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Adenosine deaminase activity in patients with Crohn's disease: distinction between active and nonactive disease

Maor, Irita; Rainis, Tovab; Lanir, Amosa; Lavy, Alexandrab

European Journal of Gastroenterology & Hepatology: July 2011 - Volume 23 - Issue 7 - p 598–602
doi: 10.1097/MEG.0b013e328346e205
Original Articles: Inflammatory Bowel Diseases

Background Crohn's disease (CD) is a common chronic inflammatory bowel disease. During the disease a cascade of immunologic events occur including mucosal influx of inflammatory cells like neutrophils. Adenosine deaminase (ADA) is important in inflammatory responses and serves as a marker of activated leukocytes.

Materials and methods In this study, we investigated the activity of total ADA (tADA) and its isoenzymes, ADA1 and ADA2, in serum and neutrophils derived from 20 active patients with CD, 20 patients in remission, as well as in 15 healthy controls.

Results Patients with active disease had significantly (P<0.001) higher levels of tADA in serum (22.9±4.9 U/l) than patients in remission or healthy controls (14.0±3.4 U/l and 13.2±2.4 U/l respectively). ADA2, the main isoenzyme in the serum was higher in active patients by 60% as compared with patients in remission and healthy controls (19.7±1.9 U/l, 12.3±1.2 U/l, and 12.2±0.9 U/l respectively). We did not find a significant difference in these parameters between healthy controls and stable patients. There was a positive correlation (R 2=0.516) between tADA activity and C-reactive protein levels in patients with CD. Enhanced activity in tADA was also detected in neutrophils that were obtained from all patients with CD as compared with healthy controls (15.3±2.9 U/g, 14.1±2.3 U/g, and 9.4±2.9 U/g protein, respectively). This is mainly due to a significant increment (up to 51%) in ADA1 activity, the main isoenzyme in the neutrophils (84% out of the tADA). The cause of this increment remains to be elucidated.

Conclusion The results obtained in this study demonstrated elevated levels of tADA and ADA2 in patients with active disease. As the patient improves and becomes clinically stable these levels decrease, approaching normal values. tADA and ADA2 can be used as markers of inflammation, and provide a supportive indicator of CD activity.

aDepartment of Biochemistry

bGastroenterology Unit, Bnai Zion Medical Center, Haifa, Israel

Correspondence to Tova Rainis, MD, Gastroenterology Unit, Bnai Zion Medical Center, PO Box 4940, Haifa 31048, Israel Tel: +972 4 8359062; fax: +972 4 8359062; e-mail:

Received November 30, 2010

Accepted March 17, 2011

© 2011 Lippincott Williams & Wilkins, Inc.