The informative value of adenosine deaminase isoenzymes testing in the diagnosis of tuberculous pleurisy with the relevance to the age of patients
https://doi.org/10.21292/2075-1230-2020-98-11-39-44
Abstract
The objective of the study: to assess the diagnostic informative value of ADA isoenzymes – ADA-1 and ADA-2 – in the pleural fluid in case of tuberculous pleurisy with the relevance to the age of patients.
Subjects and methods. In 200 patients with pleural effusion of tuberculous etiology and 152 patients with pleural effusion of non-tuberculous etiology, the activity of ADA (and its isoenzymes of ADA-1 and ADA-2) was tested.
Results. In patients with tuberculous pleurisy, the activity of ADA, ADA-1 and ADA-2 was significantly higher than in patients with pleurisy of a different etiology. Tests of ADA activity (above the threshold value of 30 u/L) had sensitivity and specificity of 95 and 94%, respectively. The sensitivity of testing the activity of ADA-1 and ADA-2 (above the threshold value of 20 u/L) was 30 and 93% with the specificity of 96% and 88%, respectively. The frequency of detecting the activity of ADA and ADA-2 above the threshold did not depend on the cellular nature of tuberculous pleurisy. The activity of ADA-2 was associated with the percentage of pleural fluid lymphocytes in the case of tuberculosis.
No influence of age on the diagnostic informative value of ADA and ADA-2 was found out. ADA-1 activity was weakly positively correlated with the age of the patients.
About the Authors
M. E. DyakovaRussian Federation
Marina E. Dyakova - Candidate of Biological Sciences, Senior Researcher
32, Polytechnicheskaya St., St. Petersburg, 194064
Phone: +7 (812) 297-86-03
T. L. Perova
Russian Federation
Tatiana L. Perova - Researcher
32, Polytechnicheskaya St., St. Petersburg, 194064
Phone: +7 (812) 297-86-03
D. S. Esmedlyaeva
Russian Federation
Dilyara S. Esmedlyaeva - Candidate of Biological Sciences, Senior Researcher
32, Polytechnicheskaya St., St. Petersburg, 194064
Phone: +7 (812) 297-86-03
P. K. Yablonskiy
Russian Federation
Petr K. Yablonskiy - Doctor of Medical Sciences, Professor, Director
32, Polytechnicheskaya St., St. Petersburg, 194064
Phone: +7 (812) 297-86-03
Phone: +7 (812) 579-25-54
References
1. Titarenko O.T., Soldatova N.V., Umarov А.M., Perova T.L. Differential diagnostic opportunities for adenosine deaminase testing in pleural effusion. Klinicheskaya Meditsina, 1995, no. 1, pp. 41-42. (In Russ.)
2. Titarenko O.T., Esmedlyaeva D.S., Dyakova M.E., Perova T.L., Popov M.Yu. Gamma interferon and adenosine deaminase in the diagnosis of tuberculous pleurisy. Probl. Tub., 2008, no. 12, pp. 27-30. (In Russ.)
3. Titarenko O.T., Esmedlyaeva D.S., Perova T.L., Аlekseeva N.P., Dyakova M.E., Popov M.Yu. Comparative value of biochemical markers of cellular immunity in the diagnosis of tuberculous pleurisy. Klinicheskaya Laboratornaya Diagnostika, 2010, no. 1, pp. 46-49. (In Russ.)
4. Ferreiro L., Esther San Jose E., Valdes L. Tuberculous pleural effusion. Arch. Bronconeumol., 2014, vol. 50, no. 10, pp. 435-443.
5. Gui X., Xiao H. Diagnosis of tuberculosis pleurisy with adenosine deaminase (ADA): a systematic review and meta-analysis. Int. J. Clin. Exp. Med., 2014, vol. 7, no. 10, pp. 3126-3135.
6. Hesdorffer C.S., Malchinkhuu E., Biragyn A., Mabrouk O.S., Kennedy R.T., Madara K., Taub D.D., Longo D.L., Schwatz J.B., Ferrucci L., Goetzi E.J. Distinctive immunoregulatory effects of adenosine on T cells of older humans. FASEB J., 2012, vol. 26, pp. 1301-1310. doi: 10.1096/fj.11-197046.
7. Jose M. Porcel Advances in the diagnosis of tuberculous pleuritis. Ann. Transl. Med., 2016, vol. 4, no. 15, pp. 282-289. doi: 10.21037/atm.2016.07.23.
8. Keng L.T., Shu C.C., Chen J.Y.P., Liang S.K., Lin C.K., Chang L.Y., Wang J.Y., Yu C.J., Lee L.N. Evaluating pleural ADA, ADA-2, IFN-γ and IGRA for diagnosing tuberculous pleurisy. J. Infect., 2013, vol. 67, pp. 294-302. doi: 10.1016/j.jinf.2013.05.009.
9. Kim C.H., Lee J., Lee J., Cliff J.M., Toulza F., Smith S., Yoo S.S., Lee S.Y., Cha S.I., Park J.Y., Dockrell H.M. Mycobacterial load affects adenosine deaminase 2 levels of tuberculous pleural effusion. J. Infect., 2015, vol. 71, no. 4, pp. 488-491. doi: 10.1016/j.jinf.2015.05.015.
10. Korczynski P., Klimiuk J., Safianowska A., Krenke R. Impact of age on the diagnostic yield of four different biomarkers of tuberculous pleural effusion. Tuberculosis, 2019, vol. 114, pp. 24-29. doi: 10.1016/j.tube.2018.11.004.
11. Linehan E., Fitzgerald D.C. Ageing and the immune system: focus on macrophages. Eur. J. Microbiol. Immunol. (Bp), 2015, vol. 5, pp. 14-24. doi: 10.1556/EUJMI-D-14-00035.
12. Michot J.-M., Madec Y., Bulifon S., Thorette-Tcherniak C., Fortineau N., Noel N., Lambotte O., El Jahiri Y., Delacour H., Deffraissy J.F., Blanc F.X. Adenosine deaminase is a useful biomarker to diagnose pleural tuberculosis in low to medium prevalence settings. Diagn. Microbiol. Infect. Dis., 2016, vol. 84, pp. 215-220. doi: 10.1016/j.diagmicrobio.2015.11.007.
13. Peter-Rodrigues E., Jimenez D. The use of adenosine deaminase and adenosine deaminase isoenzymes in diagnosis of tuberculous pleuritis. Cur. Opin. Pulmon. Med., 2000, vol. 6, no. 4, pp. 259-266. doi: 10.1097/00063198-200007000-00002.
14. Porcel J.M. Advances in the diagnosis of tuberculous pleuritic. Ann. Transl. Med., 2016, vol. 4, no. 15, pp. 282-291. doi: 10.21037/atm.2016.07.23.
15. Porcel J.M., Esquerda A., Bielsa S. Diagnostic performance of adenosine deaminase activity in pleural fluid: A single-center experience with over 2100 consecutive patients. Eur. J. Intern. Med., 2010, vol. 21, pp. 419-423. doi:10.1016/j.ejim.2010.03.011.
16. Salam N., Rane S., Das R., Faulkner M., Gund R., Kandpal U., Lewis V., Mattoo H., Prabhu S., Ranganathan V., Durdik J., George A., Rath S., Bal V. T cell ageing: effects of age on development, survival & function. Indian J. Med. Res., 2013, vol. 138, pp. 595-608.
17. Zavialov A.V., Gracia E., Glaichenhaus N., Franco R., Zavialov A.V., Lauvau G. Human adenosine deaminase 2 induces differentiation of monocytes into macrophages and stimulates proliferation of T helper cells and macrophages. J. Leukocyte Biol., 2010, vol. 88, no. 2, pp. 279-290.
18. Zemlin A.E., Burgess L.J., Carstens M.E. The diagnostic utility of adenosine deaminase isoenzymes in tuberculous pleural effusions. Int. J. Tuberc. Lung. Dis., 2009, vol. 13, no. 2, pp. 214-220.
Review
For citations:
Dyakova M.E., Perova T.L., Esmedlyaeva D.S., Yablonskiy P.K. The informative value of adenosine deaminase isoenzymes testing in the diagnosis of tuberculous pleurisy with the relevance to the age of patients. Tuberculosis and Lung Diseases. 2020;98(11):39-44. (In Russ.) https://doi.org/10.21292/2075-1230-2020-98-11-39-44