Adenosine deaminase (ADA) isoenzymes ADA1 and ADA2 in biological fluids

Evaluation of pleural effusion sCD26 and DPP-IV as diagnostic biomarkers in lung disease

In this study, we measured ADA and DPP-IV enzymatic activity and sCD26 concentration in 150 pleural effusion (PE) samples and tested for correlations between these and other cellular and biochemical measures. We found that DPP-IV in particular might improve the specificity (but not the sensitivity) of the ADA test for diagnosis of pulmonary tuberculosis, since half of the false ADA positive results in non-tuberculous PE were also DPP-IV positive. A percentage of patients with malignant PE were sCD26 or DPP-IV positive; however, some patients with benign PE also tested positive. As a pattern associated with DPP-IV (but not the CD26 protein) was observed in PE, we searched for a finding that might increase the value of these biomarkers for diagnosis of malignancy. The observed pattern was related to the presence of leukocytes, as indicated by correlations with the cell count, and to a band of 180 kDa, detected by immunoblotting.

Automobile accidents in patients with sleep apnea syndrome. An epidemiological and mechanistic study

To investigate the association between sleep apnea syndrome (SAS) and automobile accidents, and to evaluate potential underlying mechanisms, we prospectively recruited 60 consecutive patients with SAS (apnea-hypopnea index, 58 +/- 3 h-1) and 60 healthy control subjects, matched for sex and age. The number of automobile accidents during the past 3 yr was obtained from participants and insurance companies. We quantified the degree of daytime sleepiness (Epworth scale), anxiety and depression (Beck tests), and we assessed the level of vigilance (PVT 192) and driving performance (Steer-Clear). Patients had more accidents than control subjects (OR: 2.3; 95% CI: 0.97 to 5.33) and were more likely to have had more than one accident (OR: 5.2; 95% CI: 1.07 to 25.29, p < 0.05). These differences persisted after stratification for km/yr, age, and alcohol consumption. Patients were more somnolent, anxious, and depressed than control subjects (p < 0.01), and they had a lower level of vigilance and poorer driving performance (p < 0.01). Yet, we did not find any correlation between the degree of daytime sleepiness, anxiety, depression, the number of respiratory events, nocturnal hypoxemia, level of vigilance, or driving simulator performance and the risk of automobile accidents among SAS patients. In conclusion, patients with SAS have an increased risk of automobile accidents. None of the clinical or physiological markers commonly used to define disease severity appear able to discriminate those patients at higher risk of having an automobile accident.