Prostate Specific Antigen in Cord Blood

Abstract

Recent studies have demonstrated the presence of prostate specific antigen (PSA) in cord blood of male as well as female babies. The placental progesterone and estradiol up-regulate the synthesis and secretion of PSA in Placenta. This PSA is presumed to play a role in intrauterine growth of fetus by virtue of its proteolytic action on several substrates including insulin-like-growth-factorbinding-protein-3, insulin chains and Interleukin-2. This study was planned with the objective of correlating the levels of PSA in cord blood to gestation at delivery, the type of delivery and gender of the fetus. Fifty-seven cord blood samples were collected from the umbilical cord during delivery or mid-trimester abortion and analyzed for PSA using 'Active PSA DSL-9700 ultra sensitive' kit employing two-site immuno-radiometric assay principle and having a detection limit of 0.001 ng/ml. Mean PSA levels in cord blood were found to be 0.112 ± 0.027 ng/ ml. The concentration of PSA in cord blood was found to be higher in case of higher gestational age, male baby and operative delivery. 50 % of cord bloods for female babies had PSA below detection limit (range \0.001-0.460 ng/ ml), while all the male samples had detectable PSA (range 0.11-0.973 ng/ml). Higher Progesterone levels found in prenatal maternal blood in case of male babies may be responsible for the higher cord blood PSA. Mean cord blood PSA was 0.150 ± 0.150 ng/ml in forceps delivery and 0.078 ± 0.012 ng/ml in normal vaginal delivery. Forceps delivery causes much more stress and strain as compared to a normal vaginal delivery, resulting in increased levels of adrenal glucocorticoids, and therefore, higher cord blood PSA.

Reconnoitring the Status of Prostate Specific Antigen and its Role in Women

“…Some studies confirmed that extra prostatic PSA is under steroid hormonal control and androgen stimulation promotes PSA expression in women in vivo. A recent study documented that the concentration of PSA in cord blood is higher in case of higher gestational age, male baby and operative delivery and explained that higher progesterone levels in prenatal maternal blood having male babies may be responsible for the higher cord blood PSA while operative interventions like caesarian section or forceps delivery results in much more stress and strain compared to normal vaginal delivery, with subsequent increase in levels of adrenal glucocorticoids, and therefore, higher cord blood PSA [54]. Breul et al [55] reported that female patients receiving Testosterone supplementation has PSA levels comparable with that of men with significantly elevated urinary PSA levels presumably as a result of increased production of PSA by the periurethral glands.…”

Changes in Serum PSA During Normal Menstrual Cycle

“…However, since 1994 several studies have demonstrated the presence of PSA in several tissues and body fluids of women including serum, amniotic fluid, breast milk, saliva, urine, cord blood, endometrium, placenta, mammary glands, salivary glands and sweat glands. PSA levels in sera of normal healthy females change consistently during the menstrual cycle and in pregnancy [1][2][3][4][5][6][7][8][9].…”

“…PSA is a single chain glycoprotein of approximately 33 KD with chymotrypsin like activity. In vitro studies have shown that PSA can be induced by progesterone, androgens, vitamin D3 and possibly estrogens [2][3][4][5][6]10]. During normal menstrual cycle, the corpus luteal steroids are thought to stimulate the target tissues, like breast and endometrium, to produce PSA which enters blood stream and is detectable by ultra sensitive assays [9][10][11][12].…”

“…In a normal menstrual cycle, PSA is credited as a local regulator of uterine function. It is plausible that PSA, like tissue kallikrein, acts as a mediator of menstrual blood flow, the cyclic proliferation of the endometrium, implantation and/or parturition [1][2][3].…”