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ABSTRACT: The occurrance and significance of important carcinofetal antigens other than AFP and CEA are reported. These included the alpha 2 H-protein which is produced in the liver and increases in serum of patients with various tumors, the fetal sulphoglycoprotein antigen FSA from the gastric juice of patients with gastric cancer, the carcinoplacental alkaline phosphatase (REGAN-isoenzyme)which is found in the serum of patients suffering from e.g. bronchogenic, mammary, urogenital and gastrointestinal carcinomas, the beta-S-fetoprotein which is most likely to be identical with C-reactive protein, gamma-fetoprotein, the carcinofetal antigen in glial tumors (CFGA); ectopic production of placental hormones like human gonadotropin, placental lactogen, plasminogen-activators; leukemia-associated antigens. Furthermore, some other less known carcinofetal antigens are mentioned.
Klinische Wochenschrift 06/1975; 53(9):403-17.
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ABSTRACT: CEA is a beta1-glycoprotein (mol. w. approx. 200 000) which in embryonic life is usually found as a cell membrane associated antigen in the gastrointestinal (GI) tract and pancreas. Furthermore, it is secreted into body fluids. In healthy adults a very low serum concentration may be found. The clinical significance of CEA lies in its increased formation in primary and secondary adenocarcinomas of colon and rectum and pancreatic carcinoma, where values of 20 ng/ml and more are observed. However, other gastrointestinal (e.g. oesophagus, stomach, gall-bladder) and extragastrointestinal tumors (e.g. lung, breast, urogenital, prostatic, ovarial carcinomas) as well as non-malignant diseases mainly of the GI tract (e.g. hepatitis, cirrhosis, pancreatitis, colitis, diverticulitis) may provoke less frequent and lower increases in the CEA level. Healthy smokers also tend to show a slight increase in CEA concentration. A certain relationship exists between the CEA level and the size and extent of the tumor so that a decrease following operation may account for complete tumor removal, whereas a persistent or recurring increase in the CEA level is highly suspicious of metastases and/or recurrent tumor. Difficulties in proving and purifying CEA are mainly caused by multiple cross-reactions of CEA with other substances, e.g. blood group substances (A, B, Lea, Leb) and normal or other antigens (NGP, NCA, CEX, CCEA 2, NCA 2, CCA-III, FSA, BCGP). The radioimmunoassay is the most suitable method to determine CEA levels in body fluids. The 3 procedures used differ in the precipitation of the specific immune complex by ammonium sulphate (AS), Z-gel (ZG) or a second antibody (SA). Depending on the method, the upper normal limit in serum or plasma corresponds to approximately 2.5 (AS, ZG) or 12.5 (SA) nanogramme/milliliter. CEA determination in the urine is of interest in patients suffering from bladder carcinoma.
Klinische Wochenschrift 04/1975; 53(5):193-203.
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ABSTRACT: Alpha-fetoprotein (AFP) is an alpha1-glycoprotein (M.W. about 65000) appearing in the fetal serum of most mammals including man during the early stages of pregnancy; 4 weeks after birth it disappears altogether or exists at very low concentrations as in the normal adult. AFP is formed in the yolk sac, the fetal liver and the gastro-intestinal tract. One of its physiological functions in fetal life is supposed to be the protection of the fetus from maternal oestrogens (oestrophilic property). The clinical significance of AFP is based on the regular and increasing production in primary liver cell carcinoma, less frequently in teratogenetic tumors where it serves as a control of therapy and course of the disease. Less frequent, minor and temporary increases in the AFP serum level occur in several primary tumors with secondary liver involvement, and in inflammatory gastro-intestinal diseases, e.g. of the liver (hepatitis, cirrhosis). AFP has an increasing importance in gynecology (gestational age, fetal distress syndrom, malformations, hydatidiform mole/chorion carcinoma). The physico-chemical properties of AFP are widely known. Both fetal and tumor AFP appear to be immunologically and biochemically identical, as are that of tissue and biological fluids. The differences observed (variants, microheterogeneity) depend mainly on the different content of sialic acid. An antigenetic relationship exists, between the AFP of most species. The immunodiffusion (Ouchterlony) is the most frequently used but relatively insensitive test (1-5 mug/ml) in finding AFP, whereas the radioimmunoassay is the most sensitive one (up to 0,25 ng/ml) and permits the determination of normal serum levels in adults (below 20 ng/ml). The serum concentration in healthy pregnant women lies up to 500 ng/ml, in patients with hepatitis, liver cirrhosis and other liver diseases mostly under 3 mug/ml, whereas in those with primary liver cell carcinoma levels up to and above 600 mg-percent have been found.
Klinische Wochenschrift 03/1975; 53(4):147-69.
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Klinische Wochenschrift 02/1974; 52(1):1-17.
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Klinische Wochenschrift 02/1974; 52(1):18-23.
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Klinische Wochenschrift 06/1973; 51(10):494-505.
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ABSTRACT: Die Konzentrationen der Serumproteine IgA, IgG, IgM, 2-Haptoglobin, 1A-Globulin, Coeruloplasmin, Transferrin und Albumin wurden bei 39 azotmischen Patienten bestimmt bzw. ihre Vernderungen nach Nierentransplantation bei 17 Patienten ermittelt. Alle 280 Seren wurden weiterhin elektrophoretisch und immunelektrophoretisch untersucht.Zusammenfassend kommen wir zu folgenden Ergebnissen:1
Bei chronisch-urmischen Patienten sind Albumin, 1A-Globulin, Transferrin, 2-Makroglobulin und das Gesamteiwei gegenber der Norm signifikant erniedrigt. Die Immunglobuline IgG und IgM sind bei Patienten mit chronischer Glomerulonephritis niedriger als bei Patienten mit andersartigen Nephropathien. Bezglich der untersuchten Serumproteine bestehen zwischen nephrektomierten und nichtnephrektomierten Patienten keine wesentlichen Unterschiede.
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Die Serumproteine einschlielich der Immunglobuline zeigen nach Transplantation im Verlauf betrchtliche Vernderungen. Die Konzentrationsabnahme der Immunglobuline vom Ausgangswert — insbesondere der IgG-Klasse — erreicht innerhalb des 1. Monats einen gegenber der Norm signifikant erniedrigten Wert. Hierin ist vielleicht eine teilweise Erklrung fr die klinisch bekannte Infektanflligkeit zu sehen. Bei komplikationslosem Verlauf lassen alle Serumproteine ab dem 2. Monat eine Normalisierungstendenz erkennen, wobei insbesondere die Konzentrationszunahme von Transferrin und IgM auffllig ist.
3
ALG hat keinen Einflu auf die aktuelle Immunoglobulinkonzentration.
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Bei 27% der Patienten wurden nach ALG-Therapie Antikrper nachgewiesen. Diese sind vom IgG-Charakter und hauptschlich gegen Verunreinigungen der ALG-Prparation gerichtet, nur selten gegen IgG. Bei Verwendung von reinem Antilymphocyten-IgG wird man somit eine Verringerung der allergischen Erscheinungen erwarten knnen.
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Whrend akuter Abstoungskrisen kommt es bei allen Patienten ohne Ausnahme zu einem deutlichen bis starken Abfall des IgM-Spiegels. Die Verlaufsbeobachtung der IgM-Konzentration nach Nierentransplantation stellt einen brauchbaren Parameter fr die Erkennung der Abstoungskrise dar.
The concentrations of the serum proteins IgA, IgG, IgM, 2-haptoglobin, 1A-globulin, coeruloplasmin, transferrin and albumin were evaluated in 39 azotaemic patients; the modifications in concentration were also assessed in 17 patients after kidney transplantation. All 280 sera were subjected to electrophoresis and immunoelectrophoresis.The following results were obtained:1
In chronic uraemic patients, the levels of albumin, 1A-globulin, transferrin, 2-macroglobulin and total protein show a marked decrease compared to the normal range. The IgG- and IgM-concentrations are lower in patients with chronic glomerulonephritis than in other nephropathies. The protein levels measured in nephrectomised and non-nephrectomised patients did not differ considerably.
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Following transplantation considerable changes are observed in serum proteins, including immunoglobulins. In relation to the first value, the immunoglobulin concentration—especially IgG—decreases significantly within the first month. This could be a possible explanation for the clinically known susceptibility for infections. If no complications occur, all serum proteins return to normal values after the second month, whereas the transferrin and IgM-concentrations unexpectedly show a marked increase.
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Anti-lymphocytic globulin (ALG) exerts no influence on the actual immunoglobulin concentration.
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27% of the patients developed antibodies after ALG-treatment. These antibodies of IgG-type react mainly against impurities in the ALG preparation, but rarely against equine IgG. By using pure anti-lymphocytic IgG one could expect minor allergic tendencies.
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All patients show a marked to strong decrease in the IgM level during acute rejection crisis. Thus, the changes in IgM concentration after kidney transplantations appear to be a useful parameter in the early evaluation of rejection.
Journal of Molecular Medicine 04/1973; 51(10):494-505. · 4.67 Impact Factor
