What is the result of adenosine deaminase abnormality?

Adenosine deaminase (ADA) is an important enzyme in the metabolism of purine nucleosides and belongs to the thiol enzyme. It contains at least 2 active thiol groups per molecule, and its activity can completely inhibit chloromercuric acid. Adenosine deaminase activity is a sensitive indicator of liver damage. It can be used as one of the routine tests for liver function. The liver enzyme zymogram with glutamate aminotransferase can reflect the enzymatic changes of liver disease. When the ADA is abnormal, it also indicates the arrival of the disease.

1. Liver disease
Elevated ADA activity is a sensitive indicator of liver injury. It can be used as one of the routine tests for liver function. The liver enzymes with ALT or GGT can reflect the enzymatic changes of liver disease.

2. Liver damage
ALT was almost elevated in acute hepatitis (AH), ADA was only mildly and moderately elevated, and the positive rate was significantly lower than AST and ALT. Therefore, ADA has certain value in the diagnosis of acute liver injury, but it is not superior to ALT. In severe hepatitis, when enzyme bile is isolated, although ALT is not high, ADA is significantly elevated. In the late stage of AH, the ADA growth rate was higher than ALT, and its normal recovery time was later than the latter, and it was consistent with histological recovery. Therefore, ADA is more able to reflect acute liver injury than ALT and GGT, and it is helpful to detect residual disease of AH and progression of liver disease. ALT returns to normal and ADA continues to rise, often easy to relapse or prone to chronic hepatitis.

3. Chronic liver disease
ADA is superior to ALT in reflecting chronic liver injury. Serum ADA activity was significantly elevated in patients with chronic hepatitis (CH), cirrhosis, and hepatocellular carcinoma. The positive rate is 85% to 90%, and ALT is normal or slightly elevated in cirrhosis, so ADA activity can be used as a screening index for chronic liver disease. Decompensated cirrhosis ADA activity is significantly higher than compensatory cirrhosis, so the degree of chronic liver disease can be judged. In addition, chronic active hepatitis (CAH) ADA activity is significantly higher than chronic persistent hepatitis (CPH), so it can be used for differential diagnosis.

4. Liver fibrosis
The serum ADA activity of patients with cirrhosis was significantly higher than that of acute jaundice hepatitis, CPH, CAH, PHC, obstructive jaundice and control group. CAH was also significantly higher than CPH and control group, indicating that the key difference of ADA activity was liver fibrosis. It has little to do with liver cell damage. Cai Weimin（Ph.D. in Pharmacology, Nanjing Medical University）used liver cirrhosis liver tissue sections to observe the grade of liver fibrosis. It was found that the ADA positive rate (38.46%) with a mean score of ≤1.5 was significantly lower than >1.5 (86.96%), confirming ADA activity and liver. The degree of fibrosis is related. With the increase of liver fibrosis, ADA activity gradually increased, that is, cirrhosis>CAH>CPH.

5 Jaundice identification
The ADA and GGT activities of 28 patients with hepatic jaundice and 19 patients with obstructive jaundice were compared. It was found that ADA had the most significant difference, while other enzymes had no significant difference between the two jaundices (P>0.05). Another literature reported that the ADA activity and positive rate of obstructive jaundice (16.7%) were significantly lower than those of hepatic jaundice (57.3%) and cirrhosis with jaundice (80.9%), and the overlap was small, especially with GGT. At the same time, ALP and 5'-NT were measured, and all three indicators were increased, while ADA was normal, which supported the diagnosis of obstructive jaundice.

6 Other
Amoebic liver abscess (ALA) ADA activity was significantly reduced.
Severe combined immunodeficiency disease (SCID)
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