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The common alpha subunit of bovine glycoprotein hormones: limited formation of native structure by the totally nonglycosylated polypeptide chain.

The folding of the bovine glycoprotein hormone alpha subunit, synthesized in bacteria following insertion of the nucleotide sequence coding for this polypeptide, has been studied to determine the effect that a complete lack of carbohydrate has on this process. The bacterially derived alpha polypeptide (bac-alpha), extracted from E. coli in the presence of reductant and denaturant, had an estimated 0.2% native structure as determined by a conformationally sensitive radioimmunoassay. Upon reduction of disulfide bonds and reoxidation in air, the amount of native structure increased about 18-fold. Approximately 2% of the refolded bac-alpha preparation combines with the beta subunit of human chorionic gonadotropin (hCG beta) to form a complex that binds to the gonadotropin receptor and elicits a biological response. Since the correct folding (by immunological criteria) of bac-alpha (ca 3%) is significantly greater than expected from a random formation of disulfide bonds (0.1%), it appears that correct folding of alpha subunit can occur in the complete absence of carbohydrate, though in very low yield. Native bovine lutropin alpha subunit (LH alpha) and chemically deglycosylated LH alpha (which retains two asparagine-linked N-acetyl glucosamine residues per alpha oligosaccharide) were subjected to the same reduction/reoxidation regimen as the bacterially produced alpha subunit. As has been reported previously [Giudice LC, Pierce, JG, J Biol Chem 251: 6392, 1976] intact LH alpha fully regained its native structure. The partially deglycosylated LH alpha also refolds to a native-like structure in high yield as assessed by immunological assays and by its ability to combine with HCG beta to form a biologically active complex. The data show that carbohydrate, while not obligatory for correct folding, greatly facilitates the formation of functional alpha subunit.

Animals↗

The influence of oral contraceptives on the postmolar human chorionic gonadotropin regression curve.

This article reports a retrospective analysis of 149 evaluable cases of molar pregnancy managed at Women's Hospital, Los Angeles County/University of Southern California Medical Center, from January 1977, through June, 1983. In the 84 cases prior to 1981, the patients received estrogen-progestogen oral contraceptives after evacuation while the 55 patients seen after that used nonhormonal contraceptives. The frequency of abnormal regression of the serum beta-subunit of human chorionic gonadotropin in the two groups was not significantly different (22.6% in the hormonal contraception group versus 34.5% in the nonhormonal contraception group). The groups were compared for known and potential risk factors and were nearly identical with respect to patient age, parity, maternal blood type, and race. There were also no significant differences with respect to uterine size, preevacuation beta-subunit of human chorionic gonadotropin serum titer greater than 100,000 mIU/ml, and frequency of theca-lutein cysts. Gestational age was significantly shorter and the frequency of cases with a preevacuation beta-subunit of human chorionic gonadotropin serum titer greater than 250,000 mIU/ml significantly higher in the nonhormonal contraception group, indicating that the nonhormonal contraception group had a higher risk for abnormal human chorionic gonadotropin regression than the hormonal contraception group. We conclude that this study provides no evidence that the use of estrogen-progestogen oral contraceptives prior to human chorionic gonadotropin remission increases the risk for invasive mole or choriocarcinoma following molar pregnancy.

Adult↗

Serum levels of intact human chorionic gonadotropin (HCG) and its free alpha and beta subunits, in relation to maternal thyroid stimulation during normal pregnancy.

The main objective of the present study was to present additional evidence of the potentially important thyrotropic role of hCG to regulate the maternal thyroid gland during normal pregnancy. Sequential determinations (first and last trimesters) of intact hCG, free alpha and beta-hCG subunits concentrations (using monoclonal IRMAs), and assessment of parameters of thyroid function and thyroid volume were carried out in 62 pregnant women who exhibited during the first trimester of gestation low TSH levels (< or = 0.20 mU/L), and compared to 276 pregnant women with normal TSH levels. The prevalence of having low serum TSH represented 18% of all pregnancies, with almost one half of cases who transiently had undetectable TSH levels. Lowering of TSH was associated with high hCG levels, and occurred primarily during the first trimester. About 10% of women with low TSH presented transient gestational thyrotoxicosis, frequently associated with vomiting. In comparison to control subjects, women with a suppressed serum TSH had significantly and markedly higher intact hCG and free beta-hCG subunit concentrations. The results suggest that TSH reduction may result from a relative oversecretion of both intact hCG and free beta-hCG subunits, compatible with three hypotheses: a) transient overexpression of the beta-hCG gene, leading to enhanced production of hCG heterodimer; b) increased glycosylation of circulating hCG, with in turn a prolonged half life; c) larger syncytiotrophoblast mass with increased hCG production.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Discordant and variable production of human chorionic gonadotropin and its free alpha- and beta-subunits in early pregnancy.

Monoclonal antibodies specific to dimer hCG (alpha beta), free beta-subunit (beta hCG), free alpha-subunit (alpha hCG), and total beta hCG (dimer + free beta hCG) were used to monitor discordant production of hCG and its subunits during the early stages of embryo implantation. Sera collected 3 to 22 days postovum retrieval were assayed from patients participating in an in vitro fertilization program. In the majority of patients with ongoing pregnancies (n = 16), rising levels using the dimer hCG assay were first detected at an average time of 9.2 days post retrieval compared to 8.3 days for the total beta hCG assay and 6.5 days for the free beta hCG assays. Between days 5 to 9 after retrieval, the rises in the total beta hCG assay were due to predominantly free beta hCG subunit production. The proportion of total beta hCG levels due to free beta hCG subunits declined progressively from day 9 to less than 5% by day 22. Free alpha hCG levels remained low with rising levels first detected from day 18. A second group of patients (n = 12) had delayed, slowly rising levels in the total beta hCG assay which were first detected at an average of 12.4 days and associated with mainly biochemical pregnancies (n = 10). In these patients, rising total beta hCG levels were due to predominantly free beta hCG production. The subsequent loss of their pregnancy may be due to poor luteal support associated with delayed rises in dimer hCG levels. In nonconceptual cycles (n = 47) no significant rises were detected in dimer or free hCG subunits. Although the major form of hCG in circulation is dimer hCG, the origin of free beta hCG production in the early stages of implantation may be due to poorly differentiated trophoblastic tissue. Thus falling levels of free beta hCG subunits associated with increasing dimer hCG production may reflect increasing alpha hCG production by the proliferating layer of cytotrophoblastic cells.

Adult↗

Comparison of human chorionic gonadotropin regression in molar pregnancies and post-molar nonmetastatic gestational trophoblastic neoplasia.

The rate of regression of the beta subunit of human chorionic gonadotropin in patients successfully treated by single-agent chemotherapy with methotrexate (MTX) for postmolar nonmetastatic gestational trophoblastic neoplasia (NMGTN) has not previously been described. In 21 patients with NMGTN treated with MTX, the rate of regression was determined. Nineteen patients had a log-exponential disappearance of serum beta-hCG titers within 100 days. There was a 50% probability of a negative titer at 50 days. Two patients had plateauing titers within 63 days after therapy. There was no difference in beta-hCG disappearance whether MTX with citrovorum factor or MTX alone was administered. Also, the regression rate of beta-hCG titer in the treated patients was compared to 63 patients with spontaneous decline of titers postevacuation of trophoblastic disease. In the postevacuation group there was a 50% probability at 49 days of negative serum titers. All 63 patients had negative titers within 105 days after evacuation.

Chorionic Gonadotropin↗

The lutropin beta-subunit N-terminus facilitates subunit combination by offsetting the inhibitory effects of residues needed for LH activity.

Human chorionic gonadotropin (hCG) contains a beta-subunit N-terminal amino acid extension that contacts the alpha-subunit and is needed for efficient alpha and hCG beta-subunit combination. Here we report that an hCG beta-subunit analog, lacking residues 2-8, combined with the alpha-subunit more efficiently when positively charged residues between beta-subunit cysteines 10 and 11 were replaced with negatively charged residues found in the corresponding portion of follitropin. Residues 2-8 had no influence on binding of hCG to lutropin receptors. Positive charges between cysteines 10 and 11 are essential for high affinity binding of lutropins to their receptors. Therefore, the N-terminal extension found in all lutropin beta-subunits appears to have evolved to offset the inhibition of subunit combination by beta-subunit residues that are essential for lutropin activity. This beta-subunit extension is not found in follitropins or thyrotropins, hormones that have negatively charged residues between cysteines 10 and 11.

Amino Acid Sequence↗

Dimeric inhibin A as a marker for Down's syndrome in early pregnancy.

BACKGROUND: In screening for Down's syndrome in the second trimester of pregnancy, the concentrations of alpha-fetoprotein, the beta subunit of human chorionic gonadotropin, and intact human chorionic gonadotropin in material serum are widely used markers. We investigated a new marker, dimeric inhibin A, and compared its predictive value with that of the established markers. METHODS: Serum samples were obtained at 7 to 18 weeks of gestation from 58 women whose fetuses were known to be affected by Down's syndrome, 32 whose fetuses were affected by trisomy 18, and 438 whose fetuses were normal, and the samples were analyzed for each marker. Individual serum concentrations of each marker were converted to multiples of the median value at the appropriate length of gestation in the women with normal pregnancies, and rates of detection of Down's syndrome by screening for inhibin A in various combinations with the other markers were estimated by multivariate analysis. RESULTS: In the women with fetuses affected by Down's syndrome, the serum inhibin A concentrations were 2.06 times the median value in the women with normal pregnancies (P < 0.001). This compared with 2.00 times the median for the beta subunit of human chorionic gonadotropin, 1.82 times the median for intact human chorionic gonadotropin, and 0.72 for alpha-fetoprotein. The serum concentrations of inhibin A in the women with fetuses affected by Down's syndrome did not appear to be significantly elevated above normal until the end of the first trimester and were not significantly different from normal in the women with fetuses affected by trisomy 18 (P = 0.17). The rate of detection of Down's syndrome was 53 percent and the false positive rate was 5 percent when alpha-fetoprotein, the beta subunit of human chorionic gonadotropin, the maternal age were used together as predictors. The detection rate increased to 75 percent when inhibin A was added (P = 0.002). CONCLUSIONS: In the second trimester of pregnancy, measuring inhibin A in maternal serum, in combination with measurements of alpha-fetoprotein and beta subunit of human chorionic gonadotropin, significantly improved the rate of detection of Down's syndrome.

Biomarkers↗

Human chorionic gonadotropin and free beta subunit secretion in three events of pregnancy.

Serum hCG and free beta hCG subunit were measured in intrauterine pregnancies (n = 21), ectopic pregnancies (n = 20) and spontaneous abortions (n = 19) matched for gestational age. Significantly higher concentrations of both dimer and free beta subunit hCG were detected in normal pregnancies (86,336 IU/L) and 21.02 IU/L respectively) compared to abortions (10,460 IU/L and 3.73 IU/L) and ectopic pregnancies (3,900 IU/L and 3.73 IU/L) (p less than .05). When the ratio of free beta hCG/intact hCG (%) was studied, however, EP had significantly higher ratios (0.09 +/- 0.09) than IUP (p less than .05). Assessment of the relative distributions of these ratios revealed that 100% of IUP and AB and 65% of EP had ratios less than 0.10. Most notably, 35% of EP were uniquely characterized by ratios greater than 0.10. This ratio was sufficiently higher in 35% of EP to define a profile completely unique to EP. These data suggest that an increased free beta to dimer hCG ratio of greater than 0.10 may assist in the differentiation of ectopic from intrauterine pregnancies of spontaneous abortions and provide insight into a possible trophoblastic mechanics in these clinical events.

Abortion, Threatened↗

AP-2 (activating protein 2) and Sp1 (selective promoter factor 1) regulatory elements play distinct roles in the control of basal activity and cyclic adenosine 3',5'-monophosphate responsiveness of the human chorionic gonadotropin-beta promoter.

The CG beta-subunit gene (CGbeta) arose evolutionarily from the LH beta-subunit gene (LHbeta) through gene duplication. Although the promoter sequences of the CGbeta and human (h) hLHbeta genes are greater than 90% homologous, their expression patterns are distinct. LHbeta is expressed in pituitary gonadotrope cells and CGbeta is expressed in placental trophoblast cells. The placental specific and cAMP-inducible region within the CGbeta promoter has been mapped to a complex enhancer element spanning 118 bp (-318 to -200). Transcription factor-binding sites within this enhancer have been partially characterized and include multiple binding sites for AP-2 (activating protein 2) and Sp1 (selective promoter factor 1), which activate basal and cAMP-induced expression. In this study, we performed a detailed analysis of the recognition sites for these transcription factors and examined the functional roles of these elements in the control of CGbeta expression. An upstream Sp1/AP-2 binding site (-318 to -279) preferentially binds Sp1, which occludes AP-2 binding to an adjacent site. In contrast, both Sp1 and AP-2 bind concurrently to a downstream composite Sp1/AP-2 element (-220 to -188). Functionally, mutations in any of the Sp1 or AP-2 binding sites cause a progressive decrease in basal CGbeta expression. However, cAMP stimulation of the CGbeta promoter is reduced by AP-2 mutations, whereas Sp1 mutations enhance cAMP activation. We conclude that multiple AP-2 and Sp1 elements are required to maintain basal CGbeta promoter activity, but these factors have opposing effects on cAMP regulation, which is mediated primarily by AP-2.

Base Sequence↗

The biological role of the carboxyl-terminal extension of human chorionic gonadotropin [corrected] beta-subunit.

hCG is a member of a family of glycoprotein hormones which share a common alpha-subunit, but differ in their hormone-specific beta-subunits. The CG beta-subunit is unique in that it contains a hydrophilic carboxyl-terminal extension with four serine O-linked oligosaccharides. To examine the role of the O-linked oligosaccharides and the carboxyl-terminal extension of hCG beta on receptor binding, steroidogenesis in vitro, and ovulation induction in vivo, site-directed mutagenesis and gene transfer methods were used. Wild-type hCG alpha and hCG beta expression vectors were transfected into an O-glycosylation mutant Chinese hamster ovary cell line to produce intact dimer hCG lacking the beta-subunit O-linked oligosaccharide units. In addition, a mutant hCG beta gene (CG beta delta T) was generated which contained a premature termination signal at codon 115. This gene was cotransfected with the hCG alpha gene into Chinese hamster ovary cells to produce hCG dimer which lacked the carboxyl-terminal amino acids 115-145 of hCG beta (truncated hCG). The O-linked oligosaccharide deficient or truncated hCG derivatives were examined for their ability to bind to the mouse LH/hCG receptor and stimulate cAMP and steroidogenesis in vitro. These studies show that the O-linked oligosaccharides and carboxyl-terminal extension play a minor role in receptor binding and signal transduction. In contrast, comparison of the stimulatory effects of truncated and wild-type hCG in a rat ovulation assay in vivo via either intrabursal or iv injection revealed that the truncated derivative was approximately 3-fold less active than wild-type hCG. These findings indicate that the carboxyl-terminal extension of hCG beta and associated O-linked oligosaccharides are not important for receptor binding or in vitro signal transduction, but are critical for in vivo biological responses.

Animals↗

Detection of a small molecular species of human chorionic gonadotropin in the urine of patients with carcinoma of the cervix and cervical intraepithelial neoplasia: comparison with other assays for human chorionic gonadotropin and its fragments.

A low-molecular-weight glycoprotein containing sequences of the beta subunit of human chorionic gonadotropin (hCG) has been found in the urine of patients with carcinoma of the cervix using an immunoradiometric assay. This fragment has chromatographic and immunological identity with hCG beta core. This molecule was present in 52 to 77% of all patients with invasive disease, while between 11 and 27% of patients with cervical intraepithelial neoplasia (CIN) also exhibited significant hCG beta-core immunoactivity. Few patients had either a positive assay for intact hCG or a positive assay directed at an epitope on the beta subunit (beta-hCG radioimmunoassay) in serum. However, between 17 and 40% of patients with invasive disease were positive for free beta-subunit immunoactivity in the blood. The origin of the beta-core immunoactivity in the urine is uncertain; while tumor production cannot be excluded, it is possible that the molecule originates from renal metabolism of small quantities of the beta subunit of hCG. Regardless of the source of the molecule, hCG beta core is a far more sensitive marker of hCG production by tumors than is serum hCG.

Carcinoma↗

Biochemical markers in the plasma and tumors of patients with gynecologic malignancies.

Tumor markers in gynecologic malignancies can be classified generally as oncofetal proteins, carcino-placental proteins, and more specific tumor-associated antigens. Carcinoembryonic antigen (CEA) is most effective as a tumor marker in mucinous adenocarcinomas of the endocervix and ovary and in keratinizing squamous cell carcinomas of the cervix. In contrast, the use of alphafetoprotein (AFP) in gynecologic cancer is limited to patients with germ cell tumors of the ovary and specifically endodermal sinus tumors. The beta subunit of human chorionic gonadotropin (beta-hCG) remains an exemplary tumor marker for trophoblastic malignancies and may be useful in selected patients with epithelial carcinomas of the ovary. Plasma levels of these antigens are generally related to total tumor burden (tumor antigen concentration x extent of disease)). Although the lack of specificity of these markers has limited their use in the diagnosis of gynecologic malignancies, they have been effective as a means of monitoring disease status in patients whose tumors contain high antigen concentrations. More specific tumor-associated antigens have been described in ovarian cervical cancers, but their clinical efficacy remains to be demonstrated in large numbers of patients. Immunohistochemical staining of tissue specimens identifies patients whose tumors contain high antigen concentrations and who therefore should benefit most from serial plasma determinations following therapy. Potential future uses of biochemical markers include radioimmunodetection procedures using radiolabelled antibodies to tumor-associated antigens and antigen-directed chemotherapy.

Alkaline Phosphatase↗

Testicular tumors in infants and children.

Primary malignant tumors of the testis are uncommon in infants and children. Tumors of germ cell origin are identified most frequently. The clinical presentation is usually due to the presence of an enlarging scrotal mass. Determinations of the serum alpha fetoprotein (AFP) and beta subunit of human chorionic gonadotropin (beta-hCG) levels are helpful for diagnosis and management. All suspected testicular tumors should be surgically evaluated through a high inguinal incision. Postoperative chemotherapy is recommended for some patients with yolk sac tumor and all patients with embryonal rhabdomyosarcoma. Prolonged relapse-free survival is possible for most infants and children with malignant testicular tumors.

Child↗

Urinary gonadotropin fragments (UGF) in cancers of the female reproductive system. I. Sensitivity and specificity, comparison with other markers.

UGF is a mixture of human chorionic gonadotropin free beta-subunit and its fragments, and is detected in pregnancy and trophoblast disease urines. An examination of 67 nonpregnant cancer-free women showed average urine levels of 0.13 ng/ml. Six of the 67 (8.9%) had levels exceeding a selected cutoff value, 0.2 ng/ml. Of 112 woman with active gynecologic cancer, 72 (64%) had urine UGF levels exceeding this cutoff value. When urines were limited to those with creatinine greater than 0.5 mg/ml, or to first morning samples (mean creatinine 1.0 ng/ml), the sensitivity of UGF for all gynecologic cancers was raised to 76%. The sensitivity of UGF for cervical (73%), for endometrial (65%), and for ovarian (83%) cancers exceeded that of plasma CA 125 and lipid-associated sialic acid in plasma (LASA) in the same population. UGF is an exciting new tumor marker which warrants further evaluation.

Antigens, Neoplasm↗

A new series of mycobacterial expression vectors for the development of live recombinant vaccines.

Recombinant BCG (bacillus Calmette-Guérin) is a promising candidate as a live vaccine delivery system. Thus far, however, only autoreplicative plasmids carrying the heterologous genes to be expressed in BCG, together with antibiotic-resistance genes, have been successfully used. This could potentially lead to the spreading of antibiotic resistance among other bacteria, and might therefore be unsafe for the environment. In this study, we present a series of three Escherichia coli-Mycobacteria shuttle vectors which enable expression and secretion of antigens without the use of antibiotic-resistance markers. All these plasmids confer mercury resistance to the host bacteria as the only selectable marker and contain a unique restriction site to allow for single-step in-frame cloning of open reading frames downstream from the Mycobacterium tuberculosis 85A antigen promoter and export signal. The system was used to express the free beta-subunit of human chorionic gonadotropin (hCG beta), a potential target of an immunotherapeutic vaccine.

Antigens↗

Ectopic pregnancy.

Ectopic pregnancy is an important cause of morbidity and mortality worldwide. Use of transvaginal ultrasonography and quantitative measurement of the beta subunit of human chorionic gonadotropin (beta-hCG) has led to a reduction in the need for diagnostic laparoscopy. Furthermore, with earlier diagnosis, medical therapy with methotrexate can be offered and surgery avoided in some women, though the best regimen remains unclear. In the surgical management of ectopic pregnancy, the benefits of salpingectomy over salpingostomy are uncertain. Although there have been advances in the management of ectopic pregnancy there are still questions to be answered.

Female↗