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Human Reproduction Update Advance Access originally published online on July 28, 2006
Human Reproduction Update 2006 12(6):769-784; doi:10.1093/humupd/dml029
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The classification, functions and clinical use of different isoforms of HCG

Ulf-Håkan Stenman1,3, Aila Tiitinen2, Henrik Alfthan1 and Leena Valmu1

1 Department of Clinical Chemistry and 2 Department of Gynecology and Obstetrics, Helsinki University Central Hospital, Helsinki, Finland

3 To whom correspondence should be addressed at: Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, FIN-00027 HUS, Finland. E-mail: ulf-hakan.stenman{at}hus.fi

HCG is composed of two subunits, HCG{alpha} and HCGß. During early pregnancy, HCG stimulates progesterone production in the corpus luteum, and injection of HCG is widely used to induce ovulation in assisted reproduction treatment (ART). Under experimental conditions, the free subunits have been shown to exert functions other than those of HCG, but the relevance of these remains to be determined. Intact HCG, free subunits and degraded forms of these occur in biological fluids, and determinations of these are important for diagnosis and monitoring of pregnancy, pregnancy-related disorders and several types of cancer. Development of optimal methods for the various forms has been hampered by lack of appropriate standards and expression of the concentrations of the various forms in units that are not comparable. Furthermore, the nomenclature for HCG assays is confusing and in some cases misleading. These problems can now be solved; a uniform nomenclature has been established, and new standards are available for HCG, its subunits HCG{alpha} and HCGß, the partially degraded or nicked forms of HCG and HCGß, and the beta-core fragment. This review describes the biochemical and biological background for the clinical use of determinations of various forms of HCG. The clinical use of HCG and studies on HCG vaccines are briefly reviewed.

Key words: cancer / Down’s syndrome / HCG isoforms / pregnancy / trophoblastic disease


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