ADA) is one of the main enzymes of the purine metabolic pathway, catalysing the deamination of adenosine to inosine and deoxyadenosine to deoxyinosine. During inflammatory reactions the enzyme is released into the extracellular fluid, and in serous effusions of differing pathology the levels of ADA activity increase considerably. This increase has been shown to correlate with the number of nucleated cells, particularly T lymphocytes and macrophages, present in the effusions.i 2 It has also been shown that pleural effusions due to rheumatoid arthritis (RA)

Comparison of Adenosine Deaminase Level in Serum and Synovial Fluid in Patients with Juvenile Idiopathic Arthritis and Its Relation to Inflammatory Acute Phase Reactants

“…< 15 IU/L), and no signif- icant difference was observed between them. This result was compatible with the previous studies (32,33). The average of synovial fluid ADA was 30.73 ± 15.55 UI/L which was higher than the differentiation cut-off of inflammatory and non-inflammatory arthritis (16).…”

“…Adenosine is a purine nucleoside and has anti-inflammatory functions by decreasing proinflammatory cytokines, in- creasing anti-inflammatory cytokines, cytokine modulation of macrophages and monocytes and regulation of endothelial cell inflammatory functions (29)(30)(31). It has been suggested that ADA concentration may help in identification of immune system activity and differentiation of inflammatory from non-inflammatory conditions (32).…”

Uric acid a better scavenger of free radicals than vitamin C in rheumatoid arthritis

“…These patients had significantly raised (p<0.001)levels of serum adenosine deaminase an enzyme which has been known to be considerably increased in extra cellular and serous fluids during inflammatory reactions of differing pathology (8) suggesting that the active disease involves inflammation. A linear correlation was observed between Erythrocyte Sedimentation Rate, C-reactive protein, adenosine deaminase levels with the progression of the disease suggesting significant role of adenosine deaminase in inflammatory process in these patients.…”

Serum Adenosine Deaminase as Inflammatory Marker in Rheumatoid Arthritis

“…Nalesnik M et al, reported significant correlation between ADA and CRP in patients with RA without methotrexate treatment and suggested that ADA activity in serum can be used as a biochemical marker of the inflammatory process in RA [16]. In an earlier study, Yuksel and colleague [17] measured serum and synovial fluid ADA activity in patients with Rheumatoid arthritis, osteoarthritis and reactive arthritis. They did not observe significant difference among the study groups with respect to serum ADA activity.…”