Clinical Chemistry
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Clinical Chemistry 52: 1356-1365, 2006. First published April 27, 2006; 10.1373/clinchem.2006.068932
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(Clinical Chemistry. 2006;52:1356-1365.)
© 2006 American Association for Clinical Chemistry, Inc.

Endocrinology and Metabolism

Serum and Urine Tissue Kallikrein Concentrations in Male-to-Female Transsexuals Treated with Antiandrogens and Estrogens

Margrita H. Slagter1, Louis J.G. Gooren1, Willem de Ronde1, Antoninus Soosaipillai2,3, Andreas Scorilas4, Erik J. Giltay5, Miltiadis Paliouras2,3 and Eleftherios P. Diamandis2,3,a

1 Department of Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands.
2 Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
3 Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada.
4 Department of Biochemistry and Molecular Biology, University of Athens, Athens, Greece.
5 Geestelijke Gezondheidszorg (GGZ) Delfland, Institute of Mental Health, Delft, The Netherlands.

aAddress correspondence to this author at: Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, 600 University Ave., Toronto, ON, M5G 1X5 Canada. Fax 416-586-8628; e-mail ediamandis{at}mtsinai.on.ca.

Background: The expression of human tissue kallikrein genes is regulated by steroid hormones, but most studies have been conducted with cancer cell lines. Our purpose was to examine serum and urinary tissue kallikrein concentration changes in male-to-female transsexuals before and after treatment with antiandrogens and estrogens.

Methods: Thirty-five male-to-female transsexuals receiving cyproterone acetate and estrogens (orally or transdermally) were included in this study. Serum and urine samples were collected before initiation of therapy and 4 and 12 months post therapy. ELISAs were used to measure multiple kallikreins in serum and urine.

Results: After antiandrogen and estrogen therapy, serum testosterone concentrations decreased dramatically, as did serum and urinary concentrations of human glandular kallikrein (hK2) and prostate-specific antigen (PSA; hK3). Statistically significant but relatively small changes in serum and urinary concentrations of many other kallikreins were also seen. Kallikreins in serum and urine were correlated before and after treatment.

Conclusions: The concentrations of hK2 and hK3, but not of any other kallikreins, decrease dramatically after combined antiandrogen and estrogen treatment in male-to-female transsexuals. The smaller responses of the other kallikreins presumably reflect their expression in multiple tissues.






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