hCG Beta-core Fragment Research Articles

Standardization of Epitopes for Human Chorionic Gonadotropin (hCG) Immunoassays.

hCG and its variants are markers for pregnancy tests, pregnancyrelated complications, trophoblastic diseases, pre-natal screening of Down's syndrome and doping controls. Strong demands are imposed on diagnostic methods by the dynamic changes in the absolute and relative levels of hCG protein backbone variants and glycosylation isoforms in serum and urine during development of pregnancy or the progression/remission of tumors. Observed differences in the results between commercial diagnostic immunoassays reflect the unequal molar recognition of the different metabolic hCG variants, in particular the hCG beta core fragment (hCGβcf), by the diagnostic antibodies (Abs), as their epitopes are not standardized, and the fact that suboptimal hCG standards are used. To rapidly characterize Abs by their epitope recognition and specificity to evaluate their suitability for diagnostic immunoassays a procedure of comparative epitope mapping has been developed using epitope-defined reference Abs. Comparative epitope mapping of diagnostic Abs will provide the basis for the standardization of diagnostic antigenic domains/epitopes and consequently for improved reliability of hCG measurements. Diagnostic first line assays likely consist of pairs of Abs that recognize specific epitopes at the top of the neighboring peptide loops 1 and 3 (Ł1+3) and the cystine knot (ck) of hCGβ, respectively. In future, significant improvements of reliability, robustness and comparability of the results of immunoassays for complex glycoproteins such as hCG will be achieved by the use (i) of standardized diagnostic Abs against welldefined epitopes and (ii) of the new International Standards for hCG and for five hCG variants established by WHO, that are calibrated in molar (SI) units.

Characterizing urinary hCGβcf patterns during pregnancy

ObjectiveElevated concentrations of hCG beta core fragment (hCGβcf) are known to cause false-negative results in qualitative urine pregnancy test devices, but the pattern of urinary hCGβcf during normal pregnancy has not been well characterized. Here, we evaluate the relationship between urine hCG, hCGβcf, and hCG free β subunit (hCGβ) during pregnancy. Design and methodsBanked second trimester urine specimens from 100 pregnant women were screened for high concentrations of hCGβcf using a qualitative point-of-care device known to demonstrate false-negative results in the presence of elevated hCGβcf concentrations. Additional first and third trimester specimens from the same pregnancy were obtained from 10 women who generated negative/faint positive results, 5 women who generated intermediate positive results, and 10 women who generated strong positive results on the point-of-care device. Intact hCG, hCGβcf, hCGβ, and specific gravity were quantified in these 75 specimens. ResultsUrinary hCGβcf concentrations were greater than intact hCG concentrations at all times. A strong correlation (r2=0.70) was observed between urine intact hCG and hCGβcf concentrations. A poor correlation was observed between specific gravity and intact hCG (r2=0.32), hCGβ (r2=0.32), and hCGβcf (r2=0.32). The highest hCGβcf concentrations were observed between 10 and 16weeks gestation but individual women demonstrated very different patterns of hCGβcf excretion. ConclusionsUrine specimens with elevated hCGβcf are frequently encountered during pregnancy but hCGβcf excretion patterns are unpredictable. Manufacturers and clinicians must appreciate that hCGβcf is the major immunoreactive component in urine during pregnancy and must design and interpret qualitative urine hCG test results accordingly.

Estimating the hCGβcf in urine during pregnancy

ObjectiveElevated urine concentrations of hCG beta core fragment (hCGβcf) are known to cause false negative qualitative point-of-care hCG test results, but limited information is available regarding urine hCGβcf. In this study, we evaluate the relationship between serum and urine hCG concentrations and the frequency of elevated urine hCGβcf concentrations. Design and methodsPaired serum and urine specimens were obtained from 60 women at various stages of pregnancy and hCG was measured using the Abbott Architect and Roche Cobas e602 assays. Urine specimens with the greatest difference in urine hCG concentrations between these two instruments were tested using a qualitative point-of-care device and hCGβcf was quantified using LC–MS/MS. ResultsUrine hCG concentrations were lower than serum and the magnitude of the difference depended on whether the hCG assay detected hCGβcf. Elevated hCGβcf concentrations (>280,000pmol/L) were observed in 12% of specimens from an unselected patient population. There was a significant correlation (r=0.97; p<0.0001) between the difference (Roche hCG–Abbott hCG) and the hCGβcf concentration as measured by LC–MS/MS (Roche–Abbott difference IU/L=(hCGβcf (pmol/L)∗0.131+656)). ConclusionsA correlation exists between serum and urine hCG concentrations but this correlation is variable. hCGβcf concentrations can be estimated using two automated assay reagent platforms that differ in their recognition of hCGβcf.

Urinary Levels of Intact, Free Beta, and Beta Core Fragment of hCG in Early Pregnancy [35

INTRODUCTION: Reference ranges have been published for intact urinary human chorionic gonadotropin (hCG) but not for other forms. Free β and β core fragment have different profiles of daily rise of hCG compared with intact hCG. Very high levels of β core can cause false-negative point-of-care pregnancy test results, and ratio of intact to free β hCG has been related to pregnancy viability. Therefore, we sought to improve the understanding of the levels of free β and β core hCG in viable pregnancies. METHODS: Early morning urine samples were collected from 37 women with viable pregnancies throughout early pregnancy. Intact, free β, and β core hCG were measured using DELFIA immunoassays. Median levels and centile ranges by day of pregnancy were derived. RESULTS: As expected, intact hCG was present 8 days after ovulation; however, free β hCG was not measurable until day 21. Free β hCG occurred at a constant 1/100th ratio of intact hCG. Beta core hCG had a different profile, appearing in urine later than intact hCG (day 19) yet becoming the predominant form by day 35. CONCLUSION: The ranges of free β and β core hCG in viable pregnancies provide a valuable reference tool. Although levels of β core hCG in early pregnancy are negligible, they can reach 500,000 pmol/L by day 28 postovulation, a level shown to cause false-negative results in some tests. Therefore, only assays that demonstrate they are unaffected by β core hCG interference should be used in later pregnancy.

Decreased levels of genuine large free hCG alpha in men presenting with abnormal semen analysis

BackgroundThe pregnancy hormone human chorionic gonadotropin (hCG) and its free subunits (hCG alpha, hCG beta) are produced in the male reproductive tract and found in high concentrations in seminal fluid, in particular hCG alpha. This study aimed to elucidate changes in peptide hormone profiles in patients showing abnormal semen analyses and to determine the genuineness of the highly abundant hCG alpha.MethodsSeminal plasma was obtained from 45 male patients undergoing semen analysis during infertility workups. Comprehensive peptide hormone profiles were established by a panel of immunofluorometric assays for hCG, hCG alpha, hCG beta and its metabolite hCG beta core fragment, placental lactogen, growth hormone and prolactin in seminal plasma of patients with abnormal semen analysis results (n = 29) versus normozoospermic men (n = 16). The molecular identity of large hyperglycosylated hCG alpha was analyzed by mass-spectrometry and selective deglycosylation.ResultshCG alpha levels were found to be significantly lower in men with impaired semen quality (1346 +/- 191 vs. 2753 +/- 533 ng/ml, P = 0.022). Moreover, patients with reduced sperm count had reduced intact hCG levels compared with normozoospermic men (0.097 +/- 0.022 vs. 0.203 +/- 0.040 ng/ml, P = 0.028). Using mass-spectrometry, the biochemical identity of hCG alpha purified from seminal plasma was verified. Under non-reducing conditions in SDS-PAGE, hCG alpha isolated from seminal plasma migrated in a manner comparable with large free hCG alpha with an apparent molecular mass (Mr, app) of 24 kDa, while hCG alpha dissociated from pregnancy-derived holo-hCG migrated at approximately 22 kDa. After deglycosylation with PNGase F under denaturing conditions, all hCG alpha variants showed an Mr, app of 15 kDa, indicating identical amino acid backbones.ConclusionsThe findings indicate a pathophysiological relevance of hCG, particularly its free alpha subunit, in spermatogenesis. The alternative glycosylation pattern on the free large hCG alpha in seminal plasma might reflect a modified function of this subunit in the male reproductive tract.

Immunoreactive human chorionic gonadotropin beta core fragment in human pituitary.

The human pituitary has been shown to produce small amounts of immunoreactive human chorionic gonadotropin (hCG) and its alpha- and beta- subunit (hCG alpha, hCG beta). The aim of the present studies was to further examine the various hCG-related materials in the human pituitary, particularly to search for the existence of pituitary hCG beta core fragment (hCG beta cf)--like material. HCG beta cf has been found in the urine of pregnant women, patients with trophoblastic tumors and also in postmenopausal women. Gel chromatography of pituitary extract on Superdex 200 showed three distinct peaks of hCG-related immunoreactivities, i.e. hCG, hCG beta and hCG beta cf, which were distinguishable from hLH and hLH beta peaks. HCG beta cf was recognized by a specific immunometric assay (crossreactivities with hCG beta 0.016%, hLH beta 0.04%), but unreactive in an hLH + hLH beta assay. It was purified and displayed physical properties similar to those of hCG beta cf derived from pregnancy urine. Apart from immunological differences between the small molecular weight forms or fragments of hCG and LH origin, reversed phase HPLC was able to physically discriminate between hCG beta cf and hLH beta fragment. The latter was much more abundant than the former in the pituitary extract. HCG beta cf showed microheterogeneity related to its sialic acid content. In conclusion, the present data indicate that immunoreactive hCG beta cf is present in human pituitary extracts. The physical and immunological properties of pituitary hCG beta cf are distinguishable from those of the more abundant hLH beta and its fragment, and compare favorably with those of urinary hCG beta cf of trophoblastic origin.

Urinary mesothelin provides greater sensitivity for early stage ovarian cancer than serum mesothelin, urinary hCG free beta subunit and urinary hCG beta core fragment

Objectives. Early detection of ovarian cancer should improve overall survival. Multiple serum markers have been evaluated as possible tests to detect early stage disease, but few urine markers have been studied. Mesothelin has been detected in serum from patients with ovarian cancer, but has not been previously reported in urine. Methods. Mesothelin was assayed in the serum and in the urine from 28 patients with early stage (I/II) invasive epithelial ovarian cancers, 111 with advanced stage (III/IV) invasive disease and 19 with tumors of low malignant potential. Marker values have been compared to those in healthy controls and 115 patients with benign pelvic masses. Thresholds were set to include 95% of mesothelin values for 127 sera and 89 urines from healthy women. Urine values were considered: (1) as assayed; (2) normalized using the ratio of serum to urine creatinine; and (3) normalized using the Cockroft–Gault formula for glomerular filtration rate (GFR). Urines were also assayed for human chorionic gonadotropin (hCG) free beta subunit and beta subunit core fragment and similarly normalized. Results. Optimal sensitivity for early stage disease was obtained when urine mesothelin was normalized using GFR. A greater fraction of patients with early stage disease was detected with the mesothelin urine assay (42%) than with the serum assay (12%). Similarly, 75% of patients with advanced ovarian cancer had elevated mesothelin in urine compared to 48% in serum. Serum and urine levels of mesothelin correlated for early ( p = 0.02) and late ( p < 0.001) disease. Urine mesothelin exhibited greater sensitivity for early stage ovarian cancer than did hCG free beta subunit or beta subunit core fragment and complementarity was not observed. Conclusion. Urine mesothelin deserves further evaluation as a biomarker for detection of early stage ovarian cancer in combination with other urinary markers.

Establishment, Value Assignment, and Characterization of New WHO Reference Reagents for Six Molecular Forms of Human Chorionic Gonadotropin

The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) established a Working Group to investigate means of improving the comparability of immunoassays for human chorionic gonadotropin (hCG), which was selected as a prototype glycoprotein analyte. The Working Group identified development of unambiguous nomenclature and production of new highly purified International Reference Reagents calibrated in substance concentrations as its primary objectives. Preparations of intact hCG, nicked hCG, hCG beta-subunit, nicked hCG beta-subunit, hCG alpha-subunit, and hCG beta-core fragment were purified from a crude urinary hCG preparation, ampouled, lyophilized, and assigned values in substance concentrations (mol/L). Value assignment and accelerated degradation studies were carried out in accordance with WHO protocols for International Reference Reagents. The ampouled standards were assigned final values based on the recovery of immunoreactive material after reconstitution. The degradation studies showed that the standards were highly stable. The nomenclature of hCG-related molecules and immunoassays has been adopted by the IFCC, and the standards prepared and characterized by the Working Group have been formally adopted by the WHO as the First International Reference Reagents for six hCG-related molecules. These developments will enable better understanding of what assays for hCG measure and should ultimately help to improve the clinical application of these assays.

False diagnosis and needless therapy of presumed malignant disease in women with false-positive human chorionic gonadotropin concentrations

12 women were diagnosed of having postgestational choriocarcinoma on the basis of persistently positive human chorionic gonadotropin (hCG) test results in the absence of pregnancy. Most of the women had extirpative surgery or chemotherapy, or both, without significant diminution in hCG titre. Our aim was to assess whether the hCG concentrations were false-positive test results. Samples were tested for hCG, hCG free beta subunit, and hCG beta-core fragment. Assay kinetics were also assessed, and samples were tested independently by competitive RIA. False-positive hCG concentrations were identified by two criteria: detection of hCG in serum and lack of detection of hCG and its degradation products in urine; and wide variations in results for different hCG assays. We corroborated false-positive hCG values by the lack of parallel changes in hCG results when serum was diluted, by false detection of other antigens, and by failure to detect hCG with in-house assays. All 12 women met both criteria for false-positive hCG, and all had corroborating findings. In all 12 cases, a false diagnosis had been made, and most of the women had been subjected to needless surgery or chemotherapy. Assay kinetics indicated that heterophilic antibodies were responsible for the false-positive results. As a result of our findings all further therapy was stopped. Current protocols for the diagnosis and treatment of choriocarcinoma should be modified to include a compulsory test for hCG in urine.

New triple screen test for Down syndrome: combined urine analytes and serum AFP.

In this study we report a new triple test that combines serum AFP, urine beta-core fragment of hCG, total urine estriol, and maternal age for calculating individual Down syndrome odds in the second trimester. The urine beta-core fragment/estriol ratio was used as a single screening variable. Analyte levels were measured prospectively in 10 Down syndrome cases and 346 normals. Individual Down syndrome odds were calculated by multiplying the product of the Down syndrome likelihood ratios of serum AFP and urine beta-core/estriol levels by the age-related midtrimester risk. The screening efficiency of an algorithm that combines urine beta-core/estriol with maternal age was compared to one that included serum AFP data. A 90% detection rate for Down syndrome was obtained at a 4.65% false positive rate. This was superior to the 75% sensitivity at 5% false positive rate observed when beta-core/estriol and age alone were used. This new triple test has a higher screening efficiency than that generally reported for the traditional serum triple screen and other urine tests, and it also provides information on the risk of neural tube defects. If confirmed in larger trials, the new algorithm could be used as an alternative to the traditional serum triple screen.

MATERNAL SERUM SCREENING FOR FETAL GENETIC DISORDERS

Maternal serum analyte screening is an integral component of contemporary antenatal care. Based on elevated MSAFP levels, 85% to 90% of NTDs (e.g., anencephaly or spina bifida) can be detected. Using a combination of serum analytes (e.g., MSAFP, hCG, UE3) 55% to 60% of fetal Down's syndrome can be detected. Future strategies for Down's syndrome screening may include the use of new markers such as dimeric inhibin-A and urinary beta-core fragment of hCG, as well as first-trimester screening, particularly with PAPP-A and free beta-hCG.

HLH beta core fragment immunoreactivity in the urine of ovulating women: a sensitive and specific immunometric assay for its detection

Recently, we isolated an hLH beta core fragment (hLHβcf) from human pituitaries. This molecule is homologous to the hCG beta core fragment (hCGβcf), which may be a marker of normal pregnancy, Down syndrome, and certain cancers. We now report antibodies to the hLHβcf, four of which have been applied in sensitive immunoradiometric assays for urinary measurements. One of the antibodies recognizes an epitope on the hLHβcf, which is not present on the hCGβcf, hLH, or hLHβ. This specific hLHβcf antibody acts cooperatively with other newly-developed antibodies reported here to produce an assay with a sensitivity of 1 fmol/ml of hLHβcf. The specificity of these new IRMA systems will make it possible to measure the hLHβcf in urine in the presence of hLH, hLH beta, or the hCGβcf. Although the hLHβcf used to develop specific antibodies was purified from pituitaries, the assays developed recognize this metabolite in urine. Measurements of heterodimeric hLH as compared to hLHβcf in the urine of cycling women indicated that the concentration of hLHβcf rose as high as 6-7 times the concentration of hLH starting a day after the midcycle surge. The new measuring systems allow the precise quantitation of this hLH metabolite in urine.

The molecular basis for epitopes on the free beta-subunit of human chorionic gonadotrophin (hCG), its carboxyl-terminal peptide and the hCG beta-core fragment.

The molecular basis for antigenic determinants on the free beta-subunit of human chorionic gonadotrophin (hCG beta), its carboxyl-terminal peptide (hCG beta CTP) and the hCG beta-core fragment (hCG beta cf) was elucidated by means of monoclonal antibodies (MCAs). The objective of the present study was to resolve the antigenic topography of these three molecules in terms of epitope identification at different levels of structural organization as well as analysis of their spatial arrangement. An hCG beta cf preparation, a synthetic peptide corresponding to the hCG beta CTP (beta 109-145), overlapping synthetic peptides spanning the entire amino acid sequence of hCG beta, and a reduced and alkylated hCG beta preparation were assayed in a solid-phase one-site enzyme-linked immunoassay and in a soluble-phase direct-binding radioimmunoassay (RIA) or competitive RIA. The antigenic topography was mapped by incorporating the MCAs into two-site binding assays. On the surface of free hCG beta, nine different epitopes (beta 1-beta 9), arranged in three spatially distinct domains, could be distinguished. Epitopes beta 1-beta 7 were located in a single large domain on both hCG beta and the hCG beta cf whereas hCG beta CTP contained two topographically distant determinants, designated beta 8 and beta 9 respectively. All but the two epitopes located on hCG beta CTP (beta 8 and beta 9) were destroyed by reducing and alkylating hCG beta, suggesting that most antigenic determinants are predominantly non-contiguous and require an intact tertiary structure whereas the molecular structure of hCG beta CTP is linear. At a molecular level, amino acid residues spanning hCG beta 45-52, hCG beta 137-144 and hCG beta 113-116 contributed to the formation of epitopes beta 5, beta 8 and beta 9 respectively. We have also shown that the hCG beta cf represents the immunodominant part of the free beta-subunit of hCG, containing seven mainly conformationally determined epitopes, one of which has a share of the sequence beta 45-52. The hCG beta CTP does not play a critical role in the immunologically important tertiary structure of hCG beta and was itself found to be a predominantly continuous sequence also within the native hormone, expressing two spatially distant antigenic determinants located within residues beta 113-116 and beta 137-144 respectively.

Separation of nicked human chorionic gonadotropin (hCG), intact hCG, and hCG beta fragment from standard reference preparations and raw urine samples.

hCG is found in pregnancy urine and in urine from some cancer patients in a variety of forms whose concentrations have clinical importance. Recently, concerns about accurate measurement of these forms have been raised because of the finding that hCG with peptide bond cleavages within the beta-subunit is not recognized by commonly used antibodies. Such nicked forms of hCG are biologically inactive or of very low activity. They are present in normal pregnancy urine and to varying extents in the urine of patients with trophoblastic disease. International reference preparations of hCG contain nicked forms of hCG. Previously, it was not possible to separate nicked hormone from the intact form of hCG. This was a serious impediment to producing improved reference standards from natural pregnancy hormone. We now report that a simple hydrophobic purification scheme separates intact hCG from nicked hCG as well as from hCG beta core fragment. This scheme is a modification of the method of Hiyama et al. The order of elution from low to high hydrophobicity is hCG beta core fragment, nicked hCG, and lastly, intact hCG. Nicking of the putative amphipathic helix loop, hCG beta 38-57, apparently renders the hormone significantly less hydrophobic despite the equal molar content of sialic acid. The hCG CR 127 nicked preparation was only 10% as potent as the reference preparation in a heterodimer-directed assay. The nicked-depleted hCG CR 127 was 30% more potent in this assay. Improved hCG reference standards should display similar increases in immunopotency (20-30%) with most antiheterodimeric antibodies and similar increases in bio-potency assays. It should now be possible to make reference preparations of these forms of hCG directly from the raw urine of normal pregnant patients and those with trophoblastic disease.

Separation of nicked human chorionic gonadotropin (hCG), intact hCG, and hCG beta fragment from standard reference preparations and raw urine samples

hCG is found in pregnancy urine and in urine from some cancer patients in a variety of forms whose concentrations have clinical importance. Recently, concerns about accurate measurement of these forms have been raised because of the finding that hCG with peptide bond cleavages within the beta-subunit is not recognized by commonly used antibodies. Such nicked forms of hCG are biologically inactive or of very low activity. They are present in normal pregnancy urine and to varying extents in the urine of patients with trophoblastic disease. International reference preparations of hCG contain nicked forms of hCG. Previously, it was not possible to separate nicked hormone from the intact form of hCG. This was a serious impediment to producing improved reference standards from natural pregnancy hormone. We now report that a simple hydrophobic purification scheme separates intact hCG from nicked hCG as well as from hCG beta core fragment. This scheme is a modification of the method of Hiyama et al. The order of elution from low to high hydrophobicity is hCG beta core fragment, nicked hCG, and lastly, intact hCG. Nicking of the putative amphipathic helix loop, hCG beta 38-57, apparently renders the hormone significantly less hydrophobic despite the equal molar content of sialic acid. The hCG CR 127 nicked preparation was only 10% as potent as the reference preparation in a heterodimer-directed assay. The nicked-depleted hCG CR 127 was 30% more potent in this assay. Improved hCG reference standards should display similar increases in immunopotency (20-30%) with most antiheterodimeric antibodies and similar increases in bio-potency assays. It should now be possible to make reference preparations of these forms of hCG directly from the raw urine of normal pregnant patients and those with trophoblastic disease.

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.

Specificity and Detection Limit of Ten Pregnancy Tests

Pregnancy tests have sufficiently low detection limits (25-200 IU/L of human chorionic gonadotropin, hCG) and good specificity as judged by lack of cross-reaction with lutropin (LH) and follitropin (FSH). However, little information is available on the specificity of the tests for subunits and fragments of hCG. The dominating form of hCG immunoreactivity in pregnancy urine is actually a 10 kD fragment of the beta chain of hCG called the core fragment. We have evaluated ten commonly used pregnancy test with respect to specificity for various forms of hCG and detection limit. Our results show that the detection limits of the tests are close to that claimed by the manufacturers and that the main form of hCG immunoreactivity detected is intact hCG. Four of the tests also measure the free beta subunit of hCG and one method also the hCG beta core fragment, but the detection limits were 7-70 fold those for hCG.

Urinary hCG beta-core fragment as a tumor marker for bladder cancer

Human chorionic gonadotropin (hCG) is a highly specific tumor marker or trophoblastic neoplasms. Also in patients with non-trophoblastic tumors, hCG beta-related material has been frequently demonstrated in their urine. This material was termed beta-core fragment (beta-CF) since it is recognized by hCG beta-core directed antisera but not by hCG beta-carboxyterminal peptide (CTP) directed antisera. We measured the concentration of beta-CF in the urinary samples from patients with urothelial tumors and studied its clinical usefulness as a tumor marker. The concentration of beta-CF was expressed as ng/mg of creatinine in the urine and the cut-off value was 0.1 ng/mg.Cr. Thirty (61.2%) of 49 patients with bladder carcinoma had raised beta-CF levels and the positive rates were dependent upon pathological grade (25.0, 33.3 and 82.8% at G1, G2 and G3, respectively). The elevated urinary beta-CF were also detected in 5 of 7 patients with upper urinary tract carcinoma. However, there was no elevated urinary beta-CF level in prostate carcinoma. Serial determination in 13 patients with elevated beta-CF level prior to therapy showed that 12 patients had decreased concentrations after successful treatment, but 1 patient with persistently elevated urinary beta-CF level after treatment subsequently relapsed. The determination of urinary beta-CF may provide a useful tool in identifying and monitoring the response to treatment in patients with carcinomas of the bladder and the upper urinary tract.

β-Core fragments are contaminants of the World Health Organization Reference Preparations of human choriogonadotrophin and its α-subunit

Highly purified preparations of human choriogonadotrophin (hCG), hCG alpha and hCG beta, including those preparations which are being distributed by the World Health Organization as International Standards, cross-reacted in a new radioimmunoassay with increased relative specificity for the beta-core fragment of hCG. A major portion of the beta-core immunoreactivity in the hCG and hCG alpha preparations eluted from Sephadex G-100 in a position (approximate apparent molecular size 15,000-18,000) corresponding to that of purified beta-core fragment prepared from pregnancy urine. However, in the case of hCG beta-subunit preparations, virtually all of the beta-core cross-reacting material eluted from Sephadex G-100 in the same fractions as the native hCG beta-subunit. Quantitatively, the cross-reacting beta-core material accounts for less than 1% (w/w) of the total hCG or subunit immunoreactivity, as measured by conventional radioimmunoassays. The presence of the beta-core fragments as discrete molecular components of the hCG and hCG alpha preparations should be borne in mind when these preparations are used to calibrate new radioimmunoassays for hCG-related molecules.