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[Alpha1-fetoprotein: physiology, pathology and diagnosis especially in childhood (author's transl)]
Insights
Alpha1-fetoprotein (AFP) is a crucial biomarker during fetal development and in adults. Elevated AFP levels in serum and amniotic fluid can indicate serious conditions like liver cancer or neural tube defects.
Area of Science:
- Biochemistry
- Oncology
- Maternal-Fetal Medicine
Context:
- Alpha1-fetoprotein (AFP) is a glycoprotein synthesized primarily by the fetal liver, yolk sac, and gastrointestinal tract.
- Serum AFP concentrations naturally decrease after birth but are present in adults at low levels.
- Physiological increases in AFP occur during pregnancy.
Purpose:
- To elucidate the role of Alpha1-fetoprotein (AFP) as a biomarker.
- To investigate the diagnostic significance of AFP levels in various physiological and pathological conditions.
- To highlight the clinical utility of AFP assays in disease management and prenatal screening.
Summary:
- AFP levels are significantly elevated in primary liver cell carcinoma, hepatoblastoma, and teratoblastoma.
- Transient increases in AFP are observed in benign liver diseases like viral hepatitis.
- Increased AFP is also associated with hereditary conditions such as congenital tyrosinemia and ataxia-telangiectasia.
- Elevated AFP in amniotic fluid can signal congenital nephrosis.
Impact:
- AFP serum assays are vital for monitoring the progression and treatment of liver cancer and teratoblastoma.
- AFP analysis in amniotic fluid aids in the prenatal detection of neural tube defects and fetal distress.
- Understanding AFP's diverse roles enhances diagnostic capabilities in oncology and prenatal care.
Abstract:
Alpha1-fetoprotein (AFP) is an alpha1-glycoprotein which can be found in high concentration during fetal development in many mammals, birds, sharks and, also, man. The alpha-fetoproteins of various species have similar physico-chemical properties and often common antigenic determinants. Differences of microheterogeneity depend on a different content of sialin-acid. During human fetal development the serum AFP concentration falls with increasing gestational age. 4-5 weeks after birth AFP can be detected usually in low serum concentrations. Using more sensitive immunulogic techniques e.g. radioimmunoassay there was shown that AFP is present in sera of normal adults in concentrations of 10-20 ng/ml. AFP serum concentrations rise physiologically during pregnancy up to 500-550 ng/ml. During fetal development liver, yolk sac and gastrointestinal tract are the major sites of synthesis. In primary liver cell carcinoma, hepatoblastoma and in teratoblastoma containing yolk sac tissue AFP synthesis rises in tumor cells; the AFP serum concentration increases above 2 microgram/ml. In patients with benign liver diseases e.g. virus hepatitis, a transient rise of AFP serum concentrations was seen. Moreover, increased levels of AFP were found in hereditary diseases e.g. congenital tyrosinemia, ataxia-telangiectasia and in the amniotic fluid in congenital nephrosis of Finnish type. AFP assay in serum is clinically important for the control of course and treatment of primary liver cell carcinoma and teratoblastoma. AFP assay in amniotic fluid is a method for the prenatal detection of neural tube defects and the fetal distress syndrome, especially.