Anti-goat antibodies as a rare cause of high gonadotropin levels during menopausal transition

Abstract

Objective: To understand the origin of extremely high gonadotropin levels in a perimenopausal woman.

Methods: A 52-year-old woman with a 2?months of amenorrhea followed spontaneous menstrual cycles recovery was referred to our outpatient clinic with elevated follicle-stimulating hormone (FSH, 483 mUI/ml), luteinizing hormone (LH, 475 mUI/ml) and prolactin (PRL, 173?ng/ml). She was known to take levosulpiride. The gonadotropin levels did not fit with the clinical features.

Results: A gonadotroph tumor was ruled out. Further analysis confirmed constantly high FSH, LH and PRL levels. The measurements were repeated using different analytical platforms with different results. After serial dilutions, nonlinearity was present suggesting an immunoassay interference. After post-polyethylene glycol recovery, hormone levels appeared in the normal range. Anti-goat antibodies were recognized in the serum of the patient.

Conclusions: This case report shows a case of falsely abnormal high gonadotropin and PRL levels in a woman during menopause transition. In the clinical practice the evaluation of gonadotropin profile is not recommended at this age, but the abnormal levels stimulated further evaluation. An interference in the assay due to anti-goat antibodies resulted in abnormally high level of FSH and LH. A strict collaboration between clinicians and the laboratory is needed, when laboratory findings do not correspond to clinical findings.     

人工流产术后尿绒毛膜促性腺激素的消退

采用人绒毛膜促性腺激紊(HCG)单克隆抗体酶标试剂,对36例停经36d 至60d 的孕妇人工流产术后尿 HCG 消退情况进行观察。从流产术后第5d 起,每天留晨尿测 HCG,结果表明,在流产手术十分成功时,尿 HCG 转阴的时间为手术后第6天至第14天。木法较其他方法简便、迅遗、可靠,易为病人所接受,在随访人工流产和葡萄胎流产术后尿 HCG 的变化时,具有重要性。     

MOLECULAR BIOLOGY OF MALE INFERTILITY

About 15% of couples have reduced fertility and in approximately one-half of all cases the reason is male infertility, usually of genetic origin. Thus, in the context of research in genes involved in reproduction and sex determination, genetic anomalies in gametogenesis are being extensively studied. The most frequent pathogenic causes of male infertility are Y-chromosomal microdeletions (8-15%) in the long arm of the Y chromosome, which, by loss of specific DNA segments, leads to loss of vital genes for sperm production. Infertile men, who attend infertility clinics, rise to 15% among those with azoospermia or spermatogenesis problem. The new technique of intracytoplasmic sperm injection has allowed many infertile men to achieve their dreams of fatherhood. However, the spermatogenic defect is genetic anomalies, which might be a potential risk of transmitting this defect to future offspring. Therefore, genetic counseling of all couples with the diagnosis of male infertility is recommended before their enrolment in intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection. The important role of genetic abnormalities in the causation of human male infertility is increasingly recognized. While much remains to be learned in this fast-moving field, considerable progress has been made in the clinical delineation of genetic forms of male infertility and in the characterization of the responsible genes and their mutations or deletions. This review should provide insight into the understanding of parthenogenesis of male infertility in the human.     

Impact of single‐dose nandrolone decanoate on gonadotropins,blood lipids and HMG CoA reductase in healthy men

The aim was to study the effect and time profile of a single dose of nandrolone decanoate (ND) on gonadotropins, blood lipids and HMG CoA reductase [3‐hydroxy‐3‐methyl‐glutaryl‐CoA reductase (HMGCR)] in healthy men. Eleven healthy male participants aged 29–46 years were given a single dose of 150 mg ND as an intramuscular dose of Deca Durabol®, Organon. Blood samples for sex hormones, lipids and HMGCR mRNA analysis were collected prior to ND administration day 0, 4 and 14. A significant suppression of luteinising hormone (LH) and follicle‐stimulating hormone (FSH) was seen after 4 days. Total testosterone and bioavailable testosterone level decreased significantly throughout the observed study period. A small but significant decrease in sexual hormone‐binding globulin (SHBG) was seen after 4 days but not after 14 days. Total serum (S)‐cholesterol and plasma (P)‐apolipoprotein B (ApoB) increased significantly after 14 days. In 80% of the individuals, the HMGCR mRNA level was increased 4 days after the ND administration. Our results show that a single dose of 150 mg ND increases (1) HMGCR mRNA expression, (2) total S‐cholesterol and (3) P‐ApoB level. The long‐term consequences on cardiovascular risk that may appear in users remain to be elucidated.     

Immunohistochemical localization of FSH and LH in rat pituitary

Antisera to ovine FSH, LH and their β-subunits were used to localize the cell types producing these hormones in the rat pituitary. With a single section dual immunoperoxidase staining technique, two separate cell types were observed for FSH and LH. 10% of the immunohistochemically identified gonadotropic cells were found to stain for FSH. The results obtained with anti-LH and anti-FSH correspond well with those obtained with anti-β-LH and anti-β-FSH. Two separate cell types could be demonstrated for β-LH and β-TSH, although these two hormones partially cross-reacted with each other.     

促性腺激素及IL-6对卵巢癌细胞株核因子-κB表达的影响

目的:探讨促性腺激素及IL-6对卵巢癌细胞株核转录因子-κB(NF-κB)表达的影响. 方法:应用不同剂量的人重组促性腺激素及人重组白介素-6(hrIL-6)与卵巢癌细胞株OVCAR-3, Caov-3共培养,应用四甲基偶氮唑蓝(MTT)实验观测其对卵巢癌细胞生长的影响,同时应用RT-PCR和ELISA方法检测卵巢癌细胞NF-κB水平,以分析其信号传导途径. 结果:促性腺激素对卵巢癌细胞株具有促增殖作用,分别增加35%～202%(P＜0.05);67.7%～192%(P＜0.01),并使细胞内NF-κB亚单位表达增加1.53倍～3.98倍(P＜0.05),与对照组相比差异具有显著性. 在处理组卵巢癌细胞培养液中加入50 mg/L抗IL-6中和性抗体,上述2种卵巢癌细胞株的生长均有所减慢,NF-κB表达下降. 结论:提示促性腺激素对卵巢癌细胞株的促增殖过程可能由IL-6介导,促性腺激素、IL-6及NF-κB共同影响卵巢癌细胞的生长.     

Assessment of luteinizing hormone and prolactin immunoactivity in Asian and African elephant urine using assays validated for serum

Analysis of serum hormones is useful for timing artificial insemination (Luteinizing hormone) and diagnosing pregnancy (prolactin) in elephants. However, these tests require blood collection, which is not tolerated by all animals, and is impractical for field studies. Thus, developing a means to obtain these measures noninvasively could improve species management. Matched urine and serum was collected from Asian and African elephants daily throughout the follicular phase and after administration of a GnRH analogue for LH determination, and in pregnant and nonpregnant females for prolactin analyses using immunoassays validated for elephant serum. Despite identifying robust increases in circulating hormone concentrations, no concomitant changes in urinary LH or prolactin immunoactivity was detected. Concentration of samples by centrifugal filtration or ethanol precipitation did not increase the ability to measure biologically relevant changes in endogenous urinary LH or prolactin immunoactivity. Sample matrix interference was ruled out following sufficient recovery of exogenous LH or prolactin added to samples, except for samples concentrated >35-fold where some interference was suspected. These results suggest that elephants either do not excrete native LH or prolactin in urine, or concentrations are too low to be measured accurately by standard immunoassay techniques that are valid for serum analyses. Thus, it does not appear feasible or economically viable to use these noninvasive tests for ovulation detection or for pregnancy diagnosis in elephants.     

夜间尿促性腺激素对判断儿童促性腺激素释放激素类似物治疗后下丘脑-垂体-性腺轴功能的价值

目的 探讨免疫化学发光法( ICMA)检测夜间12 h尿促性腺激素对判断儿童促性腺激素释放激素类似物(GnRHa)治疗后下丘脑-垂体-性腺轴(HPGA)功能状态的价值.方法 患儿12例,其中中枢性性早熟4例(女,年龄7.3 ～9.8岁),青春期预测终身高矮小8例(男3例,女5例;年龄8.8～12.3岁).在GnRHa治疗前及治疗3个月后检测其夜间12 h尿黄体生成素(LH)和卵泡刺激素(FSH).结果 GnRHa治疗前后患儿夜间12 h尿液LH/Cr分别为(339.14±264.02) IU·mol -1和( 43.39±36.65) IU·mol-1(t=3.727,P=0.003),FSH/Cr分别为(1841.59±1287.46) IU·mol -1和( 348.20±165.22) IU·mol-1(t =3.968,P=0.002),当尿LH/Cr＞ 56.44 IU·mol-1同时又有FSH/Cr＞ 604.97 IU·mol-1时,其灵敏度及特异性分别为91.7％及100.0％;而仅当FSH/Cr＞ 604.97 IU·mol-1时,诊断HPGA未被抑制状态具有93.8％的灵敏度及85.7％的特异性;仅当LH/Cr＞ 56.44 IU·mol-1时,则其具有91.7％的灵敏度及83.3％的特异性.结论 夜间12 h尿液LH/Cr和FSH/Cr可用来判断GnRHa治疗后HPGA功能状态.     

HCG滴金免疫测定法试剂的研制及应用

应用自制的两种抗人绒毛膜促性腺激素（ＨＣＧ）单克隆抗体、分别包被硝酸纤维膜及制备胶体金结合物,建立了检测ＨＣＧ的滴金免疫测定法。结果表明,本法简便、快速,灵敏度高（最小抗原检测量为５０ｍＩＵ／Ｌ）,特异性好,与高浓度的ＬＨ、ＦＳＨ、ＴＳＨ均无交叉反应,临床检验２１７例样品,与ＥＬＩＳＡ法对比测定的符合率为１００％。