title: Mullerian inhibiting substance in humans: normal levels from infancy to adulthood.
abstract: Mullerian-inhibiting substance (MIS) is a gonadal hormone synthesized by Sertoli cells of the testis and granulosa cells of the ovary. To facilitate the use of MIS for the evaluation of intersex disorders and as a tumor marker in women with MIS-expressing ovarian tumors, we measured MIS in 600 serum samples from males and females. These data show that mean MIS values for males rise rapidly during the first year of life and are highest during late infancy, then gradually decline until puberty. In contrast, MIS values in females are lowest at birth and exhibit a minimal increase throughout the prepubertal years. Whereas MIS is uniformly measurable in all prepubertal boys studied, it is undetectable in most prepubertal female subjects. These data reveal an easily discernible sexually dimorphic pattern of expression and confirm that MIS can be used as a testis-specific marker during infancy and early childhood. MIS values that are above the upper limits for females are discriminatory for the presence of testicular tissue or ovarian tumor, and those below the lower limits for males are consistent with dysgenetic or absent testes or the presence of ovarian tissue. These data will enable normal and abnormal levels of MIS to be differentiated with higher precision and will facilitate the use of MIS in the management of gonadal disorders.
authors.affiliation: Pediatric Endocrine Unit, Massachusetts General Hospital, Boston 02114, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Lee
authors.forename: P K
authors.initials: PK
authors.lastname: Donahoe
authors.forename: T
authors.initials: T
authors.lastname: Hasegawa
authors.forename: B
authors.initials: B
authors.lastname: Silverman
authors.forename: G B
authors.initials: GB
authors.lastname: Crist
authors.forename: S
authors.initials: S
authors.lastname: Best
authors.forename: Y
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: R A
authors.initials: RA
authors.lastname: Noto
authors.forename: D
authors.initials: D
authors.lastname: Schoenfeld
authors.forename: D T
authors.initials: DT
authors.lastname: MacLaughlin
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone; D014408:Biomarkers, Tumor / Q000097:blood; D002648:Child; D002675:Child, Preschool; D015925:Cryopreservation; D012734:Disorders of Sex Development / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006023:Glycoproteins; D006107:Granulosa Cells / Q000378:metabolism; D006131:Growth Inhibitors / Q000097:blood*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010051:Ovarian Neoplasms / Q000097:blood; D011627:Puberty; D012016:Reference Values; D013735:Testicular Hormones / Q000097:blood*; D013737:Testis / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D006023:Glycoproteins; D006131:Growth Inhibitors; D013735:Testicular Hormones; D054304:Anti-Mullerian Hormone