Biology of pregnancy-associated plasma protein-A in relation to prenatal diagnostics: an overview.
Pregnancy-associated plasma protein-A (PAPP-A) is highly efficient as a serum marker in first-trimester screening for chromosomal abnormalities. Furthermore, there is increasing evidence that low levels of PAPP-A in the first trimester are associated with adverse pregnancy outcomes such as preterm delivery, intrauterine growth retardation, preeclampsia, and stillbirth. PAPP-A is a glycoprotein, produced in the placenta, and it is present in the maternal circulation in increasing concentrations during pregnancy. By means of its proteolytic activity, PAPP-A functions as a regulatory protein in the insulin-like growth factor system, known to be important for placental formation and regulation of fetal growth. This overview describes aspects of biochemistry, synthesis, and biological functions of PAPP-A, with a focus on information of importance to clinicians. The clinical applications of PAPP-A are summarized, and new insights regarding the analyses of PAPP-A discussed.
Kirkegaard
Ida
I
Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby, Aarhus, Denmark. ida.kirkegaard@ki.au.dk
Uldbjerg
Niels
N
Oxvig
Claus
C
D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis; D002869:Chromosome Aberrations; D047093:Eosinophil Major Basic Protein / Q000097:blood; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D011296:Prenatal Diagnosis; D013002:Somatomedins / Q000502:physiology
D015415:Biomarkers; D013002:Somatomedins; D047093:Eosinophil Major Basic Protein; D011266:Pregnancy-Associated Plasma Protein-A