Adenosine deaminase isoenzymes and neopterin in liver cirrhosis

ADA isoenzymes in liver cirrhosis. A total of 117 patients with liver cirrh osis were included. Serum levels of ADA were assayed in the presence and ab sence of a specific inhibitor for ADA(1). Serum neopterin was measured usin g a competitive enzyme-linked immunosorbent assay. The grade of liver insuf ficiency was assessed according to the Child-Pugh classification and the mo noethylglycinexylidide test. Serum ADA, ADA(1), ADA(2) and neopterin were h igher in cirrhotic patients than in control subjects. A stepwise increase i n serum ADA level was observed with increasing severity of liver cirrhosis. The probability of ADA(2) being greater than the mean was approximately 2. 5 times higher (2.48, CI 95%: 1.36-4.52) in patients with liver cirrhosis d ue to hepatitis C virus (HCV) infection than in those patients with cirrhos is of a different etiology. No correlation was found between ADA(2) and neo pterin. Our data show that liver insufficiency and HCV infection increase t he serum levels of ADA and its major isoenzyme ADA(2). Furthermore, ADA iso enzyme determination adds no value to total ADA value. The absence of a cor relation between ADA(2) and neopterin suggests that different physiologic p rocesses are involved in their increase.