Immunoreactive human chorionic gonadotropin and its free ß-subunit in serum and ascites of patients with malignant tumors

Human chorionic gonadotropin (hCG) is a clinically relevant marker of trophoblastic and nontrophoblastic malignancies. In the present studies, in addition to determining serum hCG, we investigated the presence and properties of hCG immunoreactivity in ascites of patients with nontrophoblastic malignant tumors and, for comparison, in ascites caused by cirrhotic liver disease. Total hCG immunoreactivity [hCG (+hCG-ß)] was found to be elevated above the reference value (>5 IU/liter) in the serum of 2 of 20 patients with cirrhosis and 11 of 20 patients with malignant tumors. For comparison, in ascites, hCG (+hCG-ß) concentrations were frequently higher than in the corresponding serum samples and exceeded 10 IU/liter in 0 of 20 cirrhotic samples and in 16 of 20 malignant samples. In order to elucidate the nature of the hCG immunoreactive material, all samples were then assessed by immunoradiometric assays specific for the intact hCG molecule (holo-hCG) and the free hCG-ß subunit, respectively. In the holo-hCG assay, elevated values were detected in 0 of 20 (0 of 20) cirrhotic ascites (serum) samples and 0 of 20 (1 of 20) malignant ascites (serum) samples. In the free hCG-ß assay, on the other hand, no positive results were obtained in the ascites or serum of 20 patients with liver cirrhosis; however, 8 of 20 serum samples and 16 of 20 ascites samples derived from tumor patients were positive. In accord with the immunological data, gel chromatographical studies of malignant ascites revealed the abundance of free hCG-ß subunit rather than that of holo-hCG. In contrast to malignancy-related ascites, in ascites of patients receiving hCG injections for treatment of infertility, holo-hCG was more abundant than free hCG-ß immunoreactivity. Incubation experiments of purified holo-hCG in ascites for 24 h at -20, 20, or 37°C showed no substantial dissociation of the hCG molecule and release of free hCG-ß immunoreactivity, thus arguing against production of free hCG-ß by degradation of holo-hCG and in favor of its tumor-related secretion. In conclusion, hCG-ß immunoreactivity is frequently elevated in malignancy-related ascites and appears to be related to the presence of free ß subunit of hCG rather than that of the intact hCG molecule. Interestingly, hCG-ß determination in ascites proved to be clearly superior to serum measurement in discriminating between tumor and cirrhosis. Thus, hCG-ß might be a useful marker of malignancy-related ascites and should be prospectively assessed for possible clinical use in comparison with other well-established parameters, such as cytology and protein determination. For this purpose, according to our results, only assays that exhibit a high sensitivity for free hCG-ß subunit appear to be suitable

Variants of human chorionic gonadotropin from pregnant women and tumor patients recognized by monoclonal antibodies

In biological fluids, hCG and its free alpha- (hCG alpha) and beta-subunits (hCG beta), occur in multiple forms. These various forms differ at the molecular level primarily in glycosylation, but also differ in protein backbone modifications corresponding to the urinary low molecular weight fragment of the hCG beta-subunit (beta-core fragment). This microheterogeneous nature can be demonstrated by isoelectric focusing in which variants are separated into bands with different isoelectric points (pI). To determine whether such isoelectric variants differ in antigenicity and consequently might escape immunoassay detection due to overspecificity of monoclonal antibodies (MCA), urinary pregnancy hCG (NIH, CR123) and tumor hCG preparations, such as a tumor-specific acidic variant of hCG (hCGav) and the hCG beta-core fragment, were separated by isoelectric focusing in the absence or presence of 8 M urea, or by sodium docedyl sulfate-polyacrylamide gel electrophoresis and enzymatically immunostained using an MCA panel directed against 17 different hCG epitopes. MCA against 14 different epitopes accessible on holo-hCG recognized all pI variants of pregnancy holo-hCG or tumor-derived hCGav, as was true for the three MCA recognizing epitopes hidden on holo-hCG but accessible on the free subunits after hCG dissociation by urea. We conclude that each individual pI-isoform of holo-hCG and its free subunits expresses the entire set of epitopes recognized by our MCA panel. The carbohydrate moieties that form a biochemical basis for hCG heterogeneity seem to be neither of major antigenic relevance, nor are they structurally related to any particular epitope. Thus, various glycosylation forms of hCG, hCG alpha, hCG beta, and hCG beta-core in normal as well as in pathological samples should safely be detectable and measureable by immunoassays employing MCA with appropriate subunit specificity

Stimulation of hCG protein and mRNA in first trimester villous cytotrophoblast cells in vitro by glycodelin A

Aim: Human chorionic gonadotropin (hCG) is produced by fetal trophoblast cells and secreted into maternal circulation mainly in the first trimester of pregnancy. Another glycoprotein, glycodelin A, is one of the main products of the maternal decidua during this period. The purpose of this study was to investigate the effect of glycodelin A on hCG release by isolated cytotrophoblast cells in vitro. Methods: Cytotrophoblast cells were prepared from human first trimester placenta and incubated with varying concentrations of glycodelin A. Supernatants were assayed for hCG protein concentrations, and quantification of beta hCG mRNA was carried out by RT-PCR. Expression of hCG was analysed in stimulated trophoblast cells and in unstimulated controls by immunocytochemistry. Results: Glycodelin A induces a dose-dependent increase of hCG production. An increase of hCG expression was measured at 100 and 200 mu g/mL glycodelin-A treatment in trophoblast cell culture by TaqMan assay on mRNA level. We found a moderate staining of hCG in control trophoblast cells, whereas a strong hCG staining was seen in glycodelin A-treated trophoblast cells. Conclusions: HCG is a marker for the differentiation process of trophoblast cells. Our results suggest that glycodelin A secreted by the decidualized endometrium is involved in the regulation of hormones produced by the trophoblast

Variation in the Thyrotropic Activity of Human Chorionic Gonadotropin in Chinese Hamster Ovary Cells Arises from Differential Expression of the Human Thyrotropin Receptor and Microheterogeneity of the Hormone.

The role of hCG as a stimulator of the human thyroid has been a subject of controversy, because discrepant results have been obtained in different in vitro assays. In an attempt to explain the variation observed in the thyroid response to hCG, we investigated the ability of hCG and that of its isoforms and glycosylation variants to inhibit [125I]bovine (b) TSH binding and stimulate adenylate cyclase in two clones, JP09 and JP26, of Chinese hamster ovary cells stably transfected with the human TSH receptor (hTSHr). The two clones differed with respect to the number of hTSHr expressed per cell (34,000 in JP09 and 2,000 in JP26 cells). Both responded extremely well to bTSH; the cAMP response to 0.001 IU/L bTSH was distinguishable from basal values. Interestingly, JP09 cells were readily stimulated by hCG (20-100 mg/L; 0.52-2.6 x 10(-6) mol/L) to release cAMP, whereas JP26 cells showed little if any response. Also, cAMP stimulation produced by asialo-hCG was 12-fold in JP09 cells and only 4-fold in JP26 cells compared to 45- and 67-fold stimulations by bTSH, respectively. Stimulation by asialo-hCG was approximately 30% that of bTSH in JP09 cells, but less than 6% in JP26 cells. When assessing the thyrotropic activity of the microheterogeneous isoforms of hCG, more alkaline pI forms were found to be more active than those of a more acidic pI regardless of whether they were derived from normal or molar pregnancy urine. Further studies with hCG, asialo-hCG, asialoagalacto-hCG, and deglycosylated hCG revealed that removal of sialic acid caused a marked increase in both its affinity for hTSHr and its cAMP-releasing potency, whereas removal of further carbohydrate, although it slightly enhanced receptor binding, was detrimental to adenylate cyclase activation. In conclusion, differences in hTSHr expression may cause a variation in the cAMP response to hCG or its glycosylation variants, as does the microheterogeneity of the hormone itself. These mechanisms may be responsible at least in part for the divergent responses of different cell types to hCG and render interpretation of the physiological meaning of the data obtained in recombinant receptor systems difficult

Globular Cluster Population of Hickson Compact Group 22a and 90c

We present the first measurement of the globular cluster populations of galaxies in Hickson compact groups, in order to investigate the effect of these high density environments on the formation and evolution of globular cluster systems. Based on V and R band images that we obtained of HCG 22a and HCG 90c with the ESO New Technology Telescope (NTT), we find a total globular cluster population of $1590\pm 854$ for HCG 22a and $2136\pm 718$ for 90c. The specific frequency for HCG 22a was found to be $S_{N}=1.9\pm 1.0$ and $S_{N}= 3.4\pm 1.1$ for HCG 90c. A power-law fit to the globular cluster radial profile of HCG 22a yields $\sigma\sim R^{-2.01\pm 0.30}$ and for HCG 90c we found $\sigma \sim R^{-1.20\pm0.16}$. A comparison of the globular cluster radial profiles with the surface brightness of the parent galaxy shows that the globular cluster systems are at least as extended as the halo light. The measured values for the specific frequency are consistent with a scenario in which the host galaxies were in a low density ``field-like'' environment when they formed their globular cluster systems.Comment: 28 pages, 13 figures, 3 tables, accepted for publication in the Astrophysical Journa

Prognostic factors in seminomas with special respect to HCG: Results of a prospective multicenter study

Objective: In a prospective multicenter trial, it was our intention to elucidate clinical prognostic factors of seminomas with special reference to the importance of human chorionic gonadotropin (HCG) elevations in histologically pure seminomas. Methods: Together with 96 participating urological departments in Germany, Austria, and Switzerland, we recruited 803 seminoma patients between 1986 and 1991. Out of 726 evaluable cases, 378 had elevated, while 348 had normal HCG values in the cubital vein. Histology was reviewed by two reference pathologists. HCG levels were determined in local laboratories and in a study laboratory. Standard therapy was defined as radiotherapy in stages I (30 Gy) and IIA/B (36 Gy) to the paraaortal and the ispilateral (stage I) and bilateral (stage IIA/B) iliac lymph nodes; higher stages received polychemotherapy and surgery in case of residual tumor masses. Statistics included chi-square tests, linear Cox regression, and log-rank test. Results: The HCG elevation is associated with a larger tumor mass (primary tumor and/or metastases). HCG-positive and HCG-negative seminomas had no different prognostic outcome after standard therapy. The overall relapse rate of 6% and the survival rate of 98% after 36 months (median) indicate an excellent prognosis. The calculation of the relative risk of developing a relapse discovered only stage of the disease and elevation of the lactate dehydrogenase concentration and its prolonged marker decay as independent prognostic factors for seminomas. A more detailed analysis of the prognostic significance of the stage revealed that the high relapse rate in stage IIB seminomas after radiotherapy (24%) is responsible for this result. Conclusions: We conclude that HCG-positive seminomas do not represent a special entity. Provided standard therapy is applied, HCG has no influence on the prognosis. Patients with stage IIB disease should be treated with chemotherapy because of the demonstrated higher relapse rate outside the retroperitoneum. Copyright (C) 1999 S. Karger AG. Basel

Galaxy Interactions in Compact Groups II: abundance and kinematic anomalies in HCG 91c

Galaxies in Hickson Compact Group 91 (HCG 91) were observed with the WiFeS integral field spectrograph as part of our ongoing campaign targeting the ionized gas physics and kinematics inside star forming members of compact groups. Here, we report the discovery of HII regions with abundance and kinematic offsets in the otherwise unremarkable star forming spiral HCG 91c. The optical emission line analysis of this galaxy reveals that at least three HII regions harbor an oxygen abundance ~0.15 dex lower than expected from their immediate surroundings and from the abundance gradient present in the inner regions of HCG 91c. The same star forming regions are also associated with a small kinematic offset in the form of a lag of 5-10 km/s with respect to the local circular rotation of the gas. HI observations of HCG 91 from the Very Large Array and broadband optical images from Pan-STARRS suggest that HCG 91c is caught early in its interaction with the other members of HCG 91. We discuss different scenarios to explain the origin of the peculiar star forming regions detected with WiFeS, and show that evidence point towards infalling and collapsing extra-planar gas clouds at the disk-halo interface, possibly as a consequence of long-range gravitational perturbations of HCG 91c from the other group members. As such, HCG 91c provides evidence that some of the perturbations possibly associated with the early phase of galaxy evolution in compact groups impact the star forming disk locally, and on sub-kpc scales.Comment: 25 pages, 21 figures, MNRAS accepted. Until publication of the article, the interactive component of Figure 4 is available at this URL: http://www.mso.anu.edu.au/~fvogt/website/misc.htm

VLA neutral hydrogen imaging of compact groups

Images of the neutral hydrogen (H I) in the direction of the compact groups of galaxies, HCG 31, HCG 44, and HCG 79 are presented. The authors find in HCG 31 and HCG 79, emission contained within a cloud much larger than the galaxies as well as the entire group. The H I emission associated with HCG 44 is located within the individual galaxies but shows definite signs of tidal interactions. The authors imaged the distribution and kinematics of neutral hydrogen at the two extremes of group sizes represented in Hickson's sample. HCG 44 is at the upper limit while HCG 18, HCG 31, and HCG 79 are at the lower end. Although the number of groups that have been imaged is still very small, there may be a pattern emerging which describes the H I morphology of compact groups. The true nature of compact groups has been the subject of considerable debate and controversy. The most recent observational and theoretical evidence strongly suggests that compact groups are physically dense, dynamical systems that are in the process of merging into a single object (Williams and Rood 1987, Hickson and Rood 1988, Barnes 1989). The neutral hydrogen deficiency observed by Williams and Rood (1987) is consistent with a model in which frequent galactic collisions and interactions have heated some of the gas during the short lifetime of the group. The H I disks which are normally more extended than the luminous ones are expected to be more sensitive to collisions and to trace the galaxy's response to recent interactions. Very Large Array observations can provide in most cases the spatial resolution needed to confirm the dynamical interactions in these systems

Intra-group Light in Hickson Compact Groups

We have analyzed the intra-group light component of 3 Hickson Compact Groups (HCG 79, HCG 88 and HCG 95) with detections in two of them: HCG 79, with $46\pm11$ of the total $B$ band luminosity and HCG 95 with $11\pm26$. HCG 88 had no component detected. This component is presumably due to tidally stripped stellar material trapped in the group potential and represents an efficient tool to determine the stage of dynamical evolution and to map its gravitational potential. To detect this low surface brightness structure we have applied the wavelet technique OV\_WAV, which separates the different components of the image according to their spatial characteristic sizes.Comment: Small update on the associated institutions lis

An unusual cause of gynaecomastia in a male

Summary: Beta-human chorionic gonadotropin (βhCG) is normally produced by syncytiotrophoblasts of the placenta during pregnancy and aids embryo implantation. However, it is also secreted in varying amounts in non-pregnant conditions commonly heralding a neoplastic process. We present a case of 50-year-old man, who presented with bilateral gynaecomastia with elevated testosterone, oestradiol, suppressed gonadotropins with progressively increasing levels of human chorionic gonadotropin (hCG). Biochemical and radiological investigations including ultrasonography of testes, breast tissue, MRI pituitary and CT scan full body did not identify the source of hCG. FDG PET scan revealed a large mediastinal mass with lung metastasis. Immunostaining and histological analysis confirmed the diagnosis of primary choriocarcinoma of the mediastinum. It is highly aggressive and malignant tumor with poor prognosis. Early diagnosis and management are essential for the best outcome. Learning Points: High βhCG in a male patient or a non-pregnant female suggests a paraneoplastic syndrome. In the case of persistently positive serum hCG, exclude immunoassay interference by doing the urine hCG as heterophilic antibodies are not present in the urine. Non-gestational choriocarcinoma is an extremely rare trophoblastic tumor and should be considered in young men presenting with gynaecomastia and high concentration of hCG with normal gonads. A high index of suspicion and extensive investigations are required to establish an early diagnosis of extra-gonadal choriocarcinoma. Early diagnosis is crucial to formulate optimal management strategy and to minimize widespread metastasis for best clinical outcome