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  • Title: Adenosine deaminase activity and its isoenzymes in the sputum of patients with pulmonary tuberculosis.
    Author: Dimakou K, Hillas G, Bakakos P.
    Journal: Int J Tuberc Lung Dis; 2009 Jun; 13(6):744-8. PubMed ID: 19460251.
    Abstract:
    BACKGROUND: Adenosine deaminase (ADA) has been widely used for the diagnosis of tuberculous pleural effusion. Two isoenzymes have been described, ADA(1) and ADA(2). OBJECTIVE: To evaluate the diagnostic value of sputum ADA, ADA(1) and ADA(2) activity in pulmonary tuberculosis (TB). DESIGN: We measured total ADA, ADA(1) and ADA(2) activity in the sputum of 27 patients with pulmonary TB (11 had a negative Ziehl-Neelsen stain for acid-fast bacilli [AFB]). Nineteen patients with lung cancer were used as controls. RESULTS: Sputum total ADA activity was significantly higher in TB than in lung cancer patients (median 18 U/l [range 3-70] vs. 6 U/l [2-16]; P < 0.001). Sputum ADA(2) activity was significantly higher in TB compared to lung cancer patients (9 U/l [0-65] vs. 5 U/l [0-12]; P = 0.001). Sputum ADA(2) was significantly higher than ADA(1) in TB patients (P = 0.001). Sputum ADA and ADA(2) were higher in both AFB-positive and AFB-negative TB patients. Using a cut-off level of respectively 16 UI/l and 5UI/l for sputum total ADA and ADA(2), sensitivity and specificity were 55.6% and 100% for total ADA and 81.5% and 63.2% for ADA(2). CONCLUSION: Sputum total ADA and ADA(2) levels are elevated in patients with pulmonary TB. As they are elevated even in AFB-negative patients, they may assist in the early diagnosis of pulmonary TB.
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