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[Community-acquired pneumonia: serum adenosine-deaminase activity in the aetiological diagnosis]
Ramón Fernández Alvarez1, Luis Molinos Martín, José Antonio Gullón Blanco
1Sección de Neumología, Hospital Universitario de Canarias, La Laguna, Tenerife, España. ENELLANO@terra.es
Background:
Adenosine deaminase (ADA) is a cytoplasmic enzyme which activity is increased in disorders that stimulate cells involved in the immune system. In community-acquired pneumonia (CAP), increased levels of serum ADA have been associated with the presence of atypical microorganisms as the source of the former. Previous studies have shown ADA increases in non-infectious diseases. We evaluated the factors that may influence plasmatic ADA (ADAp) levels in CAP patients.
Patients And Methods:
A study with cases (245 episodes of CAP) and controls (49) was designed, and the differences in ADAp activity with regard to organisms, comorbidity factors and complications were analyzed. A logistic regression analysis was performed.
Results:
CAP caused by atypical microorganisms were found to have increased ADAp values. Variables that independently increased ADAp levels were: atypical etiology (OR = 5.9), liver disease (OR = 5.8), diabetes mellitus (OR = 1.9), and prior antibiotic consumption (OR = 1.7).
Conclusions:
ADAp is an etiologic marker that could be useful in the empiric approach of the treatment of CAP.
Insights
Plasmatic adenosine deaminase (ADAp) levels are elevated in community-acquired pneumonia (CAP) patients with atypical pathogens. Factors like liver disease and diabetes also increase ADAp, suggesting its use as an etiologic marker for CAP.
Area of Science:
- Biochemistry
- Immunology
- Infectious Diseases
Context:
- Adenosine deaminase (ADA) is an enzyme linked to immune system activity.
- Elevated serum ADA levels have been observed in community-acquired pneumonia (CAP), particularly with atypical microorganisms.
- Previous research indicates ADA increases in non-infectious conditions, necessitating further investigation into influencing factors.
Purpose:
- To investigate factors influencing plasmatic ADA (ADAp) levels in CAP patients.
- To determine the association between ADAp levels and specific etiologies, comorbidities, and complications in CAP.
- To evaluate ADAp as a potential diagnostic marker for CAP.
Summary:
- A study analyzed 245 CAP cases and 49 controls, examining ADAp activity in relation to causative organisms, comorbidities, and complications.
- Results showed significantly increased ADAp levels in CAP cases attributed to atypical microorganisms.
- Independent predictors for elevated ADAp included atypical etiology (OR=5.9), liver disease (OR=5.8), diabetes mellitus (OR=1.9), and prior antibiotic use (OR=1.7).
Impact:
- Plasmatic ADAp can serve as an etiologic marker, aiding in the empiric treatment approach for CAP.
- Understanding factors influencing ADAp levels can improve diagnostic accuracy and patient management strategies for pneumonia.
- This research highlights the potential of ADAp as a biomarker in differentiating CAP causes and guiding clinical decisions.