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Urinary Prostate-Specific Antigen Is a Noninvasive Indicator of Sexual Development in Male Children

ITARU SATO^*,

ATSUKO YOSHIKAWA^,

TOSHIJI MUKAI

From the ^* Scientific Crime Laboratory, Kanagawa Prefectural Police, Yokohama, Japan; the Department of Legal Medicine, St Marianna University School of Medicine, Kawasaki, Japan; the Department of Microbiology and Immunology, The Institute of Medical Science, Tokyo University, Tokyo, Japan; the ^|| Department of Pediatrics, St Marianna University School of Medicine, Kawasaki, Japan; the ^¶ Department of Cellular and Molecular Biology, Primate Research Institute, Kyoto University, Inuyama, Japan; and the ^# Department of Urology, St Marianna University School of Medicine, Kawasaki, Japan.

Correspondence to: Dr Itaru Sato, Forensic Biology Unit, Scientific Crime Laboratory, Kanagawa Prefectural Police, 155-1, Naka-ku, Yamashita-cho, Yokohama, 231-0023, Japan (e-mail: itaru-s{at}m2.ocv.ne.jp).

Testicular androgen induces the synthesis of prostate specific antigen (PSA) in acinar epithelial cells of the prostate. We examined PSA activity in urine from 136 male children from birth up to 17 years of age. We detected PSA at various intervals in early infant urine over a period of 1–4 months. During this period, urinary secretion of testosterone (T) gradually declined, accompanied by 1 or more surges of T prior to a transient increase in PSA in urine from full- and preterm infants (67%, n = 6). Although mean urinary T concentrations during elevations of PSA in preterm infants were 3.1 and 5.6 times greater than in full-term infants and adults, the overall mean urinary PSA concentration of full and preterm infants was just 45% and 18% that of adults, respectively. PSA was not detected in children aged 0.3 to 9 years, after which a gradual increase in urinary PSA activity was observed after 10 years of age. Urinary PSA activity was markedly persistent after Tanner stage III pubertal development. To our knowledge, this is the first study to demonstrate an induction of PSA during early infancy by bioactive T in normally developing human males. We conclude that urinary PSA is a non-invasive, useful indicator for developmental studies from neonatal and adolescent males, which can be measured with a confirmatory semiquantitative PSA assay.

     Key words: Urine, infant, puberty

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