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1 Departments of Clinical Laboratories, Urology, and Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY
Address correspondence to the author at: Departments of Clinical Laboratories, Urology, and Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021; Email liljah@mskcc.org
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Featured Article: Lilja H, Christensson A, Dahlen U, et al. Prostate-Specific Antigen in Serum Occurs Predominantly in Complex with
1-Antichymotrypsin. Clin Chem 1991;37:1618–25.1
Prostate-specific antigen (PSA),2 a kallikrein-like serine protease, is one of the most abundant proteins secreted by the prostate into seminal fluid (1). In the early 1990s, when the study reported in the paper presented here was initiated, serum testing for PSA was coming into widespread use as a means of testing for prostate cancer. Nevertheless, several aspects of PSA in serum remained puzzling; notably, different assays yielded up to 4-fold differences in measured serum PSA concentrations, despite standardization against PSA from seminal fluid.
Before our investigation, PSA in seminal fluid was known to occur as active monomeric peptidase (1), but the nature of PSA in blood remained unclear. We speculated that release of catalytic PSA into an abundance of protease inhibitors in blood could prompt PSA to form inhibitor complexes, similar to the way the digestive enzyme trypsin from the pancreas forms enzyme-inhibitor
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