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Human Reproduction, Vol. 16, No. 11, 2438-2444, November 2001
© 2001 European Society of Human Reproduction and Embryology

Lens culinaris agglutinin-reactive {alpha}-fetoprotein, an alternative variant to {alpha}-fetoprotein in prenatal screening for Down's syndrome

Ritsu Yamamoto1,3, Masaki Azuma1, Nobuhiko Hoshi, Tatsuro Kishida1, Shinji Satomura2 and Seiichiro Fujimoto1

1 Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo 060-8638, 2 Osaka Research Laboratories, Wako Pure Chemical Industries, Ltd., Amagasaki, 661-0963, Japan

BACKGROUND: Three serum tests, {alpha}-fetoprotein (AFP), human chorionic gonadotrophin and unconjugated oestriol, are now widely used for screening for Down's syndrome. Lens culinaris agglutinin-reactive {alpha}-fetoprotein (AFP-L3) is a variant of {alpha}-fetoprotein with {alpha}1->6 fucose appended to the reducing terminal N-acetylglucosamine. It is the most prominent AFP detected in the serum of patients with hepatocellular carcinoma. METHODS: We investigated microheterogeneities of the carbohydrate chain on AFP in fetal liver tissues, amniotic fluids and maternal sera obtained from pregnancies with Down's syndrome using lectin affinity electrophoresis with four lectins. The percentages of AFP-L3 in maternal sera from 22 Down's syndrome and 227 unaffected pregnancies were determined. RESULTS: Unlike the case with AFP concentration, the percentage of AFP-L3 in maternal serum and amniotic fluid was similar, and apparantly not influenced by membrane permeability. Knowing the percentage of AFP-L3 in maternal serum was effective for discriminating between Down's syndrome-affected pregnancies and unaffected pregnancies. The percentage of AFP-L3 in maternal serum identified 55% of Down's syndrome cases with a 5% false-positive rate. CONCLUSIONS: AFP-L3 should be an effective replacement for AFP in prenatal Down's syndrome screening.

Key words: {alpha}-fetoprotein/AFP-L3/Down's syndrome/Lens culinaris agglutinin/prenatal screening

3 To whom correspondence should be addressed. E-mail: rityam{at}med.hokudai.ac.jp


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