Activities of Serum Adenosine Deaminase and its Isoenzymes in Patients with Systemic Lupus Erythematosus, Rheumatoid Arthritis, Ankylosing Spondylitis and Myasthenia Gravis

Abstract

Objective The aim of this study was to evaluate the changes and diagnostic value of serum ADA activity in autoimmune diseases, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), ankylosing spondylitis (AS), and myasthenia gravis (MG).

Methods Serum ADA activity, including total ADA (tADA) and its isoenzymes (ADA1 and ADA2), was determined in patients with different autoimmune diseases (144 RA, 114 SLE, 55 AS, 68 MG). The changes in serum ADA activity in patients were analysed. A receiver operating characteristic (ROC) curve analysis was applied to evaluate the diagnostic performance of serum ADA activity.

Results Compared with healthy controls, the serum tADA activity in SLE patients was significantly increased (p<0.001), while the serum tADA activity in patients with RA, AS and MG did not change (p>0.05). The ROC analysis showed that the optimal cut-off value of serum tADA activity for SLE diagnosis was 10.5 U/L (79.8% specificity and 74.6% sensitivity; likelihood ratio (LR): 3.693; p<0.001). Moreover, our results showed that there were no significant changes of ADA1 and ADA2 activity in RA, AS and MG patients, while the serum ADA2 activity was significantly increased in SLE patients. The ROC analysis showed that ADA2 activity could be used in diagnosing SLE with 75.4% specificity and 78.1% sensitivity (LR: 3.175). Based on the ROC curve analysis, serum tADA activity (79.8% specificity and 74.6% sensitivity; likelihood ratio (LR): 3.693) and ADA2 activity (75.4% specificity and 78.1% sensitivity; LR: 3.175) are unlikely to be used in diagnosing SLE. Furthermore, there was a positive correlation between tADA activity and SLE disease activity (r=0.303, p=0.010). Notably, serum tADA activity in SLE patients with arthritis was higher than in patients without arthritis (p=0.005), which suggests that tADA activity might be related to lupus arthritis.

Conclusion These findings suggest that serum tADA and ADA2 activity might play an important role in SLE progression.

Zusammenfassung

Ziel Ziel dieser Studie war es, die Veränderungen sowie den diagnostischen Wert der ADA-Aktivität im Serum bei Autoimmunerkrankungen, einschließlich des systemischen Lupus erythematodes (SLE), der rheumatoiden Arthritis (RA), der Spondylitis ankylosans (AS) sowie der Myasthenia gravis (MG) zu beurteilen.

Methoden Die ADA-Aktivitäten im Serum, einschließlich Gesamt-ADA (tADA) sowie ihrer Isoenzyme (ADA1 und ADA2) wurden bei Patienten mit verschiedenen Autoimmunerkrankungen (144 RA, 114 SLE, 55 AS, 68 MG) bestimmt. Die Veränderungen der ADA-Aktivität im Serum bei den Patienten wurden analysiert. Die Grenzwertoptimierungskurve (ROC) wurde verwendet, um die Diagnostikleistung der ADA-Aktivitäten im Serum zu beurteilen.

Ergebnisse Im Vergleich zu den gesunden Kontrollen war die tADA-Aktivität im Serum bei den SLE-Patienten deutlich erhöht (P<0,001), während die tADA-Aktivität im Serum bei den Patienten mit RA, AS und MG unverändert blieb (P>0,05). Darüber hinaus wurden in unseren Ergebnissen gezeigt, dass es keine signifikanten Veränderungen bei den ADA1- und ADA2-Aktivitäten der RA-, AS- und MG-Patienten gaben, während die ADA2-Aktivität im Serum bei den SLE-Patienten deutlich erhöht wurde. Die ROC-Analyse zeigte, tADA-Aktivität (mit 79,8% iger Spezifität und 74,6%iger Sensitivität; LR: 3.693) und ADA2-Aktivität (mit 75,4% iger Spezifität und 78,1%iger Sensitivität; LR: 3.175) sind unwahrscheinlich bei der diagnose SLE. Außerdem gab es eine positive Korrelation zwischen tADA-Aktivität sowie SLE-Krankheitsaktivität (r=0,303, P=0,108). die Serum-tADA-Aktivität bei SLE-Patienten mit Arthritis höher war als bei Patienten ohne Arthritis (P=0.005)

Konklusion Diese Ergebnisse deuten darauf hin, dass die tADA- sowie ADA2-Aktivität im Serum eine wichtige Rolle bei der SLE-Progression spielen könnte

Schlüsselwörter

ADA-Aktivität - Isoenzym - Autoimmunerkrankung - Diagnose

Key words

ADA activity - isoenzyme - autoimmune disease - diagnosis

Publikationsverlauf

Artikel online veröffentlicht:
21. November 2019

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