title: Maternal serum urea resistant alkaline phosphatase in Down syndrome pregnancy.
abstract: BACKGROUND
  The normal levels of alkaline phosphatase (AP) activity in maternal serum are virtually the same as those observed in Down syndrome (DS) pregnancies at 14-20 weeks' gestation. Using urea inhibition of AP, we observed an atypical AP isoenzyme in the neutrophils of mothers with trisomy 21 fetuses.
  
  
  OBJECTIVE
  To assess the use of urea as a selective inhibitor of serum AP in order to seek a possible diagnostic difference between normal and DS pregnancies.
  
  
  METHODS
  Serum AP samples from 24 DS pregnancies and 204 control cases were examined at 12-22 weeks' gestation with and without 2.5 M urea AP inhibition at 18 degrees C for 2 h. The levels of AP activity obtained without urea and the percentage urea AP inhibition were analyzed in the two groups.
  
  
  RESULTS
  Without urea treatment, no significant difference of total alkaline phosphatase activity levels was detected between the 204 normal controls and the 24 DS samples. Using 2.5 M urea AP inhibition, after 120 min of exposure at 18 degrees C, the residual activity, as a percentage of initial values of AP, showed significantly higher resistance in the DS samples (> or = 50 IU/l of total AP activity) at 15-22 weeks' gestation. However, at 12-14 weeks (< or = 45 IU/l of total AP activity), no significant difference was found between the DS and control cases.
  
  
  CONCLUSIONS
  Serum urea resistant alkaline phosphatase in DS pregnancies showed a significant difference only at 15-22 weeks' gestation, compared with normal controls.
authors.affiliation: Laboratoire d'Enzymologie, Service Universitaire d'Hématologie, CHU Rangueil, 31403 Toulouse Cedex 4, France. crowte.n@wanadoo.fr
authors.forename: Jean
authors.initials: J
authors.lastname: Grozdea
authors.forename: France
authors.initials: F
authors.lastname: De La Farge
authors.forename: Georges
authors.initials: G
authors.lastname: Bourrouillou
authors.forename: Mady
authors.initials: M
authors.lastname: Calot
authors.forename: Jean P
authors.initials: JP
authors.lastname: Cambus
authors.forename: Pierre
authors.initials: P
authors.lastname: Valdiguié
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000037:antagonists & inhibitors / Q000097:blood*; D004314:Down Syndrome / Q000175:diagnosis / Q000201:enzymology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy / Q000097:blood*; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis; D014508:Urea / Q000494:pharmacology
chemical_list: D014508:Urea; D000469:Alkaline Phosphatase