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Mohan CD, Rangappa S, Nayak SC, Jadimurthy R, Wang L, Sethi G, Garg M, Rangappa KS. Bacteria as a treasure house of secondary metabolites with anticancer potential. Semin Cancer Biol 2021; 86:998-1013. [PMID: 33979675 DOI: 10.1016/j.semcancer.2021.05.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 12/27/2022]
Abstract
Cancer stands in the frontline among leading killers worldwide and the annual mortality rate is expected to reach 16.4 million by 2040. Humans suffer from about 200 different types of cancers and many of them have a small number of approved therapeutic agents. Moreover, several types of major cancers are diagnosed at advanced stages as a result of which the existing therapies have limited efficacy against them and contribute to a dismal prognosis. Therefore, it is essential to develop novel potent anticancer agents to counteract cancer-driven lethality. Natural sources such as bacteria, plants, fungi, and marine microorganisms have been serving as an inexhaustible source of anticancer agents. Notably, over 13,000 natural compounds endowed with different pharmacological properties have been isolated from different bacterial sources. In the present article, we have discussed about the importance of natural products, with special emphasis on bacterial metabolites for cancer therapy. Subsequently, we have comprehensively discussed the various sources, mechanisms of action, toxicity issues, and off-target effects of clinically used anticancer drugs (such as actinomycin D, bleomycin, carfilzomib, doxorubicin, ixabepilone, mitomycin C, pentostatin, rapalogs, and romidepsin) that have been derived from different bacteria. Furthermore, we have also discussed some of the major secondary metabolites (antimycins, chartreusin, elsamicins, geldanamycin, monensin, plicamycin, prodigiosin, rebeccamycin, salinomycin, and salinosporamide) that are currently in the clinical trials or which have demonstrated potent anticancer activity in preclinical models. Besides, we have elaborated on the application of metagenomics in drug discovery and briefly described about anticancer agents (bryostatin 1 and ET-743) identified through the metagenomics approach.
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Affiliation(s)
| | - Shobith Rangappa
- Adichunchanagiri Institute for Molecular Medicine, Adichunchanagiri University, BG Nagara, 571448, Nagamangala Taluk, India
| | - S Chandra Nayak
- Department of Studies in Biotechnology, University of Mysore, Manasagangotri, Mysore, 570006, India
| | - Ragi Jadimurthy
- Department of Studies in Molecular Biology, University of Mysore, Manasagangotri, Mysore, 570006, India
| | - Lingzhi Wang
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117600, Singapore; Cancer Science Institute of Singapore, National University of Singapore, Singapore, 117599, Singapore
| | - Gautam Sethi
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117600, Singapore
| | - Manoj Garg
- Amity Institute of Molecular Medicine and Stem Cell Research, Amity University, Uttar Pradesh, Noida, 201313, India
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Malki Y, Martinez J, Masurier N. 1,3-Diazepine: A privileged scaffold in medicinal chemistry. Med Res Rev 2021; 41:2247-2315. [PMID: 33645848 DOI: 10.1002/med.21795] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/20/2021] [Accepted: 02/17/2021] [Indexed: 12/19/2022]
Abstract
Privileged structures have been widely used as effective templates for drug discovery. While benzo-1,4-diazepine constitutes the first historical example of such a structure, the 1,3 analogue is just as rich in terms of applications in medicinal chemistry. The 1,3-diazepine moiety is present in numerous biological active compounds including natural products, and is used to design compounds displaying a large range of biological activities. It is present in the clinically used anticancer compound pentostatin, in several recent FDA approved β-lactamase inhibitors (e.g., avibactam) and also in coformycin, a natural product known as a ring-expanded purine analogue displaying antiviral and anticancer activities. Several other 1,3-diazepine containing compounds have entered into clinical trials. This heterocyclic structure has been and is still widely used in medicinal chemistry to design enzyme inhibitors, GPCR ligands, and so forth. This review endeavours to highlight the main use of the 1,3-diazepine scaffold and its derivatives, and their applications in medicinal chemistry, drug design, and therapy. We will focus more particularly on the development of enzyme inhibitors incorporating this scaffold, with a strong emphasis on the molecular interactions involved in the inhibition mechanism.
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Affiliation(s)
- Yohan Malki
- IBMM, Université de Montpellier, CNRS, ENSCM, Montpellier, France
| | - Jean Martinez
- IBMM, Université de Montpellier, CNRS, ENSCM, Montpellier, France
| | - Nicolas Masurier
- IBMM, Université de Montpellier, CNRS, ENSCM, Montpellier, France
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Ludford PT, Tor Y. Ascertaining the activity and inhibition of adenosine deaminase via fluorescence-based assays. Methods Enzymol 2020; 639:71-90. [PMID: 32475413 DOI: 10.1016/bs.mie.2020.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A fluorescence-based assay for adenosine deaminase (ADA) activity and inhibition, which may also be formatted as an inhibitor discovery assay, is described. It relies on differences in fluorescence between an isothiazolo-based adenosine analogs (tzA) and its deaminated product, the corresponding inosine derivative (tzI), which facilitates a real-time monitoring of enzymatic activity. Inhibitors are added to the enzyme-substrate reaction mixture at various concentrations and the fluorescence signal is recorded over 10min. The percent inhibition is calculated from the signal change at 10min relative to the uninhibited reaction. The percent inhibition is plotted against inhibitor concentration and fitted to a Hill curve. IC50 values are then calculated.
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Affiliation(s)
- Paul T Ludford
- Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, CA, United States
| | - Yitzhak Tor
- Department of Chemistry and Biochemistry, University of California, San Diego, La Jolla, CA, United States.
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Zhang XG, Ma GY, Kou F, Liu WJ, Sun QY, Guo GJ, Ma XD, Guo SJ, Jian-Ning Z. Reynoutria Japonica from Traditional Chinese Medicine: A Source of Competitive Adenosine Deaminase Inhibitors for Anticancer. Comb Chem High Throughput Screen 2020; 22:113-122. [PMID: 30987561 DOI: 10.2174/1386207322666190415100618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 02/15/2019] [Accepted: 03/29/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Adenosine deaminase (ADA) is an important enzyme in purine metabolism and is known as a potential therapeutic target for the treatment of lymphoproliferative disorders and cancer. Traditional Chinese Herbal Medicine (TCHM) is widely used alone or in combination with chemotherapy to treat cancer, due to its ability to deliver a broad variety of bioactive secondary metabolites as promising sources of novel organic natural agents. OBJECTIVE In the present study, 29 varieties of medicinal plants were screened for the presence of ADA inhibitors. RESULTS Extracts from Reynoutria japonica, Glycyrrhiza uralensis, Lithospermum erythrorhizon, Magnolia officinalis, Gardenia jasminoides, Stephania tetrandra, Commiphora myrrha, Raphanus sativus and Corydalis yanhusuo demonstrated strong ADA inhibition with rates greater than 50%. However, Reynoutria japonica possessed the highest ADA inhibitory activity at 95.26% and so was used in our study for isolating the ADA inhibitor to be further studied. Eight compounds were obtained and their structures were identified. The compound H1 had strong ADA inhibitory activity and was deduced to be emodin by 1H and 13C-NMR spectroscopic analysis with an IC50 of 0.629 mM. The molecular docking data showed that emodin could bind tightly to the active site of ADA. Our results demonstrated that emodin displayed a new biological activity which is ADA inhibitory activity with high cytotoxic activity against K562 leukemia cells. The bioactivity of cordycepin was significantly increased when used in combination with emodin. CONCLUSION Emodin may represent a good candidate anti-cancer therapy and adenosine protective agent.
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Affiliation(s)
- Xin-Guo Zhang
- School of Life Science and Engineering, Key Laboratory of Drug Screening and Deep Processing for Traditional Chinese and Tibetan Medicine of Gansu Province, Lanzhou University of Technology, Lanzhou 730050, China
| | - Guo-Yan Ma
- School of Life Science and Engineering, Key Laboratory of Drug Screening and Deep Processing for Traditional Chinese and Tibetan Medicine of Gansu Province, Lanzhou University of Technology, Lanzhou 730050, China
| | - Fei Kou
- School of Life Science and Engineering, Key Laboratory of Drug Screening and Deep Processing for Traditional Chinese and Tibetan Medicine of Gansu Province, Lanzhou University of Technology, Lanzhou 730050, China
| | - Wen-Jie Liu
- School of Life Science and Engineering, Key Laboratory of Drug Screening and Deep Processing for Traditional Chinese and Tibetan Medicine of Gansu Province, Lanzhou University of Technology, Lanzhou 730050, China
| | - Qiao-Yun Sun
- School of Life Science and Engineering, Key Laboratory of Drug Screening and Deep Processing for Traditional Chinese and Tibetan Medicine of Gansu Province, Lanzhou University of Technology, Lanzhou 730050, China
| | - Guang-Jun Guo
- School of Life Science and Engineering, Key Laboratory of Drug Screening and Deep Processing for Traditional Chinese and Tibetan Medicine of Gansu Province, Lanzhou University of Technology, Lanzhou 730050, China
| | - Xiao-Di Ma
- School of Life Science and Engineering, Key Laboratory of Drug Screening and Deep Processing for Traditional Chinese and Tibetan Medicine of Gansu Province, Lanzhou University of Technology, Lanzhou 730050, China
| | - Si-Jia Guo
- School of Life Science and Engineering, Key Laboratory of Drug Screening and Deep Processing for Traditional Chinese and Tibetan Medicine of Gansu Province, Lanzhou University of Technology, Lanzhou 730050, China
| | - Zhu Jian-Ning
- Drug Evaluation and Certification Center of Gansu Food and Drug Administration, Lanzhou 730060, China
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Bagheri S, Saboury AA, Haertlé T. Adenosine deaminase inhibition. Int J Biol Macromol 2019; 141:1246-1257. [PMID: 31520704 DOI: 10.1016/j.ijbiomac.2019.09.078] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 12/18/2022]
Abstract
Adenosine deaminase is a critical enzyme in purine metabolism that regulates intra and extracellular adenosine concentrations by converting it to inosine. Adenosine is an important purine that regulates numerous physiological functions by interacting with its receptors. Adenosine and consequently adenosine deaminase can have pro or anti-inflammatory effects on tissues depending on how much time has passed from the start of the injury. In addition, an increase in adenosine deaminase activity has been reported for various diseases and the significant effect of deaminase inhibition on the clinical course of different diseases has been reported. However, the use of inhibitors is limited to only a few medical indications. Data on the increase of adenosine deaminase activity in different diseases and the impact of its inhibition in various cases have been collected and are discussed in this review. Overall, the evidence shows that many studies have been done to introduce inhibitors, however, in vivo studies have been much less than in vitro, and often have not been expanded for clinical use.
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Affiliation(s)
- S Bagheri
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - A A Saboury
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran.
| | - T Haertlé
- Institut National de la Recherche Agronomique, Nantes, France
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Arun KG, Sharanya CS, Sadasivan C. Computational and experimental validation of morin as adenosine deaminase inhibitor. J Recept Signal Transduct Res 2018; 38:240-245. [PMID: 29843562 DOI: 10.1080/10799893.2018.1476543] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Adenosine deaminase (ADA) is one of the major enzymes involved in purin metabolism, it has a significant role in cell growth and differentiation. Over-activity of ADA has been noticed in some pathology, like malignancy and inflammation and makes it an attractive target for the development of drugs for such diseases. In the present study, ADA inhibitory activity of morin, a bioactive flavonoid, was assessed through computational and biophysical methods. The enzyme kinetics data showed that morin is a competitive inhibitor of ADA. Binding energy calculated from ITC analysis was -7.11 kcal/mol. Interaction of morin with ADA was also studied using fluorescence quenching method. Molecular docking studies revealed the structural details of the interaction. Molecular dynamics study in explicit solvent was also conducted to assess the structural stability of protein ligand complex.
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Affiliation(s)
- K G Arun
- a Department of Biotechnology and Microbiology , Kannur University, Thalassery Campus , Kannur , Kerala , India
| | - C S Sharanya
- a Department of Biotechnology and Microbiology , Kannur University, Thalassery Campus , Kannur , Kerala , India
| | - C Sadasivan
- a Department of Biotechnology and Microbiology , Kannur University, Thalassery Campus , Kannur , Kerala , India
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Zhang XG, Liu JW, Tang P, Liu ZY, Guo GJ, Sun QY, Yin JJ. Identification of a New Uncompetitive Inhibitor of Adenosine Deaminase from Endophyte Aspergillus niger sp. Curr Microbiol 2017; 75:565-573. [PMID: 29243069 DOI: 10.1007/s00284-017-1418-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 12/08/2017] [Indexed: 11/28/2022]
Abstract
Adenosine deaminase (ADA) is an enzyme widely distributed from bacteria to humans. ADA is known as a potential therapeutic target for the treatment of lymphoproliferative disorders and cancer. Endophytes are endosymbionts, often bacteria or fungi, which live within plant tissues and internal organs or intercellular space. Endophytes have a broad variety of bioactive metabolites that are used for the identification of novel natural compounds. Here, 54 morphologically distinct endophyte strains were isolated from six plants such as Peganum harmala Linn., Rheum officinale Baill., Gentiana macrophylla Pall., Radix stephaniae tetrandrae, Myrrha, and Equisetum hyemale Linn. The isolated strains were used for the search of ADA inhibitors that resulted in the identification of the strain with the highest inhibition activity, Aspergillus niger sp. Four compounds were isolated from this strain using three-step chromatography procedure, and compound 2 was determined as the compound with the highest inhibition activity of ADA. Based on the results of 1H and 13C NMR spectroscopies, compound 2 was identified as 3-(4-nitrophenyl)-5-phenyl isoxazole. We showed that compound 2 was a new uncompetitive inhibitor of ADA with high cytotoxic effect on HepG2 and SMCC-7721 cells (the IC50 values were 0.347 and 0.380 mM, respectively). These results suggest that endophyte strains serve as promising sources for the identification of ADA inhibitors, and compound 2 could be an effective drug in the cancer treatment.
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Affiliation(s)
- Xin-Guo Zhang
- School of Life Science and Engineering, Key Laboratory of Herbal-Tebitan Drug Screening and Deep Processing of Gansu Province, Lanzhou University of Technology, Lanzhou, 730050, China.
| | - Jin-Wen Liu
- School of Life Science and Engineering, Key Laboratory of Herbal-Tebitan Drug Screening and Deep Processing of Gansu Province, Lanzhou University of Technology, Lanzhou, 730050, China
| | - Peng Tang
- School of Life Science and Engineering, Key Laboratory of Herbal-Tebitan Drug Screening and Deep Processing of Gansu Province, Lanzhou University of Technology, Lanzhou, 730050, China
| | - Zi-Yu Liu
- School of Life Science and Engineering, Key Laboratory of Herbal-Tebitan Drug Screening and Deep Processing of Gansu Province, Lanzhou University of Technology, Lanzhou, 730050, China
| | - Guang-Jun Guo
- School of Life Science and Engineering, Key Laboratory of Herbal-Tebitan Drug Screening and Deep Processing of Gansu Province, Lanzhou University of Technology, Lanzhou, 730050, China
| | - Qiao-Yun Sun
- School of Life Science and Engineering, Key Laboratory of Herbal-Tebitan Drug Screening and Deep Processing of Gansu Province, Lanzhou University of Technology, Lanzhou, 730050, China
| | - Jian-Jun Yin
- School of Life Science and Engineering, Key Laboratory of Herbal-Tebitan Drug Screening and Deep Processing of Gansu Province, Lanzhou University of Technology, Lanzhou, 730050, China.
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Arun KG, Sharanya CS, Sandeep PM, Sadasivan C. Inhibitory activity of hibifolin on adenosine deaminase- experimental and molecular modeling study. Comput Biol Chem 2016; 64:353-358. [PMID: 27591790 DOI: 10.1016/j.compbiolchem.2016.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 06/19/2016] [Accepted: 08/20/2016] [Indexed: 10/21/2022]
Abstract
Adenosine deaminase (ADA) is an enzyme involved in purine metabolism. ADA converts adenosine to inosine and liberates ammonia. Because of their critical role in the differentiation and maturation of cells, the regulation of ADA activity is considered as a potential therapeutic approach to prevent malignant and inflammatory disorders. In the present study, the inhibitory activity of a plant flavonoid, hibifolin on ADA is investigated using enzyme kinetic assay and isothermal titration calorimetry. The inhibitory constant of hibifolin was found to be 49.92μM±3.98 and the mode of binding was reversible. Isothermal titration calorimetry showed that the compound binds ADA with binding energy of -7.21Kcal/mol. The in silico modeling and docking studies showed that the bound ligand is stabilized by hydrogen bonds with active site residues of the enzyme. The study reveals that hibifolin can act as a potential inhibitor of ADA.
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Affiliation(s)
- K G Arun
- Department of Biotechnology and Microbiology, Kannur University, Thalassery Campus, Kannur, Kerala, 670661, India; Inter University Centre for Bioscience, KannurUniversity, Thalassery Campus, Kannur, Kerala, 670661, India
| | - C S Sharanya
- Department of Biotechnology and Microbiology, Kannur University, Thalassery Campus, Kannur, Kerala, 670661, India; Inter University Centre for Bioscience, KannurUniversity, Thalassery Campus, Kannur, Kerala, 670661, India
| | - P M Sandeep
- Department of Biotechnology and Microbiology, Kannur University, Thalassery Campus, Kannur, Kerala, 670661, India; Inter University Centre for Bioscience, KannurUniversity, Thalassery Campus, Kannur, Kerala, 670661, India
| | - C Sadasivan
- Department of Biotechnology and Microbiology, Kannur University, Thalassery Campus, Kannur, Kerala, 670661, India; Inter University Centre for Bioscience, KannurUniversity, Thalassery Campus, Kannur, Kerala, 670661, India.
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Kathiresan K, Saravanakumar K, Sahu SK, Sivasankaran M. Adenosine deaminase production by an endophytic bacterium (Lysinibacillus sp.) from Avicennia marina. 3 Biotech 2014; 4:235-239. [PMID: 28324425 PMCID: PMC4026454 DOI: 10.1007/s13205-013-0144-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 05/21/2013] [Indexed: 11/17/2022] Open
Abstract
The present study was carried out with the following objectives: (1) to isolate the endophytic bacilli strains from the leaves of mangrove plant Avicennia marina, (2) to screen the potential strains for the production of adenosine deaminase, (3) to statistically optimize the factors that influence the enzyme activity in the potent strain, and (4) to identify the potent strain using 16S rRNA sequence and construct its phylogenetic tree. The bacterial strains isolated from the fresh leaves of a mangrove A. marina were assessed for adenosine deaminase activity by plating method. Optimization of reaction process was carried out using response surface methodology of central composite design. The potent strain was identified based on 16S rRNA sequencing and phylogeny. Of five endophytic strains, EMLK1 showed a significant deaminase activity over other four strains. The conditions for maximum activity of the isolated adenosine deaminase are described. The potent strain EMLK1 was identified as Lysinibacillus sp. (JQ710723) being the first report as a mangrove endophyte. Mangrove-derived endophytic bacillus strain Lysinibacillus sp. EMLK1 is proved to be a promising source for the production of adenosine deaminase and this enzyme deserves further studies for purification and its application in disease diagnosis.
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Ali TH, Ali NH, Haroun BM, Tantawy AE. Purification and partial characterization of NAD aminohydrolase from Aspergillus oryzae NRRL447. World J Microbiol Biotechnol 2013; 30:819-25. [PMID: 24158390 DOI: 10.1007/s11274-013-1483-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 09/04/2013] [Indexed: 10/26/2022]
Abstract
Aspergillus oryzae aminohydrolase free acid phosphodiesterase catalyzes nicotinamide adenine dinucleotide to deamino-NAD and ammonia. The enzyme was purified to homogeneity by a combination of acetone precipitation, anion exchange chromatography and gel filtration chromatography. The enzyme was purified 230.5 fold. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the purified enzyme showed a single protein band of MW 94 kDa. The enzyme displayed maximum activity at pH 5 and 40 °C with NAD as substrate. The enzyme activity appeared to be stable up to 40 °C. The enzyme activity was enhanced slightly by addition of Na⁺ and K⁺, whereas inhibited strongly by addition of Ag⁺, Mn²⁺, Hg²⁺ and Cu²⁺ to the reaction mixtures. The enzyme hydrolyzes several substrates, suggesting a probable non-specific nature. The enzyme catalyzes the hydrolytic cleavage of amino group of NAD, adenosine, AMP, CMP, GMP, adenosine, cytidine and cytosine to the corresponding nucleotides, nucleosides or bases and ammonia. The substrate concentration-activity relationship is the hyperbolic type and the apparent Km and Kcat for the tested substrates were calculated.
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Affiliation(s)
- Thanaa H Ali
- Department of Microbial Chemistry, National Research Centre, Dokki, Cairo, Egypt,
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Abstract
Adenosine Deaminase Isoenzymes in the Diagnosis and Monitoring of Rheumatoid ArthritisThe aim of this study was determination of the catalytic activities of adenosine deaminase (ADA), ADA1 and ADA2 isoenzymes in the serum of patients suffering from rheumatoid arthritis (RA) who were and were not treated with methotrexate (MTX), and identification of the possibilities of using these biochemical parameters in diagnosing and monitoring the treatment effects in RA. Catalytic activities of total ADA (tADA) and ADA2 in serum were determined by a spectrophotometric method. A statistically significant correlation was found between the total ADA and ADA1 values, as well as between tADA and ADA2 in the serum of all patients suffering from RA. Determination of ADA1 and ADA2 isoenzyme catalytic activities in the serum of patients who might be suffering from RA improves the diagnostic value of total ADA catalytic activity determination. ADA2 catalytic activity in serum can be a useful biochemical marker in diagnosing and monitoring RA. Decrease in ADA1 isoenzyme catalytic activities in the serum of patients suffering from RA who were treated with MTX can help in the observation of MTX therapy effects.
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