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Congenital Deficiency versus Hereditary Persistence of Human Alpha-fetoprotein: A Meta-analysis and Overview of Potential Biomedical Consequences

Year 2012, Volume: 4 Issue: 2, 1 - 19, 26.05.2012

Abstract

Human alpha-fetoprotein (AFP) is a 70 kD tumor-associated fetal protein (oncofetal protein) which has been utilized clinically as a biomarker for both multiple cancers and for fetal defects including neural tube defects and chromosomal abnormalities. Extreme low and high levels of serum AFP in conjunction with gene mutations have now been established in disorders such as congenital deficiency (CD) and hereditary persistence (HP) of AFP. The objectives of the present review are to compare the clinical manifestations and analyze the mutational basis of these two AFP genetic disorders in accordance with presently accepted models of AFP gene regulation. The regulatory elements of AFP gene expression i.e., enhancers, promoters, and silencers are described in light of the genetic alterations expressed by the CD- and HP-AFP patients. By use of structure/function peptide mapping of the full-length AFP amino acid sequence, the potential biomedical consequences exhibited by CD-AFP and HP-AFP patients are presented and discussed. A new prospective on placental dysfunction in these AFP genetic disorders has also been introduced. Using AFP reference levels in maternal serum, cord blood, newborn blood, pediatric and adult serum, AFP serum concentrations are presented that could alert the obstetrician of potential CD-AFP during pregnancy. Knowledge of such serum values could provide tools to allow clinicians to distinguish between adult HP-AFP and malignant/non-malignant diseases such as liver and germ cell tumors, cirrhosis, hepatitis, and various liver disorders. Knowledge of AFP reference levels might serve to guide the clinician in avoiding: a) misguided diagnoses; b) unnecessary treatments and therapies; and c) undue anxieties and stress during pregnant and non-pregnant states.

References

  • 1. Abelev GI, Eraiser TL. Cellular aspects of alphafetoprotein reexpression in tumors. Seminars in Cancer Biology. 1999; 9: 95-107.
  • 2. Mizejewski GJ. Alpha-fetoprotein as a biologic response modifier: relevance to domain and subdomain structure. Proc Soc Exp Biol Med. 1997; 215: 333-62.,
  • 3. Gonzalez SA, Keeffe EB. Diagnosis of hepatocellular carcinoma: role of tumor markers and liver biopsy. Clin Liver Dis. 2011; 15: 297-306.
  • 4. Mizejewski GJ. Physiology of alpha-fetoprotein as a biomarker for perinatal distress: relevance to adverse pregnancy outcome. Exp Biol Med (Maywood). 2007; 232: 993-1004.
  • 5. Mizejewski GJ. Levels of alpha-fetoprotein during pregnancy and early infancy in normal and disease states. Obstet Gynecol Surv. 2003; 58: 804-26.
  • 6. Bader D, Riskin A, Vafsi O, et al. Alpha-fetoprotein in the early neonatal period--a large study and review of the literature. Clin Chim Acta. 2004; 349: 15-23.
  • 7. Masseyeff R, Gilli J, Krebs B, Calluaud A, Bonet C. Evolution of alpha-fetoprotein serum levels throughout life in humans and rats, and during pregnancy in the rat. Ann N Y Acad Sci. 1975; 259: 17-28.
  • 8. Mizejewski GJ. Biological roles of alpha-fetoprotein during pregnancy and perinatal development. Exp Biol Med (Maywood). 2004; 229: 439-63.
  • 9. Crandall BF. Alpha-fetoprotein: a review. Crit Rev Clin Lab Sci. 1981; 15: 127-85.
  • 10.Crandall BF, Chua C. Risks for fetal abnormalities after very and moderately elevated AF-AFPs. Prenat Diagn. 1997; 17: 837-41.
  • 11. Mizejewski GJ, Carter TP, Beblowski DW, Bellisario R. Measurement of serum alpha-fetoprotein in early infancy: utilization of dried blood specimens. Pediatr Res. 1983; 17: 47-50.
  • 12.Caceres G, Dauphinee MJ, Eisele LE, MacColl R, Mizejewski GJ. Anti-prostate cancer and anti-breast cancer activities of two peptides derived from alphafetoprotein. Anticancer Res. 2002; 22: 2817-20.
  • 13. Mizejewski GJ, Bellisario R, Carter TP. Birth weight and alpha-fetoprotein in the newborn. Pediatrics. 1984; 73: 736-7.
  • 14.Blohm MEG, Vesterling-Horner D, Calaminus G, Gobel U. Alpha1-fetoprotein (AFP) reference values in infants up to 2 years of age. Pediatr Hematol Oncol 1998; 15: 135-42.
  • 15.Christiansen M, Hogdall CK, Andersen JR, NorgaardPedersen B. Alpha-fetoprotein in plasma and serum of healthy adults: preanalytical, analytical and biological sources of variation and construction of age-dependent reference i ntervals. Scand J Clin Lab Invest. 2001; 61: 205-15.
  • 16. Kashyap R, Jain A, Nalesnik M, et al. Clinical significance of elevated alpha-fetoprotein in adults and children. Dig Dis Sci. 2001; 46: 1709-13.
  • 17. La'ulu SL, Rasmussen KJ, Robert WL. Pediatric reference intervals for serum alpha-fetoprotein. Clin Chim Acta. 2011; 412: 1695-6.
  • 18. Haddow JE, Palomaki GE, Knight GJ, et al. Prenatal screening for Down's syndrome with use of maternal serum markers. N Engl J Med. 1992; 327: 588-93.
  • 19. Mizejewski GJ. Alpha-Fetoprotein. In: Hickman PE, Koerbin G, editors. Methods in Clinical Chemistry: Pesce Kaplan Publishers; 2009.
  • 20.Brock DJ, Bolton AE, Monaghan JM. Prenatal diagnosis of anencephaly through maternal serumalphafetoprotein measurement. Lancet. 1973; 2: 923-4.
  • 21. Leek AE, Ruoss CF, Kitau MJ, Chard T. Raised alphafetoprotein in maternal serum with anencephalic pregnancy. Lancet. 1973; 2: 385.
  • 22.Cuckle HS, Holding S, Jones R, Groome NP, Wallace EM. Combining inhibin A with existing secondtrimester markers in maternal serum screening for Down's syndrome. Prenat Diagn. 1996; 16: 1095-100.
  • 23. Thomas RL, Blakemore KJ. Evaluation of elevations in maternal serum alpha-fetoprotein: a review. Obstet Gynecol Surv. 1990; 45: 269-83.
  • 24.Brock DJ, Sutcliffe RG. Alpha-fetoprotein in the antenatal diagnosis of anencephaly and spina bifida. Lancet. 1972; 2: 197-9.
  • 25.Benn PA, Craffey A, Horne D, Ramsdell L, Rodis JF. Elevated maternal serum alpha-fetoprotein with low unconjugated estriol and the risk for lethal perinatal outcome. J Matern Fetal Med. 2000; 9: 165-9.
  • 26.Bartha JL, Comino-Delgado R, Arce F, Alba P, Broullon JR, Barahona M. Relationship between alphafetoprotein and fetal erythropoiesis. J Reprod Med. 1999; 44: 689-97.
  • 27.Bartha JL, Illanes S, Abdel-Fattah SA, Harrison G, Soothill PW. Maternal serum alpha-fetoprotein, fetal middle cerebral artery blood flow velocity and fetal haemoglobin in pregnancies at risk of fetal anaemia. Prenat Diagn. 2006; 26: 101-4.
  • 28. Mizejewski G. New insights into AFP structure and function: Potential biomedical applications. Mizejewski G, Porter IH, editors. Orlando: Academic Press; 1985.
  • 29. Norgaard-Pedersen B, Klebe JG. Alpha 1-fetoprotein and carbonic anhydrase B and C concentration in cord blood from newborn infants of diabetic mothers. Acta Endocrinol Suppl (Copenh). 1974; 182: 81-6.
  • 30. Mizejewski GJ, Bellisario R,Beblowski DW,Carter TP. Adaptation of commercial radioimmunoassay kit for measurement of alpha-fetoprotein in dried blood specimens from newborns.Clin Chem.1982;28:1207- 10.
  • 31.Bloomer JR, Waldmann TA, McIntire KR, Klatskin G. alpha-fetoprotein in noneoplastic hepatic disorders. JAMA. 1975; 233: 38-41.
  • 32.Ruoslahti E, Seppala M. Normal and increased alphafetoprotein in neoplastic and non-neoplastic liver disease. Lancet. 1972; 300: 278-9.
  • 33.Bei R, Mizejewski GJ. Alpha fetoprotein is more than a hepatocellular cancer biomarker: from spontaneous immune response in cancer patients to the development of an AFP-based cancer vaccine. Curr Mol Med. 2011; 11: 564-81.
  • 34. Dourov N, Mayer R, de Martelaere F, Godart S, Gepts W, Maurus R. Melanotic neuroectodermal tumor of infancy with high serum levels of alpha-fetoprotein. Ultrastructural study and immunological evidence of glial fibrillary protein and alpha-fetoprotein. J Oral Pathol. 1987; 16: 251-5.
  • 35. Schneider DT, Calaminus G, Gobel U. Diagnostic value of alpha 1-fetoprotein and beta-human chorionic gonadotropin in infancy and childhood. Pediatr Hematol Oncol. 2001; 18: 11-26.
  • 36. Yamashita N, Kanai H, Kamiya K, Yamada K, Togari H, Nakamura T. Immature teratoma producing alphafetoprotein without components of yolk sac tumor in the pineal region. Childs Nerv Syst. 1997; 13: 225-8.
  • 37. Seregni E, Savelli G, Bombardieri E. Alpha-fetoprotein (AFP) in germ cell tumors of the testis. J Nucl Med Allied Sci. 1989; 33: 42-5.
  • 38.Bei R, Budillon A, Reale MG, et al. Cryptic epitopes on alpha-fetoprotein induce spontaneous immune responses in hepatocellular carcinoma, liver cirrhosis, and chronic hepatitis patients. Cancer Res. 1999; 59: 5471-4.
  • 39.Cochran PK, Chauvenet AR, Hart PS, et al. Hereditary persistence of alpha-fetoprotein in a child with testicular germ cell tumor. Med Pediatr Oncol. 1999; 32: 436-7.
  • 40. Gross S, Castillo W, Crane M, et al. Maternal serum alpha-fetoprotein and human chorionic gonadotropin levels in women with human immunodeficiency virus. Am J Obstet Gynecol. 2003; 188: 1052-6.
  • 41. Lange PH, McIntire KR, Waldmann TA, Hakala TR, Fraley EE. Alpha-fetoprotein and human chorionic gonadotropin in the management of testicular tumors. J Urol. 1977; 118: 593-6.
  • 42. Terentiev AA, Moldogazieva NT. Structural and functional mapping of alpha-fetoprotein. Biochemistry (Mosc). 2006; 71: 120-32.
  • 43. van Deuren M, Verhagen M, Weemeas C. Hereditary persistence of alpha-fetoprotein. Neth J Med. 2011; 69: 96.
  • 44. Gillespie JR, Uversky VN. Structure and function of alpha-fetoprotein: a biophysical overview. Biochim Biophys Acta. 2000; 1480: 41-56.
  • 45.Johnson PJ, Poon TC, Hjelm NM, Ho CS, Blake C, Ho SK. Structures of disease-specific serum alphafetoprotein isoforms. Br J Cancer. 2000; 83: 1330-7.
  • 46. Mizejewski GJ. Alpha-fetoprotein structure and function: relevance to isoforms, epitopes, and conformational variants. Exp Biol Med (Maywood). 2001; 226: 377-408.
  • 47. Greenberg F, Faucett A, Rose E, et al. Congenital deficiency of alpha-fetoprotein. Am J Obstet Gynecol. 1992; 167: 509-11.
  • 48. Muller F, Dreux S, Sault C, et al. Very low alphafetoprotein in Down syndrome maternal serum screening. Prenat Diagn. 2003; 23: 584-7.
  • 49. Petit FM, Hebert M, Picone O, et al. A new mutation in the AFP gene responsible for a total absence of alpha feto-protein on second trimester maternal serum screening for Down syndrome. Eur J Hum Genet. 2009; 17: 387-90.
  • 50. Sharony R, Amiel A, Bouaron N, Kidron D, Itzhaky D, Fejgin M. Congenital deficiency of alpha-fetoprotein and associated chromosomal abnormality in the placenta. Am J Med Genet A. 2003; 121: 113-7.
  • 51. Sharony R, Zadik I, Parvari R. Congenital deficiency of alpha feto-protein. Eur J Hum Genet. 2004; 12: 871- 4.
  • 52. Sher C, Shohat M. Congenital deficiency of AFP and Down syndrome screening. Prenat Diagn. 1997; 17: 884-5.
  • 53.Bonnin A, Goeden N, Chen K, et al. A transient placental source of serotonin for the fetal forebrain. Nature. 2011; 472: 347-50.
  • 54. Panova IG, Tatikolov AS, Poltavtseva RA, Sukhikh GT. alpha-Fetoprotein in Human Fetal Vitreous Body. Bull Exp Biol Med. 2011; 150: 420-1.
  • 55. Gabant P, Forrester L, Nichols J, et al. Alphafetoprotein, the major fetal serum protein, is not essential for embryonic development but is required for female fertility. Proc Natl Acad Sci U S A. 2002; 99: 12865-70.
  • 56. De Mees C, Laes JF, Bakker J, et al. Alpha-fetoprotein controls female fertility and prenatal development of the gonadotropin-releasing hormone pathway through an antiestrogenic action. Mol Cell Biol. 2006; 26: 2012-8.
  • 57. Mizejewski G. Mapping of structure-function peptide sites on the human alpha-fetoprotein amino acid sequence. Atlas of Genetics and Cytogenetics in Oncology and Haematology. 2009; Deep Insight Section: 1-65.
  • 58. Mizejewski GJ. Biological role of alpha-fetoprotein in cancer: prospects for anticancer therapy. Expert Rev Anticancer Ther. 2002; 2: 709-35.
  • 59. Mizejewski GJ. Alpha-fetoprotein (AFP)-derived peptides as epitopes for hepatoma immunotherapy: a commentary. Cancer Immunol Immunother. 2009; 58: 159-70.
  • 60. Mizejewski GJ. The phylogeny of alpha-fetoprotein in vertebrates: survey of biochemical and physiological data. Crit Rev Eukaryot Gene Expr. 1995; 5: 281-316.
  • 61. Mizejewski GJ, Vonnegut M. Characteristics of the androgenization produced in mice by neonatal exposure to alpha-fetoprotein antibodies. Teratology. 1982; 25: 351-60.
  • 62. Mizejewski GJ, Vonnegut M, Simon R. Neonatal androgenization using antibodies to alpha-fetoprotein. Brain Res. 1980; 188: 273-7.
  • 63. Ferguson Smith MA, May HM, O'Hare E, Aitken DA. Hereditary persistence of alphafetoprotein: a new autosomal dominant trait identified in an antenatal screening programme for spina bifida. J Med Genet. 1983; 20: 454-8.
  • 64. Houwert AC, Giltay JC, Lentjes EG, Lock MT. Hereditary persistence of alpha-fetoprotein (HPAF P): review of the literature. Neth J Med. 2010; 68: 354-8.
  • 65. Grigor KM, Detre SI, Kohn J, Neville AM. Serum alpha1-foetoprotein levels in 153 male patients with germ cell tumours. Br J Cancer. 1977; 35: 52-8.
  • 66. Lin JN, Wang KL, Chuang JH. Primary testicular tumors in children. Int Surg. 1988; 73: 190-2.
  • 67. Talerman A, Haije WG, Baggerman L. Serum alphafetoprotein (AFP) in patients with germ cell tumors of the gonads and extragonadal sites: correlation between endodermal sinus (yolk sac) tumor and raised serum AFP. Cancer. 1980; 46: 380-5.
  • 68. Staples J. Alphafetoprotein, cancer, and benign conditions. Lancet. 1986; 2: 1277.
  • 69. Flechon A, Droz JP. Hereditary persistence of alphafetoprotein in testis disease. J Urol. 2001; 165: 2004.
  • 70. Feng YZ, Liu J, Zhou XR. Hereditary persistence of alpha-fetoprotein. Chinese Journal of Cancer Research. 1994; 6: 232-4.
  • 71. Abt D, Meier M, Markart P, Schmid HP. Hereditary persistence of alpha-fetoprotein mimicking testicular cancer in a patient with acute epididymitis. Scand J Urol Nephrol. 2011.45:354-355.
  • 72. Greenberg F, Rose E, Alpert E. Hereditary persistence of alpha-fetoprotein.Gastroenterology.1990; 98:1083-5.
  • 73. Schefer H, Mattmann S, Joss RA. Hereditary persistence of alpha-fetoprotein. Case report and review of the literature. Ann Oncol. 1998; 9: 667-72.
  • 74. Tsuchida Y, Ikeda H, Yamashita K, Kaneko M. Hereditary persistence of alpha-fetoprotein and its origin. Med Pediatr Oncol. 2000; 35: 506-8.
  • 75. Nishio H, Heiskanen M, Palotie A, Belanger L, Dugaiczyk A. Tandem arrangement of the human serum albumin multigene family in the subcentromeric region of 4q: evolution and chromosomal direction of transcription. J Mol Biol. 1996; 259: 113- 9.
  • 76. Sakai M, Morinaga T, Urano Y, Watanabe K, Wegmann TG, Tamaoki T. The human alphafetoprotein gene. Sequence organization and the 5' flanking region. J Biol Chem. 1985; 260: 5055-60.
  • 77. Lazarevich NL. Molecular mechanisms of alphafetoprotein gene expression. Biochemistry (Mosc). 2000; 65: 117-33.
  • 78.Chen H, Egan JO, Chiu JF. Regulation and activities of alpha-fetoprotein. Crit Rev Eukaryot Gene Expr. 1997; 7: 11-41.
  • 79. Guertin M, LaRue H, Bernier D, et al. Enhancer and promoter elements directing activation and glucocorticoid repression of the alpha 1-fetoprotein gene in hepatocytes. Mol Cell Biol. 1988; 8: 1398-407.
  • 80. Zhang XK, Dong JM, Chiu JF. Regulation of alphafetoprotein gene expression by antagonism between AP-1 and the glucocorticoid receptor at their overlapping binding site. J Biol Chem. 1991; 266: 8248-54.
  • 81. McVey JH, Michaelides K, Hansen LP, et al. A G-->A substitution in an HNF I binding site in the human alpha-fetoprotein gene is associated with hereditary persistence of alpha-fetoprotein (HPAFP). Hum Mol Genet. 1993; 2: 379-84.
  • 82. Alj Y, Georgiakaki M, Savouret JF, et al. Hereditary persistence of alpha-fetoprotein is due to both proximal and distal hepatocyte nuclear factor-1 site mutations. Gastroenterology. 2004; 126: 308-17.
  • 83.Blesa JR, Vidal J, Giner-Duran R, et al. Detection of hereditary persistence of alpha-fetoprotein by conformation-sensitive gel electrophoresis analysis. Clin Chem. 2003; 49: 2102-3.
  • 84. Yeh SH, Kao JH, Chen PJ. Heterogeneity of hereditary persistence of alpha-fetoprotein. Gastroenterology. 2004; 127: 687.
  • 85. Alj Y, Milgrom E, Guiochon-Mantel A. Rapid determination of alpha-fetoprotein gene promoter mutations in hereditary persistence of alphafetoprotein. Clin Chem. 2004; 50: 1706-7.
  • 86. Nagata-Tsubouchi Y, Ido A, et al. Molecular mechanisms of hereditary persistence of alphafetoprotein (AFP) in two Japanese families A hepatocyte nuclear factor-1 site mutation leads to induction of the AFP gene expression in adult livers. Hepatol Res. 2005; 31: 79-87.
  • 87. Li X, Alexander S. Hereditary persistence of alphafetoprotein. Pediatr Blood Cancer. 2009; 52: 403-5.
  • 88.Jelliffe-Pawlowski L, Baer R, Moon-Grady AJ, Currier RJ. Second trimester serum predictors of congenital heart defects in pregnancies without chromosomal or neural tube defects. Prenat Diagn. 2011,31:466-472.
  • 89.Jelliffe-Pawlowski LL, Walton-Haynes L, Currier RJ. Using second trimester ultrasound and maternal serum biomarker data to help detect congenital heart defects in pregnancies with positive triple-marker screening results. Am J Med Genet A. 2008; 146A: 2455-67.
  • 90. Palazon LS, Copado MA, Ruiz-Gutierrez V, Dorado M, Rodriguez Burgos A. Antibodies to alphafetoprotein disrupt histogenesis in cultured chick retinae. Tissue Cell. 1996; 28: 223-6.
  • 91.Bonnin A, Levitt P. Fetal, maternal, and placental sources of serotonin and new implications for developmental programming of the brain. Neuroscience. 2011; 197: 1-7.
  • 92. Panova IG, Tatikolov AS. [Study of the content of alpha-fetoprotein and serum albumin in the vitreous body of the eye of human embryos]. Izv Akad Nauk Ser Biol. 2011: 235-9.
  • 93.Belyaev NN, Bogdanov AY, Savvulidi PG, et al. The Influence of Alpha-fetoprotein on Natural Suppressor Cell Activity and Ehrlich Carcinoma Growth. Korean J Physiol Pharmacol. 2008; 12: 193-7.
  • 94. Kim Y, Nakagawa Y, Sugiyama H, et al. Induction of CD4+ murine natural killer T-like cells by immunization with syngeneic thymoma expressing embryonic alpha-fetoprotein. Cell Immunol. 2003; 226: 1-10.
  • 95. Yamamoto M, Tatsumi T, Miyagi T, et al. alphaFetoprotein impairs activation of natural killer cells by inhibiting the function of dendritic cells. Clin Exp Immunol. 2011; 165: 211-9.
  • 96. Toder V, Blank M, Gold-Gefter L, Nebel L. The effect of alpha-fetoprotein on the growth of placental cells in vitro. Placenta. 1983; 4: 79-86.
  • 97. Everman DB, Shuman C, Dzolganovski B, O'Riordan MA, Weksberg R, Robin NH. Serum alpha-fetoprotein levels in Beckwith-Wiedemann syndrome. J Pediatr. 2000; 137: 123-7
  • 98. Mussa A, Ferrero GB, Ceoloni B, et al. Neonatal hepatoblastoma in a newborn with severe phenotype of Beckwith-Wiedemann syndrome. Eur J Pediatr. 2011,170:1407-1411.
  • 99. Hughes-Benzie RM, Tolmie JL, McNay M, Patrick A. Simpson-Golabi-Behmel syndrome: disproportionate fetal overgrowth and elevated maternal serum alphafetoprotein. Prenat Diagn. 1994; 14: 313-8.
  • 100. Seralini GE, Lafaurie M, Castelli D, Krebs B, Stora C. Alpha-fetoprotein and blockade of the sexual cycle. C R Acad Sci III. 1984; 298: 397-402.
  • 101. Seralini GE, Stora C. Inhibition of Murine Genital Function by Alpha-Fetoprotein. Tumor Biol. 1987; 8: 292-3.
  • 102. Castelli D, Aussel C, Lafaurie M, Ayraud N, Stora C. Immunolocalization of alpha-fetoprotein in the ovary and hypophysis of immature female rats. Histochem J. 1982; 14: 879-87.
  • 103. Greenstein BD. Effects of rat alpha-fetoprotein administration on estradiol free fraction, the onset of puberty, and neural and uterine nuclear estrogen receptors. Endocrinology. 1992; 130: 3184-90.
  • 104. Lambert JC, Seralini GE, Stora C, Vallette G, Vranckx R, Nunez EA. Effects of alphafetoprotein on isolated mouse oocytes. Tumour Biol. 1986; 7: 91-7.
  • 105. Meijs-Roelofs HMA, Kramer P. Maturation of the inhibitory feedback action of oestrogen on folliclestimulating hormone secretaion in the immature female rat: A role for alpha-foetoprotein. J Endocrinol. 1979; 81: 199-208.
  • 106. Seralini GE, Lafaurie M, Krebs B, Stora C. Alphafetoprotein and atretic follicles in the ovary of the pregnant rat. Tumour Biol. 1986; 7: 1-8.
  • 107. Boyd HA, Myrup C, Wohlfahrt J, Westergaard T, Norgaard-Pedersen B, Melbye M. Maternal serum alpha-fetoprotein level during pregnancy and isolated cryptorchidism in male offspring. Am J Epidemiol. 2006; 164: 478-86.
  • 108. Chierigo P, Puccetti O, Visona A, et al. [High alpha-fetoprotein persistence after orchiectomy. On a case of uncommon etiology]. Urologia. 2010; 77 Suppl 17: 27-31.
  • 109. El-Bahrawy M. alpha-Fetoprotein-Producing Non-Germ Cell Tumors of the Urological System. Rev Urol. 2011; 13: 14-9.
  • 110. Meguro S, Yasuda M. alpha-Fetoproteinproducing ovarian tumor in a postmenopausal woman with germ cell differentiation. Ann Diagn Pathol. 2011.
Year 2012, Volume: 4 Issue: 2, 1 - 19, 26.05.2012

Abstract

References

  • 1. Abelev GI, Eraiser TL. Cellular aspects of alphafetoprotein reexpression in tumors. Seminars in Cancer Biology. 1999; 9: 95-107.
  • 2. Mizejewski GJ. Alpha-fetoprotein as a biologic response modifier: relevance to domain and subdomain structure. Proc Soc Exp Biol Med. 1997; 215: 333-62.,
  • 3. Gonzalez SA, Keeffe EB. Diagnosis of hepatocellular carcinoma: role of tumor markers and liver biopsy. Clin Liver Dis. 2011; 15: 297-306.
  • 4. Mizejewski GJ. Physiology of alpha-fetoprotein as a biomarker for perinatal distress: relevance to adverse pregnancy outcome. Exp Biol Med (Maywood). 2007; 232: 993-1004.
  • 5. Mizejewski GJ. Levels of alpha-fetoprotein during pregnancy and early infancy in normal and disease states. Obstet Gynecol Surv. 2003; 58: 804-26.
  • 6. Bader D, Riskin A, Vafsi O, et al. Alpha-fetoprotein in the early neonatal period--a large study and review of the literature. Clin Chim Acta. 2004; 349: 15-23.
  • 7. Masseyeff R, Gilli J, Krebs B, Calluaud A, Bonet C. Evolution of alpha-fetoprotein serum levels throughout life in humans and rats, and during pregnancy in the rat. Ann N Y Acad Sci. 1975; 259: 17-28.
  • 8. Mizejewski GJ. Biological roles of alpha-fetoprotein during pregnancy and perinatal development. Exp Biol Med (Maywood). 2004; 229: 439-63.
  • 9. Crandall BF. Alpha-fetoprotein: a review. Crit Rev Clin Lab Sci. 1981; 15: 127-85.
  • 10.Crandall BF, Chua C. Risks for fetal abnormalities after very and moderately elevated AF-AFPs. Prenat Diagn. 1997; 17: 837-41.
  • 11. Mizejewski GJ, Carter TP, Beblowski DW, Bellisario R. Measurement of serum alpha-fetoprotein in early infancy: utilization of dried blood specimens. Pediatr Res. 1983; 17: 47-50.
  • 12.Caceres G, Dauphinee MJ, Eisele LE, MacColl R, Mizejewski GJ. Anti-prostate cancer and anti-breast cancer activities of two peptides derived from alphafetoprotein. Anticancer Res. 2002; 22: 2817-20.
  • 13. Mizejewski GJ, Bellisario R, Carter TP. Birth weight and alpha-fetoprotein in the newborn. Pediatrics. 1984; 73: 736-7.
  • 14.Blohm MEG, Vesterling-Horner D, Calaminus G, Gobel U. Alpha1-fetoprotein (AFP) reference values in infants up to 2 years of age. Pediatr Hematol Oncol 1998; 15: 135-42.
  • 15.Christiansen M, Hogdall CK, Andersen JR, NorgaardPedersen B. Alpha-fetoprotein in plasma and serum of healthy adults: preanalytical, analytical and biological sources of variation and construction of age-dependent reference i ntervals. Scand J Clin Lab Invest. 2001; 61: 205-15.
  • 16. Kashyap R, Jain A, Nalesnik M, et al. Clinical significance of elevated alpha-fetoprotein in adults and children. Dig Dis Sci. 2001; 46: 1709-13.
  • 17. La'ulu SL, Rasmussen KJ, Robert WL. Pediatric reference intervals for serum alpha-fetoprotein. Clin Chim Acta. 2011; 412: 1695-6.
  • 18. Haddow JE, Palomaki GE, Knight GJ, et al. Prenatal screening for Down's syndrome with use of maternal serum markers. N Engl J Med. 1992; 327: 588-93.
  • 19. Mizejewski GJ. Alpha-Fetoprotein. In: Hickman PE, Koerbin G, editors. Methods in Clinical Chemistry: Pesce Kaplan Publishers; 2009.
  • 20.Brock DJ, Bolton AE, Monaghan JM. Prenatal diagnosis of anencephaly through maternal serumalphafetoprotein measurement. Lancet. 1973; 2: 923-4.
  • 21. Leek AE, Ruoss CF, Kitau MJ, Chard T. Raised alphafetoprotein in maternal serum with anencephalic pregnancy. Lancet. 1973; 2: 385.
  • 22.Cuckle HS, Holding S, Jones R, Groome NP, Wallace EM. Combining inhibin A with existing secondtrimester markers in maternal serum screening for Down's syndrome. Prenat Diagn. 1996; 16: 1095-100.
  • 23. Thomas RL, Blakemore KJ. Evaluation of elevations in maternal serum alpha-fetoprotein: a review. Obstet Gynecol Surv. 1990; 45: 269-83.
  • 24.Brock DJ, Sutcliffe RG. Alpha-fetoprotein in the antenatal diagnosis of anencephaly and spina bifida. Lancet. 1972; 2: 197-9.
  • 25.Benn PA, Craffey A, Horne D, Ramsdell L, Rodis JF. Elevated maternal serum alpha-fetoprotein with low unconjugated estriol and the risk for lethal perinatal outcome. J Matern Fetal Med. 2000; 9: 165-9.
  • 26.Bartha JL, Comino-Delgado R, Arce F, Alba P, Broullon JR, Barahona M. Relationship between alphafetoprotein and fetal erythropoiesis. J Reprod Med. 1999; 44: 689-97.
  • 27.Bartha JL, Illanes S, Abdel-Fattah SA, Harrison G, Soothill PW. Maternal serum alpha-fetoprotein, fetal middle cerebral artery blood flow velocity and fetal haemoglobin in pregnancies at risk of fetal anaemia. Prenat Diagn. 2006; 26: 101-4.
  • 28. Mizejewski G. New insights into AFP structure and function: Potential biomedical applications. Mizejewski G, Porter IH, editors. Orlando: Academic Press; 1985.
  • 29. Norgaard-Pedersen B, Klebe JG. Alpha 1-fetoprotein and carbonic anhydrase B and C concentration in cord blood from newborn infants of diabetic mothers. Acta Endocrinol Suppl (Copenh). 1974; 182: 81-6.
  • 30. Mizejewski GJ, Bellisario R,Beblowski DW,Carter TP. Adaptation of commercial radioimmunoassay kit for measurement of alpha-fetoprotein in dried blood specimens from newborns.Clin Chem.1982;28:1207- 10.
  • 31.Bloomer JR, Waldmann TA, McIntire KR, Klatskin G. alpha-fetoprotein in noneoplastic hepatic disorders. JAMA. 1975; 233: 38-41.
  • 32.Ruoslahti E, Seppala M. Normal and increased alphafetoprotein in neoplastic and non-neoplastic liver disease. Lancet. 1972; 300: 278-9.
  • 33.Bei R, Mizejewski GJ. Alpha fetoprotein is more than a hepatocellular cancer biomarker: from spontaneous immune response in cancer patients to the development of an AFP-based cancer vaccine. Curr Mol Med. 2011; 11: 564-81.
  • 34. Dourov N, Mayer R, de Martelaere F, Godart S, Gepts W, Maurus R. Melanotic neuroectodermal tumor of infancy with high serum levels of alpha-fetoprotein. Ultrastructural study and immunological evidence of glial fibrillary protein and alpha-fetoprotein. J Oral Pathol. 1987; 16: 251-5.
  • 35. Schneider DT, Calaminus G, Gobel U. Diagnostic value of alpha 1-fetoprotein and beta-human chorionic gonadotropin in infancy and childhood. Pediatr Hematol Oncol. 2001; 18: 11-26.
  • 36. Yamashita N, Kanai H, Kamiya K, Yamada K, Togari H, Nakamura T. Immature teratoma producing alphafetoprotein without components of yolk sac tumor in the pineal region. Childs Nerv Syst. 1997; 13: 225-8.
  • 37. Seregni E, Savelli G, Bombardieri E. Alpha-fetoprotein (AFP) in germ cell tumors of the testis. J Nucl Med Allied Sci. 1989; 33: 42-5.
  • 38.Bei R, Budillon A, Reale MG, et al. Cryptic epitopes on alpha-fetoprotein induce spontaneous immune responses in hepatocellular carcinoma, liver cirrhosis, and chronic hepatitis patients. Cancer Res. 1999; 59: 5471-4.
  • 39.Cochran PK, Chauvenet AR, Hart PS, et al. Hereditary persistence of alpha-fetoprotein in a child with testicular germ cell tumor. Med Pediatr Oncol. 1999; 32: 436-7.
  • 40. Gross S, Castillo W, Crane M, et al. Maternal serum alpha-fetoprotein and human chorionic gonadotropin levels in women with human immunodeficiency virus. Am J Obstet Gynecol. 2003; 188: 1052-6.
  • 41. Lange PH, McIntire KR, Waldmann TA, Hakala TR, Fraley EE. Alpha-fetoprotein and human chorionic gonadotropin in the management of testicular tumors. J Urol. 1977; 118: 593-6.
  • 42. Terentiev AA, Moldogazieva NT. Structural and functional mapping of alpha-fetoprotein. Biochemistry (Mosc). 2006; 71: 120-32.
  • 43. van Deuren M, Verhagen M, Weemeas C. Hereditary persistence of alpha-fetoprotein. Neth J Med. 2011; 69: 96.
  • 44. Gillespie JR, Uversky VN. Structure and function of alpha-fetoprotein: a biophysical overview. Biochim Biophys Acta. 2000; 1480: 41-56.
  • 45.Johnson PJ, Poon TC, Hjelm NM, Ho CS, Blake C, Ho SK. Structures of disease-specific serum alphafetoprotein isoforms. Br J Cancer. 2000; 83: 1330-7.
  • 46. Mizejewski GJ. Alpha-fetoprotein structure and function: relevance to isoforms, epitopes, and conformational variants. Exp Biol Med (Maywood). 2001; 226: 377-408.
  • 47. Greenberg F, Faucett A, Rose E, et al. Congenital deficiency of alpha-fetoprotein. Am J Obstet Gynecol. 1992; 167: 509-11.
  • 48. Muller F, Dreux S, Sault C, et al. Very low alphafetoprotein in Down syndrome maternal serum screening. Prenat Diagn. 2003; 23: 584-7.
  • 49. Petit FM, Hebert M, Picone O, et al. A new mutation in the AFP gene responsible for a total absence of alpha feto-protein on second trimester maternal serum screening for Down syndrome. Eur J Hum Genet. 2009; 17: 387-90.
  • 50. Sharony R, Amiel A, Bouaron N, Kidron D, Itzhaky D, Fejgin M. Congenital deficiency of alpha-fetoprotein and associated chromosomal abnormality in the placenta. Am J Med Genet A. 2003; 121: 113-7.
  • 51. Sharony R, Zadik I, Parvari R. Congenital deficiency of alpha feto-protein. Eur J Hum Genet. 2004; 12: 871- 4.
  • 52. Sher C, Shohat M. Congenital deficiency of AFP and Down syndrome screening. Prenat Diagn. 1997; 17: 884-5.
  • 53.Bonnin A, Goeden N, Chen K, et al. A transient placental source of serotonin for the fetal forebrain. Nature. 2011; 472: 347-50.
  • 54. Panova IG, Tatikolov AS, Poltavtseva RA, Sukhikh GT. alpha-Fetoprotein in Human Fetal Vitreous Body. Bull Exp Biol Med. 2011; 150: 420-1.
  • 55. Gabant P, Forrester L, Nichols J, et al. Alphafetoprotein, the major fetal serum protein, is not essential for embryonic development but is required for female fertility. Proc Natl Acad Sci U S A. 2002; 99: 12865-70.
  • 56. De Mees C, Laes JF, Bakker J, et al. Alpha-fetoprotein controls female fertility and prenatal development of the gonadotropin-releasing hormone pathway through an antiestrogenic action. Mol Cell Biol. 2006; 26: 2012-8.
  • 57. Mizejewski G. Mapping of structure-function peptide sites on the human alpha-fetoprotein amino acid sequence. Atlas of Genetics and Cytogenetics in Oncology and Haematology. 2009; Deep Insight Section: 1-65.
  • 58. Mizejewski GJ. Biological role of alpha-fetoprotein in cancer: prospects for anticancer therapy. Expert Rev Anticancer Ther. 2002; 2: 709-35.
  • 59. Mizejewski GJ. Alpha-fetoprotein (AFP)-derived peptides as epitopes for hepatoma immunotherapy: a commentary. Cancer Immunol Immunother. 2009; 58: 159-70.
  • 60. Mizejewski GJ. The phylogeny of alpha-fetoprotein in vertebrates: survey of biochemical and physiological data. Crit Rev Eukaryot Gene Expr. 1995; 5: 281-316.
  • 61. Mizejewski GJ, Vonnegut M. Characteristics of the androgenization produced in mice by neonatal exposure to alpha-fetoprotein antibodies. Teratology. 1982; 25: 351-60.
  • 62. Mizejewski GJ, Vonnegut M, Simon R. Neonatal androgenization using antibodies to alpha-fetoprotein. Brain Res. 1980; 188: 273-7.
  • 63. Ferguson Smith MA, May HM, O'Hare E, Aitken DA. Hereditary persistence of alphafetoprotein: a new autosomal dominant trait identified in an antenatal screening programme for spina bifida. J Med Genet. 1983; 20: 454-8.
  • 64. Houwert AC, Giltay JC, Lentjes EG, Lock MT. Hereditary persistence of alpha-fetoprotein (HPAF P): review of the literature. Neth J Med. 2010; 68: 354-8.
  • 65. Grigor KM, Detre SI, Kohn J, Neville AM. Serum alpha1-foetoprotein levels in 153 male patients with germ cell tumours. Br J Cancer. 1977; 35: 52-8.
  • 66. Lin JN, Wang KL, Chuang JH. Primary testicular tumors in children. Int Surg. 1988; 73: 190-2.
  • 67. Talerman A, Haije WG, Baggerman L. Serum alphafetoprotein (AFP) in patients with germ cell tumors of the gonads and extragonadal sites: correlation between endodermal sinus (yolk sac) tumor and raised serum AFP. Cancer. 1980; 46: 380-5.
  • 68. Staples J. Alphafetoprotein, cancer, and benign conditions. Lancet. 1986; 2: 1277.
  • 69. Flechon A, Droz JP. Hereditary persistence of alphafetoprotein in testis disease. J Urol. 2001; 165: 2004.
  • 70. Feng YZ, Liu J, Zhou XR. Hereditary persistence of alpha-fetoprotein. Chinese Journal of Cancer Research. 1994; 6: 232-4.
  • 71. Abt D, Meier M, Markart P, Schmid HP. Hereditary persistence of alpha-fetoprotein mimicking testicular cancer in a patient with acute epididymitis. Scand J Urol Nephrol. 2011.45:354-355.
  • 72. Greenberg F, Rose E, Alpert E. Hereditary persistence of alpha-fetoprotein.Gastroenterology.1990; 98:1083-5.
  • 73. Schefer H, Mattmann S, Joss RA. Hereditary persistence of alpha-fetoprotein. Case report and review of the literature. Ann Oncol. 1998; 9: 667-72.
  • 74. Tsuchida Y, Ikeda H, Yamashita K, Kaneko M. Hereditary persistence of alpha-fetoprotein and its origin. Med Pediatr Oncol. 2000; 35: 506-8.
  • 75. Nishio H, Heiskanen M, Palotie A, Belanger L, Dugaiczyk A. Tandem arrangement of the human serum albumin multigene family in the subcentromeric region of 4q: evolution and chromosomal direction of transcription. J Mol Biol. 1996; 259: 113- 9.
  • 76. Sakai M, Morinaga T, Urano Y, Watanabe K, Wegmann TG, Tamaoki T. The human alphafetoprotein gene. Sequence organization and the 5' flanking region. J Biol Chem. 1985; 260: 5055-60.
  • 77. Lazarevich NL. Molecular mechanisms of alphafetoprotein gene expression. Biochemistry (Mosc). 2000; 65: 117-33.
  • 78.Chen H, Egan JO, Chiu JF. Regulation and activities of alpha-fetoprotein. Crit Rev Eukaryot Gene Expr. 1997; 7: 11-41.
  • 79. Guertin M, LaRue H, Bernier D, et al. Enhancer and promoter elements directing activation and glucocorticoid repression of the alpha 1-fetoprotein gene in hepatocytes. Mol Cell Biol. 1988; 8: 1398-407.
  • 80. Zhang XK, Dong JM, Chiu JF. Regulation of alphafetoprotein gene expression by antagonism between AP-1 and the glucocorticoid receptor at their overlapping binding site. J Biol Chem. 1991; 266: 8248-54.
  • 81. McVey JH, Michaelides K, Hansen LP, et al. A G-->A substitution in an HNF I binding site in the human alpha-fetoprotein gene is associated with hereditary persistence of alpha-fetoprotein (HPAFP). Hum Mol Genet. 1993; 2: 379-84.
  • 82. Alj Y, Georgiakaki M, Savouret JF, et al. Hereditary persistence of alpha-fetoprotein is due to both proximal and distal hepatocyte nuclear factor-1 site mutations. Gastroenterology. 2004; 126: 308-17.
  • 83.Blesa JR, Vidal J, Giner-Duran R, et al. Detection of hereditary persistence of alpha-fetoprotein by conformation-sensitive gel electrophoresis analysis. Clin Chem. 2003; 49: 2102-3.
  • 84. Yeh SH, Kao JH, Chen PJ. Heterogeneity of hereditary persistence of alpha-fetoprotein. Gastroenterology. 2004; 127: 687.
  • 85. Alj Y, Milgrom E, Guiochon-Mantel A. Rapid determination of alpha-fetoprotein gene promoter mutations in hereditary persistence of alphafetoprotein. Clin Chem. 2004; 50: 1706-7.
  • 86. Nagata-Tsubouchi Y, Ido A, et al. Molecular mechanisms of hereditary persistence of alphafetoprotein (AFP) in two Japanese families A hepatocyte nuclear factor-1 site mutation leads to induction of the AFP gene expression in adult livers. Hepatol Res. 2005; 31: 79-87.
  • 87. Li X, Alexander S. Hereditary persistence of alphafetoprotein. Pediatr Blood Cancer. 2009; 52: 403-5.
  • 88.Jelliffe-Pawlowski L, Baer R, Moon-Grady AJ, Currier RJ. Second trimester serum predictors of congenital heart defects in pregnancies without chromosomal or neural tube defects. Prenat Diagn. 2011,31:466-472.
  • 89.Jelliffe-Pawlowski LL, Walton-Haynes L, Currier RJ. Using second trimester ultrasound and maternal serum biomarker data to help detect congenital heart defects in pregnancies with positive triple-marker screening results. Am J Med Genet A. 2008; 146A: 2455-67.
  • 90. Palazon LS, Copado MA, Ruiz-Gutierrez V, Dorado M, Rodriguez Burgos A. Antibodies to alphafetoprotein disrupt histogenesis in cultured chick retinae. Tissue Cell. 1996; 28: 223-6.
  • 91.Bonnin A, Levitt P. Fetal, maternal, and placental sources of serotonin and new implications for developmental programming of the brain. Neuroscience. 2011; 197: 1-7.
  • 92. Panova IG, Tatikolov AS. [Study of the content of alpha-fetoprotein and serum albumin in the vitreous body of the eye of human embryos]. Izv Akad Nauk Ser Biol. 2011: 235-9.
  • 93.Belyaev NN, Bogdanov AY, Savvulidi PG, et al. The Influence of Alpha-fetoprotein on Natural Suppressor Cell Activity and Ehrlich Carcinoma Growth. Korean J Physiol Pharmacol. 2008; 12: 193-7.
  • 94. Kim Y, Nakagawa Y, Sugiyama H, et al. Induction of CD4+ murine natural killer T-like cells by immunization with syngeneic thymoma expressing embryonic alpha-fetoprotein. Cell Immunol. 2003; 226: 1-10.
  • 95. Yamamoto M, Tatsumi T, Miyagi T, et al. alphaFetoprotein impairs activation of natural killer cells by inhibiting the function of dendritic cells. Clin Exp Immunol. 2011; 165: 211-9.
  • 96. Toder V, Blank M, Gold-Gefter L, Nebel L. The effect of alpha-fetoprotein on the growth of placental cells in vitro. Placenta. 1983; 4: 79-86.
  • 97. Everman DB, Shuman C, Dzolganovski B, O'Riordan MA, Weksberg R, Robin NH. Serum alpha-fetoprotein levels in Beckwith-Wiedemann syndrome. J Pediatr. 2000; 137: 123-7
  • 98. Mussa A, Ferrero GB, Ceoloni B, et al. Neonatal hepatoblastoma in a newborn with severe phenotype of Beckwith-Wiedemann syndrome. Eur J Pediatr. 2011,170:1407-1411.
  • 99. Hughes-Benzie RM, Tolmie JL, McNay M, Patrick A. Simpson-Golabi-Behmel syndrome: disproportionate fetal overgrowth and elevated maternal serum alphafetoprotein. Prenat Diagn. 1994; 14: 313-8.
  • 100. Seralini GE, Lafaurie M, Castelli D, Krebs B, Stora C. Alpha-fetoprotein and blockade of the sexual cycle. C R Acad Sci III. 1984; 298: 397-402.
  • 101. Seralini GE, Stora C. Inhibition of Murine Genital Function by Alpha-Fetoprotein. Tumor Biol. 1987; 8: 292-3.
  • 102. Castelli D, Aussel C, Lafaurie M, Ayraud N, Stora C. Immunolocalization of alpha-fetoprotein in the ovary and hypophysis of immature female rats. Histochem J. 1982; 14: 879-87.
  • 103. Greenstein BD. Effects of rat alpha-fetoprotein administration on estradiol free fraction, the onset of puberty, and neural and uterine nuclear estrogen receptors. Endocrinology. 1992; 130: 3184-90.
  • 104. Lambert JC, Seralini GE, Stora C, Vallette G, Vranckx R, Nunez EA. Effects of alphafetoprotein on isolated mouse oocytes. Tumour Biol. 1986; 7: 91-7.
  • 105. Meijs-Roelofs HMA, Kramer P. Maturation of the inhibitory feedback action of oestrogen on folliclestimulating hormone secretaion in the immature female rat: A role for alpha-foetoprotein. J Endocrinol. 1979; 81: 199-208.
  • 106. Seralini GE, Lafaurie M, Krebs B, Stora C. Alphafetoprotein and atretic follicles in the ovary of the pregnant rat. Tumour Biol. 1986; 7: 1-8.
  • 107. Boyd HA, Myrup C, Wohlfahrt J, Westergaard T, Norgaard-Pedersen B, Melbye M. Maternal serum alpha-fetoprotein level during pregnancy and isolated cryptorchidism in male offspring. Am J Epidemiol. 2006; 164: 478-86.
  • 108. Chierigo P, Puccetti O, Visona A, et al. [High alpha-fetoprotein persistence after orchiectomy. On a case of uncommon etiology]. Urologia. 2010; 77 Suppl 17: 27-31.
  • 109. El-Bahrawy M. alpha-Fetoprotein-Producing Non-Germ Cell Tumors of the Urological System. Rev Urol. 2011; 13: 14-9.
  • 110. Meguro S, Yasuda M. alpha-Fetoproteinproducing ovarian tumor in a postmenopausal woman with germ cell differentiation. Ann Diagn Pathol. 2011.
There are 110 citations in total.

Details

Primary Language English
Journal Section Reviews
Authors

Gerald Mizejewski

Publication Date May 26, 2012
Published in Issue Year 2012 Volume: 4 Issue: 2

Cite

APA Mizejewski, G. (2012). Congenital Deficiency versus Hereditary Persistence of Human Alpha-fetoprotein: A Meta-analysis and Overview of Potential Biomedical Consequences. Journal of Pediatric Sciences, 4(2), 1-19. https://doi.org/10.17334/jps.81128
AMA Mizejewski G. Congenital Deficiency versus Hereditary Persistence of Human Alpha-fetoprotein: A Meta-analysis and Overview of Potential Biomedical Consequences. Journal of Pediatric Sciences. June 2012;4(2):1-19. doi:10.17334/jps.81128
Chicago Mizejewski, Gerald. “Congenital Deficiency Versus Hereditary Persistence of Human Alpha-Fetoprotein: A Meta-Analysis and Overview of Potential Biomedical Consequences”. Journal of Pediatric Sciences 4, no. 2 (June 2012): 1-19. https://doi.org/10.17334/jps.81128.
EndNote Mizejewski G (June 1, 2012) Congenital Deficiency versus Hereditary Persistence of Human Alpha-fetoprotein: A Meta-analysis and Overview of Potential Biomedical Consequences. Journal of Pediatric Sciences 4 2 1–19.
IEEE G. Mizejewski, “Congenital Deficiency versus Hereditary Persistence of Human Alpha-fetoprotein: A Meta-analysis and Overview of Potential Biomedical Consequences”, Journal of Pediatric Sciences, vol. 4, no. 2, pp. 1–19, 2012, doi: 10.17334/jps.81128.
ISNAD Mizejewski, Gerald. “Congenital Deficiency Versus Hereditary Persistence of Human Alpha-Fetoprotein: A Meta-Analysis and Overview of Potential Biomedical Consequences”. Journal of Pediatric Sciences 4/2 (June 2012), 1-19. https://doi.org/10.17334/jps.81128.
JAMA Mizejewski G. Congenital Deficiency versus Hereditary Persistence of Human Alpha-fetoprotein: A Meta-analysis and Overview of Potential Biomedical Consequences. Journal of Pediatric Sciences. 2012;4:1–19.
MLA Mizejewski, Gerald. “Congenital Deficiency Versus Hereditary Persistence of Human Alpha-Fetoprotein: A Meta-Analysis and Overview of Potential Biomedical Consequences”. Journal of Pediatric Sciences, vol. 4, no. 2, 2012, pp. 1-19, doi:10.17334/jps.81128.
Vancouver Mizejewski G. Congenital Deficiency versus Hereditary Persistence of Human Alpha-fetoprotein: A Meta-analysis and Overview of Potential Biomedical Consequences. Journal of Pediatric Sciences. 2012;4(2):1-19.