Urinary prostate-specific antigen is a noninvasive indicator of sexual development in male children

ABSTRACT: Testicular androgen induces the synthesis of pros-tate specific antigen (PSA) in acinar epithelial cells of the prostate.We examined PSA activity in urine from 136 male children from birthup to 17 years of age. We detected PSA at various intervals in earlyinfant urine over a period of 1–4 months. During this period, urinarysecretion of testosterone (T) gradually declined, accompanied by 1or more surges of T prior to a transient increase in PSA in urine fromfull- and preterm infants (67%, n 5 6). Although mean urinary Tconcentrations during elevations of PSA in preterm infants were 3.1and 5.6 times greater than in full-term infants and adults, the overallmean urinary PSA concentration of full and preterm infants was just45% and 18% that of adults, respectively. PSA was not detected inchildren aged 0.3 to 9 years, after which a gradual increase in urinaryPSA activity was observed after 10 years of age. Urinary PSAactivity was markedly persistent after Tanner stage III pubertaldevelopment. To our knowledge, this is the first study to demonstratean induction of PSA during early infancy by bioactive T in normallydeveloping human males. We conclude that urinary PSA is a non-invasive, useful indicator for developmental studies from neonataland adolescent males, which can be measured with a confirmatorysemiquantitative PSA assay.Key words: Urine, infant, puberty.J Androl 2007;28:150–154