Molecular forms of adenosine deaminase in pleural effusions

The molecular forms of adenosine deaminase (ADA) were studied in pleural effusions with high ADA activity. The molecular forms were separated by polyacrylamide gel electrophoresis (PAGE), and the molecular masses estimated by gel filtration. Effusions investigated were: tuberculosis (TB) (20 cases), lymphoma (3 cases), chronic myelogenous leukemia (1 case) and empyema (6 cases). Two ADA forms were identified, a small form (Smf-ADA) and a large form (Lmf-ADA). Without exception, the tuberculous effusions have shown only Lmf-ADA. All the other effusions contained both forms, the Smf-ADA being predominant. This was also the ADA pattern seen in normal lymphocytes. These findings may indicate different mechanisms of ADA release or origins of ADA in the various effusions. The Lmf-ADA may be secreted by activated T cells in TB, which would confirm the notion that ADA activity reflects cellular immunity. In contrast, in the nontuberculous cases the ADA probably leaked from damaged lymphocytes or neutrophils, hence the reflection of the cellular ADA pattern. The PAGE pattern may also be of value in distinguishing between TB and these other causes of high pleural fluid ADA.