Modulation of human chorionic gonadotrophin bioactivity during the first trimester of pregnancy |
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Authors: | Mock P; Bischof P; Rivest R; Campana A; Chardonnens D |
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Institution: | Department of Obstetrics and Gynaecology, University Hospital, Geneva, Switzerland. |
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Abstract: | The objective of this study was to evaluate the bioactivity of human
chorionic gonadotrophin (HCG) during first trimester pregnancy. This was
done by means of a retrospective analysis of sera from patients with first
trimester normal intrauterine and ectopic pregnancies. Serum samples were
obtained from 38 women with amenorrhoea of <10 weeks. From these, 19 had
a normal intrauterine pregnancy (IUP) and 19 an ectopic pregnancy (EP).
Cases were allocated to either low serum immunoreactive HCG (HCGi),
intermediate HCGi or high HCGi concentrations (HCGi <5000 mUI/ml,
between 5000 and 40,000 mIU/ml and >40,000 mIU/ml respectively). HCGi
and oestradiol were measured by enzyme immunoassays and bioactive HCG by
the mouse Leydig cell bioassay. All results were analysed by analysis of
variance and unpaired Student's t-test. There was a significant difference
between bioactive to immunoreactive HCG ratios (b/i ratio) between the
subgroups of low, intermediate and high HCGi concentrations. Lower b/i
ratios were found when HCGi concentrations were high (HCG b/i mean +/- SEM:
high subgroup, 0.33 +/- 0.07 versus low subgroup: 1.50 +/- 0.12; P <
0.0001). Furthermore, the b/i ratios were inversely correlated with
oestradiol (P < 0.0001) and HCGi (P < 0.0001) concentrations but not
with gestational age. There was no difference in the b/i ratios when
comparing IUP with EP. It is concluded that, in first trimester
pregnancies, there is a likely modulation of HCG bioactivity which is
inversely correlated with HCGi and oestradiol concentration. The underlying
mechanisms and their physiological relevance remain to be elucidated.
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