Urinary prostate-specific antigen is a noninvasive indicator of sexual development in male children

Area of Science:

• Urology
• Pediatrics
• Endocrinology

Background:

• Testicular androgen (testosterone) is known to induce prostate-specific antigen (PSA) synthesis in prostate acinar epithelial cells.
• Urinary PSA levels can serve as a non-invasive biomarker, but its presence and dynamics in developing males are not fully understood.

Purpose of the Study:

• To investigate the presence and patterns of urinary PSA in male children from birth to 17 years of age.
• To explore the relationship between testosterone secretion and PSA levels during early infancy and puberty.

Main Methods:

• Collected and analyzed urine samples from 136 male children (birth to 17 years) for PSA and testosterone (T) concentrations.
• Correlated urinary T levels with transient increases in urinary PSA during the first 1-4 months of life.
• Assessed PSA levels across different age groups and Tanner stages.

Main Results:

• Detected transient increases in urinary PSA in 67% of infants (full-term and preterm) following testosterone surges within the first 1-4 months.
• Urinary PSA was undetectable in children aged 0.3 to 9 years, with gradual increases observed after age 10.
• Marked and persistent urinary PSA activity was noted after Tanner stage III pubertal development.

Conclusions:

• Bioactive testosterone induces PSA during early human infancy, a finding demonstrated here for the first time.
• Urinary PSA is a valuable, non-invasive biomarker for assessing male development from the neonatal period through adolescence.
• A confirmatory semiquantitative PSA assay can be used for measuring this developmental indicator.