Adenosine deaminase activity in serum and placenta of patients with anembryonic pregnancies and missed abortions

The cellular immunity and oxidative stress markers in early pregnancy loss

OBJECTIVE

We investigated whether changes in cellular immunity and oxidative stress in pregnancy have any association with spontaneous miscarriage.

MATERIAL AND METHODS

Circulating adenosine deaminase (ADA) activity as a marker of cellular immunity and malondialdehyde (MDA) and catalase (CAT), glutathione peroxidase (GPx) as markers of T lymphocyte activation and parameters of oxidative stress and antioxidant defense were compared between 40 women with early pregnancy loss and another 40 women with ungoing healthy pregnancy.

RESULTS

Women with miscarriage had higher serum ADA and GPx levels when compared with women with normal pregnancy (p = 0.034 and p < 0.001, respectively). Although serum MDA level was slightly higher in women with miscarriage, the difference was not significant (p = 0.083). CAT levels were alike in both groups.

CONCLUSION

We have demonstrated an increased cellular immunity and perhaps a compensated oxidative stress related to increased antioxidant activation in women with early spontaneous pregnancy loss.

Adenosine deaminase activity in normal pregnancy and pregnancy associated disorders

Adenosine deaminase (ADA) is an enzyme of purine salvage pathway and has two important isoenzymes ADA1 and ADA2. The activity of ADA has been changed in diseases characterized by altered cell-mediated immunity. It was observed that total serum ADA activity was decreased during normal pregnancy compared with non-pregnant women. However, total serum ADA activity and serum ADA2 activity was increased in hyperemesis gravidarum and pre-eclampsia in pregnant women. Less information is available regarding role of ADA in abortions (recurrent and missed) and anembryonic pregnancies. Here, we review the activity of ADA and its isoenzymes. Despite these findings, it will be interesting to know whether activity of ADA will be same if ADA is estimated throughout the pregnancy and in pregnancy related complications from early first trimester to third trimester, as all studies until now were carried out at a particular stage of pregnancy.

Effect of ADA1 mother-fetus and wife-husband phenotypic differences on the ratio birth weight/placental weight in fertile women and on reproductive success in couples with RSA

OBJECTIVES

To study the effect Adenosine Deaminase locus 1 (ADA(1)) mother-fetus and wife-husband phenotypic differences on the ratio Birth Weight/Placental Weight (BW/PW) in fertile women and on reproductive success in couples with repeated spontaneous abortion (RSA).

METHODS

209 couples with primary RSA and a consecutive series of 379 healthy puerperae with their newborn infants from the White Caucasian population of central Italy were studied. In primary RSA women reproductive success was indicated by the presence of at least one live-born infant within 5 years of follow up. Two way contingency tables were analyzed by chi-square.

RESULTS

The proportion of primary RSA couples with at least a live-born infant shows the highest value in couples mother ADA(1)1/father carrier of ADA(1)*2 allele (55.2%) and the lowest value in reciprocal couples mother carrier of ADA(1)*2 allele /father ADA(1)1 (18.7%) (O.R. = 5.33; P = 0.023). The highest ratio BW/PW is observed in the class mother ADA(1)1/newborn carrier of ADA(1)*2 allele while the lowest ratio is observed in the reciprocal class mother carrier of ADA(1)*2 allele/ newborn ADA(1)1.

CONCLUSIONS

Differences between mother and fetus in ADA(1) phenotype may influence the ratio BW/PW in healthy women and reproductive success in RSA women.

Serum adenosine deaminase and its isoenzyme activities in pregnancy

OBJECTIVE

ADA is widely distributed in human tissues, which may contribute to the maturation of the immunological system, especially the proliferation and differentiation of lymphoid cells, and seems to be critical at different stages of the maturation process. The activity of ADA changes in diseases characterized by the alteration of cell-mediated immunity. In this study we examined changes in serum total ADA activity and the patterns of two ADA isoenzymes, ADA-1 and ADA-2, in healthy pregnant women, and evaluated the possible role of the alteration of cell-mediated immunity during pregnancy as causes of changes in ADA activity.

MATERIALS AND METHODS

We measured serum activities of total ADA, ADA-1 and ADA-2 in healthy pregnant women (n=129) and age-matched healthy nonpregnant women (n=42). We divided the study group into three different subgroups: first trimester, second trimester and third trimester.

RESULTS

Serum ADA, ADA-1 and ADA-2 activities in healthy pregnant women were significantly lower than in nonpregnant women (p<0.001, p<0.001 and p<0.01 respectively). ADA (p<0.001) and ADA-2 (p<0.001) activities in the first trimester were significantly lower than in the control group. However, there were no significant differences between the first trimester and control group according to their ADA-1 activities (p=0.016). ADA (p<0.001), ADA-1 (p<0.001) and ADA-2 (p<0.008) activities in the second trimester were significantly lower than in the control group. Combined trisomy 21 risk, biochemical trisomy 21 risk, age risk and trisomy 18 + Nuchal translucency (NT) risk were calculated using a first trimester screening test in 63 pregnant women. Furthermore, trisomy 21 risk, age risk and trisomy 18 risk were calculated by triple test in 52 pregnant women. ADA, ADA-1 and ADA-2 activities were not significantly correlated with risks in the first trimester screening test. ADA-1 activity was slightly significantly negative correlated with age risk (r= -0.314, p<0.05) and trisomy 18 risk (p<0.05) in the triple test. ADA (p<0.05) and ADA-2 (p<0.05) activities were slightly significantly correlated with gestational age, while there was no significant correlation between ADA-1 activity and gestational age.

CONCLUSION

Serum ADA activity may be useful for clinical diagnosis and observation of high-risk pregnancies in which cell-mediated immunity has been altered.

Changes in serum adenosine deaminase activity during normal pregnancy

Adenosine deaminase (ADA), an enzyme essential for the differentiation of lymphoid cells, has been used for monitoring diseases with altered immunity. The purpose of this study was to investigate the changes in serum ADA activity throughout normal pregnancy. We measured the catalytic values of serum ADA from 202 normal pregnant women using a commercial kit. Subjects were divided into four groups according to the gestational age in weeks (Gwks) (Group I: 5-9 Gwks [n=58]; Group II: 15-20 Gwks [n= 63]; Group III: 24-30 Gwks [n=34]; Group IV: 30-39 Gwks [n=47]). The serum ADA levels for the Groups I, II, III, and IV were as follows: 20.1 +/- 6.9 IU/L, 20.0 +/- 7.6 IU/L, 37.9 +/- 19.9 IU/L, and 24.5 +/- 8.6 IU/L, respectively. The serum ADA activity of group III was significantly higher than the other groups (p<0.05). However, there was no significant correlation between the Gwks and the serum ADA activity. Furthermore, other parameters, such as maternal age (p=0.29), gestational age at delivery (p=0.07), delivery mode (p=0.39), and birth weight (p=0.59) had no correlation with ADA activity. Reference values of serum ADA in normal pregnancy may provide important database for making clinical decisions in pregnancies complicated by conditions where cellular immunity has been altered.