Original Investigation

Serum Adenosine Deaminase Activity and Neopterin Levels during Therapy in Patients with Pulmonary Tuberculosis and Community-Acquired Pneumonia


  • Esma Altunoğlu
  • Füsun Erdenen
  • Remise Gelişgen
  • Özlem Kar
  • Gülcan Güntaş Korkmaz
  • Cüneyt Müderrisoğlu
  • Ömür Tabak
  • Hafize Uzun

İstanbul Med J 2014;15(2):78-82


Adenosine deaminase (ADA) and neopterin are increased in disorders that stimulate cells involved in the immune system. We investigated the effect of therapy on serum ADA activity and neopterin levels in patients with pulmonary tuberculosis (TB) and with community-acquired pneumonia (CAP).


Seventeen pulmonary TB, 24 CAP, and a control group of 20 healthy volunteers were included in this study. ADA and neopterin assay was performed colorimetrically and by ELISA, respectively, before and 2 months after therapy (rifampicin+isoniazid+ethambutol and pyrazinamide) of patients with TB and before and 15 days after therapy (ampicillin- sulbactam) of CAP.


Serum ADA activity and neopterin levels were significantly higher in patients with TB than those in pneumonia and controls. Serum neopterin levels were significantly higher in patients with CAP than controls. No significant differences were found in ADA levels between pneumonia and control subjects. The ADA and neopterin levels decreased in active tuberculosis at the second month of treatment. No significant differences were found in neopterin levels between CAP and TB after treatment. But, serum neopterin and ADA levels were still significantly higher in patients with tuberculosis than controls despite treatment.


Although ADA activity may be useful for diagnosis and monitoring therapy in both specific and nonspecific pulmonary infections, neopterin values may be used in pneumonia patients along with the traditional biomarkers, such as white blood cell (WBC), erythrocyte rate (ESR), C-reactive protein (CRP).

Keywords: Pulmonary tuberculosis, community-acquired pneumonia, adenosine deaminase, neopterin