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Serum prostate-specific antigen measured in children from birth to age 18 years
E W Randell1, E P Diamandis, G Ellis
1Department of Clinical Biochemistry, University of Toronto, Ontario, Canada.
Insights
Prostate-specific antigen (PSA) is detectable in cord blood and in newborns of both sexes. PSA levels in males rise during puberty, but its presence in newborns is not a reliable indicator of male gender.
Area of Science:
- Biochemistry
- Pediatrics
- Endocrinology
Background:
- Prostate-specific antigen (PSA) is a biomarker predominantly associated with the prostate gland.
- Understanding PSA levels in early life is crucial for interpreting potential health indicators.
Purpose of the Study:
- To measure prostate-specific antigen (PSA) levels in cord blood, neonates, and children up to 18 years.
- To investigate the presence and patterns of PSA in relation to age and sex.
Main Methods:
- Serum samples from 94 cord bloods, 44 newborns, and 330 children were analyzed.
- A sensitive third-generation PSA assay was employed using the IMMULITE analyzer.
Main Results:
- Detectable PSA concentrations were found in many cord and neonatal sera (male and female), with higher frequency in males.
- PSA levels decreased in prepubertal children but reappeared in males around puberty.
- PSA levels in newborns showed significant overlap between sexes, limiting its use for gender assignment.
Conclusions:
- Detectable PSA in cord/newborn sera may stem from hormonal stimulation (androgenic in males, prolactin/progesterone in females).
- PSA is not a reliable marker for determining male gender in newborns with ambiguous genitalia.
- The study provides insights into the ontogeny of PSA and its hormonal influences in early life.
Abstract:
We measured prostate-specific antigen (PSA) in serum from 94 cord- blood samples, from 44 newborns, and from 330 children up to age 18 years, using a highly sensitive "third generation" PSA assay on the IMMULITE (Diagnostic Products Corp.) analyzer. The serum was that remaining after cross-matching for blood transfusion. Most children were hospitalized for special care or surgery. We found detectable concentrations of PSA (> or = 0.003 micrograms/L) in many cord sera and in sera from both male and female neonates. PSA was more frequently detectable in cord and newborn sera from males than from females, but there was considerable overlap in values between the sexes, negating any possible usefulness of PSA for assigning male gender to newborns with ambiguous genitalia. PSA decreased to undetectable concentrations in most prepubertal males and females but became detectable around the age of puberty in males. We speculate that the presence of detectable PSA in cord and newborn sera results from androgenic stimulation of prostatic tissue in males or from stimulation of breast or other tissue by prolactin or progesterone in females.