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Interpretation on Clinical Significance of Adenosine Deaminase (ADA)

Liver is the main site for protein and enzyme synthesis in the body. In liver diseases, liver cells are damaged and their synthesis ability decreases, which affects protein and enzyme synthesis and causes changes in the activities of various proteins and enzymes[1]. With the development of testing technology, adenosine deaminase (ADA) and other specific proteins have gradually become important indicators for clinical evaluation of liver function[2].

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What Is Adenosine Deaminase (ADA)?

ADA is an important enzyme in purine nucleoside metabolism, which can specifically catalyze the dehydrogenation reaction of adenine nucleoside to produce xanthine. ADA is widely distributed in various tissues of the human body and closely related to cellular immune activity. ADA in serum is a nucleic acid metabolizing enzyme that has an important relationship with cellular immune activity, mainly from liver[3].

Clinical Significance of ADA

Liver Disease

ADA activity is a sensitive indicator of liver injury and can be used as one of the routine tests of liver function. Hipro Biotechnology offers bulk order live test kits including adenosine deaminase test kits. Click to see if you need it.

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ADA Activity in Serum can be Measured for:

  • To judge acute liver injury and residual lesions, ADA is mild-to-moderate increased in acute hepatitis, but significantly increased in severe hepatitis when enzyme bile separation occurs. In the late stage of acute hepatitis, the increase rate of ADA is higher than that of ALT, and the recovery time of ADA is later than that of ALT. Patients with ALT returning to normal and ADA continuously rising are often prone to relapse or chronic hepatitis.

  • Assist in the diagnosis of chronic liver disease, which can be used as a screening index of chronic liver disease. Serum ADA activity was significantly increased in patients with chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. The positive rate of ADA in chronic active hepatitis is 85% ~ 90%. ADA activity in chronic active hepatitis is significantly higher than that in chronic persistent hepatitis.

  • It is helpful for the diagnosis of liver fiber.

  • It is helpful to distinguish jaundice. The serum ADA activity and positive rate of obstructive jaundice are significantly lower than those of hepatocellular jaundice and liver cirrhosis with jaundice.

Diagnosis and Differential Diagnosis of Tuberculosis

Determination of ADA activity in body fluids is an important auxiliary method in the diagnosis and differential diagnosis of tuberculosis.

The activity of ADA in serum, hydrothorax, cerebrospinal fluid and bronchoalveolar lavage fluid of patients with tuberculosis increased to varying degrees.

Cerebrospinal fluid ADA can be used as an important index in the diagnosis and differential diagnosis of central nervous system diseases.

ADA is significantly increased in patients with tuberculous meningitis, which can be used in the differential diagnosis of tuberculous meningitis, purulent meningitis and viral meningitis.

Cerebrospinal fluid ADA can be used as a routine examination item for early diagnosis, observation of disease condition and curative effect. ADA is a highly specific marker of tuberculous pleural effusion. ADA activity in pleural effusion can be used in the differential diagnosis of tuberculous pleurisy and cancerous pleurisy.

According to relevant literature, a pleural ADA greater than 40U/L indicates tuberculous, while a pleural ADA less than 35U/L indicates malignant or non-tuberculous.

Differential Diagnosis of Diabetes

It has been reported that serum ADA is significantly increased in patients with type 2 diabetes mellitus and has a significant positive correlation with HbA1c, while there is no significant correlation between ADA and HbA1c in patients with type 1 diabetes mellitus.

Therefore, the determination of serum ADA has certain significance for the differential diagnosis of type 1 diabetes mellitus and type 2 diabetes mellitus, and for measuring the quality of blood glucose control in type 2 diabetes mellitus patients[4].

Diagnosis of Hematological Diseases

The detection of serum ADA activity is helpful to the clinical staging and classification of leukemia, the differential diagnosis of leukemia and the early diagnosis of chronic myelogenous or slow lymphoblastic crisis, and can be used as a biochemical index to judge the burden of leukemia cells in patients.

In addition, the serum ADA activity is also increased in patients with malignant hematologic diseases such as malignant lymphoma, multiple myeloma, malignant histiocytosis and myelodysplastic syndromes.

Evaluation of Systemic Lupus Erythematosus (SLE)

Serum ADA activity is significantly increased in SLE patients, and the degree of increase is closely related to the severity of the disease.

Therefore, monitoring serum ADA activity in SLE patients has important clinical significance for evaluating the condition and treatment effect.

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Auxiliary Diagnosis of Other Diseases

ADA can also be used in the observation and therapeutic evaluation of iron deficiency anemia, hemorrhagic fever with renal syndrome, nasal polyps and other diseases. As a famous IVD manufacturer, Hipro Biotechnology sells adenosine deaminase test kits for many years. Click to see if this wholesale product is what you want!

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In conclusion, ADA activity detection has become one of the auxiliary diagnostic indicators of many diseases, which provides important reference value for the early diagnosis, differential diagnosis, disease monitoring and treatment effect evaluation of many diseases.  Hipro Biotechnology has various types of reagents used in clinical chemistry in stock. Welcome contact us for diagnosis reagents prices.


[1] Yang W W. Relationship between serum adenosine deaminase level and liver histology in patients with autoimmune hepatitis [J]. Liver, 2018, 23(7):4.

[2] JIANG Ranran, Xu Yang, Ning Li, et al. Clinical application of adenosine deaminase in liver diseases [J]. China Practical Medicine, 2021.

[3] MENG X S. Application value of serum adenosine deaminase, monoamine oxidase combined with lipid test in the diagnosis of fatty liver [J]. Chinese Medical Guideline, 2019, 17(18):2.

[4] Sun Jiaxiang, Li Yan. Clinical significance of detection of serum adenosine deaminase in patients with diabetes mellitus [J]. International Journal of Lab Med, 2011, 32(1):2.

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