ELEVATED SERUM CATHEPSIN-B1 AND VAGINAL PATHOLOGY AFTER PRENATAL DES EXPOSURE

  • 1 January 1978
    • journal article
    • research article
    • Vol. 52  (3) , 321-327
Abstract
Activities of the lysosomal enzymes, cathepsin B1 (CB1), .beta.-glucuronidase, and .beta.-N-acetyl-D-glucosaminidase, as well as sialyl transferase, alkaline phosphatase, and placenta-like alkaline phosphatase, were determined on blind-coded serums from 99 women exposed to diethylstilbestrol DES) in utero and 40 unexposed subjects of comparable age range. Cathepsin B1 averaged 100%, 1040% (P < 0.001), 2720% (P < 0.001), and 4760% (P < 0.001) of controls in DES-exposed women with no genital tract abnormalities (N = 11), adenosis (N = 68), adenosis with concomitant dysplasia (N = 15), and clear-cell adenocarcinoma (N = 5), respectively. The latter two groups also exhibited modest increments in serum sialyl transferase activity (P < 0.01). Activities of the other four enzymes in serums of DES-exposed women were unchanged from those of controls, suggesting that alterations in CB1 were not due to generalized increases in lysosomal membrane instability or other gross cellular damage. In 2 DES-exposed women with clear-cell adenocarcinoma, from whom serial samples were available, preoperative levels of serum CB1 fell from a mean of 4280% to values indistinguishable from controls by 7-12 days after tumor excision, concurrently with objective signs of remission. Recrudescence of serum CB1 levels preceded by at least 3 mo. clinical evidence of persistent adenosis accompanied by vaginal dysplasia. Although the nature of the increments in CB1-like activity in the majority of subjects with DES-related pathology remains to be determined, the findings may complement present methods of physical diagnosis and prognosis.