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Systemic lupus erythematosus (SLE) is an autoimmune and inflammatory disease with periods of exacerbation and remission. SLE is characterized by the irreversible breakdown of immunological self-tolerance, where there is deregulation of multiple aspects of the immune system. SLE immune dysfunction is characterized by activation of autoreactive T lymphocytes, and hyperactivity of B lymphocytes with consequent production of several autoantibodies. ATP is a purinergic mediator released into the extracellular space in response to cell and tissue damage which operates as a danger signal to modulate immune and inflammatory responses. ATP binds to P2 receptors and its levels are regulated by NTPDase (CD39). SLE patients exhibit increased levels of ATP which binds to P2X receptors resulting in activation of the inflammasome and consequent release of IL-1β and IL-18, cytokines associated with disease pathogenesis. CD39 is upregulated in SLE representing an important immunoregulatory mechanism by controlling inflammation and favoring the production of adenosine. The aim of this review is to clarify the effects of ATP on the modulation of the inflammatory process and immune responses via P2 receptors as well as the role of NTPDase in the immunopathogenesis of SLE.

Sickle cell anemia (SCA) is a hemoglobinopathy characterized by hemolysis and vaso-occlusions caused by rigidly distorted red blood cells. Sickle cell crisis is associated with extracellular release of nucleotides and platelets, which are critical mediators of hemostasis participating actively in purinergic thromboregulatory enzymes system.This study aimed to investigate the activities of purinergic system ecto-enzymes present on the platelet surface as well as CD39 and CD73 expressions on platelets of SCA treated patients. Fifteen SCA treated patients and 30 health subjects (control group) were selected. Ecto-nucleoside triphosphate diphosphohydrolase (E-NTPDase), ecto-5'-nucleotidase (E-5'-NT) and ecto-adenosine deaminase (E-ADA) activities were measured in platelets isolated from these individuals. Results demonstrated an increase of 41 % in the E-NTPDase for ATP hydrolysis, 52% for ADP hydrolysis and 60 % in the E-ADA activity in SCA patients (P0.05); however, a two folds decrease in the CD39 expression in platelets was observed in the same group (P0.01). The increased E-NTPDase activity could be a compensatory mechanism associated with the low expression of CD39 in platelets. Besides, alteration of these enzymes activities suggests that the purinergic system could be involved in the thromboregulatory process in SCA patients.

Background Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease, where there is irreversible breakdown of immunological self-tolerance. Extracellular adenosine triphosphate (ATP) and adenosine are signaling molecules that play an important part in the immune response. During inflammation and the immune response, a group of enzymes control these molecules, including ectonucleoside triphosphate diphosphohydrolase (E-NTPDase), E-5′-nucleotidase, and ecto-adenosine deaminase (E-ADA). We determined the activity and expression of E-NTPDase, the expression of E-5′-nucleotidase, the activity of E-ADA in lymphocytes and serum of SLE patients. Methods This study involved 35 patients with SLE and 30 healthy subjects as a control group. E-NTPDase activity and expression were increased in lymphocytes from SLE patients (31% and 37% for activity and expression, respectively) compared with the control group. Results An approximately 42% increase in E-ADA activity in lymphocytes was observed in SLE patients compared with the control group, in serum the ADA activity was decreased by 57% in SLE patients. Expression of E-5′-nucleotidase was not changed in SLE patients. Conclusions E-NTPDase and E-ADA perform key functions in the modulation of the immune and inflammatory response in SLE.

Background Uterine cervical neoplasia is an important worldwide malignancy sometimes associated with thrombosis. Ectonucleotidases are membrane-bound enzymes which participate in thromboregulation by hydrolyzing adenine nucleotides in the extracellular medium. In this sense, we aimed to investigate their activity in patients with uterine cervical neoplasia. Methods We evaluated NTPDase and 5′-nucleotidase activities from patients previously treated for uterine cervical neoplasia with either conization or radiotherapy (RTX). These patients were divided into four groups: two conization groups (I and II) and two RTX groups (III and IV), which were further divided based on the amount of time that had passed since the conclusion of their treatment, where groups I and III were extended-remission-period groups (patients with 1 to 5 years elapsed after the conclusion of treatment), and groups II and IV were recently treated patients (treated up to three months before). Results For both conization and RTX groups, ATP and ADP hydrolysis decreased in the extended-remission groups when compared to the control and recently treated groups. On the other hand, AMP hydrolysis was decreased in all the treated groups (both conization and RTX) compared to the control. CD39 expression was decreased in extended-remission groups (I and III) when compared to the other groups. Conclusions NTPDase protects against platelet aggregation and 5‘-nucleotidase is more involved in the control of adenosine formation.

The purpose of this study was to investigate the activities of ecto-nucleoside triphosphate diphosphohydrolase (E-NTPDase; EC 3.6.1.5; CD39) and adenosine deaminase (E-ADA; EC 3.5.4.4) in lymphocytes from patients with rheumatoid arthritis (RA). Thirty patients diagnosed with RA through American College of Rheumatology criteria as well as 30 healthy patients were selected. Peripheral blood lymphocytes were isolated, and E-NTPDase and E-ADA activities were assayed. The results demonstrated an increased E-NTPDase activity (both ATP and ADP as substrates) and a decreased E-ADA activity in RA patients. These data suggest an organic effort to preserve the adenosine level, which is known to have anti-inflammatory and analgesic properties, working as a potent suppressor of immune response.

The extracellular nucleotides, ATP and ADP, as well as the nucleoside adenosine have been implicated in a great number of pathologic and physiological functions. However, extracellular adenine nucleotide levels are controlled by a complex cell surface-located group of enzymes called ectonucleotidases. We evaluated activities of enzymes that hydrolyze adenine nucleotides and nucleosides in platelets from patients with ischemic heart disease (IHD).Sixty IHD patients were selected for the study. The activities of ectonucleoside triphosphate diphosphohydrolase (NTPDase, CD39), ectonucleotide pyrophosphatase/phosphodiesterase (E-NPP), ecto-5'-nucleotidase and adenosine deaminase (ADA) were studied in isolated platelets of these patients, as well as the platelet aggregation and NTPDase expression.The results show that NTPDase, ecto-5'-nucleotidase, E-NPP activities and NTPDase expression were increased in platelets of IHD patients when compared with the control group (p0.05). On the other hand, ADA activity and platelet aggregation were decreased in IHD patients, when compared with the control group (p0.05).The pathological condition in IHD generates alterations in ectonucleotidase activities as a compensatory organic response to thrombotic events that occur in IHD.

Multiple sclerosis (MS) is the most common chronic disabling neurological disease in young adults. Alterations in platelet function have been observed in MS; however, the mechanism and the relevance of this blood cell disorder with regard to MS pathogenesis are not yet understood. The aim of this study was to evaluate activities of ectonucleoside thiphosphate diphosphohydrolase (NTPDase, CD39), ectonucleotide pyrophosphatase/phosphodiesterase (E-NPP), 5′-nucleotidase and adenosine deaminase (ADA) in platelets from patients with the relapsing–remitting form of MS (RRMS), as well as to analyze platelet aggregation and expression of NTPDase. The results obtained show that NTPDase, 5′-nucleotidase, E-NPP and ADA activities were decreased in platelets of RRMS patients when compared with the control group (p < 0.05). In addition, NTPDase expression in platelets was also decreased in these patients (p < 0.05); however, no differences were observed in platelet aggregation between RRMS patients and the control group. Our results suggest that the alterations in NTPDase, E-NPP, 5′-nucleotidase and ADA may have contributed to the alterations in platelet function in MS by altering the levels of nucleotides and nucleosides in the circulation.

The objective of this work was to evaluate the effect of different glucose levels on the ATP, ADP and AMP hydrolysis in the platelets of diabetic, hypertensive and diabetic/hypertensive participants.The activities of the enzymes NTPDase (ATP and ADP hydrolysis) and 5'-nucleotidase (AMP hydrolysis), and CD39 expression were analyzed in human blood platelets of diabetic (DM-2), hypertensive (HT) and diabetic/hypertensive (DM-2/HT) patients. To evaluate the interference of glucose and fructose in NTPDase and 5'-nucleotidase activities, experiments were performed with glucose, fructose and mannitol concentrations ranging from 5 to 30 mM in platelet-rich plasma (PRP). Pre-incubation times of 10, 120 min and 24h were used.NTPDase and 5'-nucleotidase activities increased with increasing glucose and fructose concentrations (P0.001) and the different times of pre-incubation did not interfere in ectonucleotidases activities (P0.5). NTPDase and 5'-nucleotidase activities demonstrated a positive correlation between serum glucose levels and ATP and ADP hydrolysis in DM-2 and DM-2/HT patients. CD39 expression demonstrated that DM-2, HT and DM-2/HT groups presented a significant increase when compared to the control group (P0.004).The hydrolysis of adenine nucleotides is enhanced in platelets of patients with diabetes and hypertension. We observed that an increasing glucose concentration had a direct effect on ATP, ADP and AMP hydrolysis. Furthermore, CD39 expression was enhanced in all patients groups, indicating that these enzyme activities are related with diabetes and hypertension.

Objective Ectonucleotide pyrophosphatase/phosphodiesterase (E-NPP) and adenosine deaminase (ADA) activities, in the platelets and serum, were examined in patients with uterine cervix neoplasia without treatment as well as in patients treated by conization or radiotherapy (RTX). Design and methods The patients were divided based on the amount of time from the end of the treatments until the day of the blood sampling. Groups I (n = 19) (conization) and III (n = 11) (radiotherapy) (treated from one to five years earlier), groups II (n = 19) (conization) and IV (n = 16) (radiotherapy) (treated recently; up to three months earlier) and the non-treated group (cancer) (n = 7). Results E-NPP and ADA in the platelets and E-NPP in the serum were decreased in all the treated groups in relation to the control and non-treated groups, while ADA in the serum was decreased only in the conization groups in relation to them. In group II, E-NPP and ADA, in the platelets, were increased in relation to group IV. Conclusion The tendency of reduction for E-NPP and ADA indicates that they may act together to control nucleotide levels and it may also be speculated that surgery causes greater platelet activation contributing to the changes seen in the conization groups. In this sense, platelets seem to be more sensitive than serum.