Hirsutism in women. Effective therapy that is safe for long-term use

Influence of different homologous and heterologous combinations of antibodies and enzyme conjugates of dehydroepiandrostosterone on the sensitivity and specificity of DHEA ELISA

Anti-sera were raised against three immunogen: dehydroepiandrostosterone-17-carboxymethyl-oxime-bovine serum albumin (DHEA-17-CMO-BSA), DHEA-7-CMO-BSA, and dehydroepiandrostosterone-3-hemisuccinate-bovine serum albumin (DHEA-3-HS-BSA). They were evaluated with horseradish peroxidase (HRP)-labeled DHEA-17-CMO, DHEA-7-CMO, DHEA-3-HS enzyme conjugates for their influence on the sensitivity and specificity of ELISA. Of the various combinations, DHEA-3-HS-BSA antiserum along with DHEA-7-CMO-horseradish peroxidase (DHEA-7-CMO-HRP) enzyme conjugate showed no cross-reaction with any of the closely related steroids. All the homologous combinations appeared to be less sensitive due to their low affinity for dehydroepiandrostosterone. Out of six heterologous systems tested, only three combinations, (1) anti-DHEA-17-CMO antiserum and DHEA-7-CMO-horseradish peroxidase, (2) anti-DHEA-7-CMO-antiserum and DHEA-3-HS-horseradish peroxidase, and (2) anti-DHEA-3-HS-antiserum and DHEA-7-CMO-horseradish peroxidase, showed displacement. The former two assays were less specific; the first one showed 15.38% and 16.66% cross-reaction with androstenediol and testosterone, respectively, whereas the second assay showed 30.3%, 22.72%, 111.1%, 62.5%, and 31.25% cross-reaction with DHEA-glucuronide, 16-dihydroxyprogesterone, androstenediol, etiocholon-3-β-ol-17-one, and aldosterone, respectively. The ability of DHEA to displace the DHEA-enzyme conjugate and the specificity of the assay appear to depend on the position of the enzyme label on the DHEA molecule as well as on the availability of antigenic sites in particular combinations of antibody and DHEA-enzyme conjugates.

Performance Characteristics of a Novel Tandem Mass Spectrometry Assay For Serum Testosterone

Background: Commercial immunoassays for testosterone (Te) may give inaccurate results for samples from women and children, leading to misdiagnosis and inappropriate treatment. We developed a sensitive and specific tandem mass spectrometric assay for measurement of Te at the concentrations encountered in women and children.

Methods: Te was extracted with methyl tert-butyl ether from 100 μL of serum or plasma, derivatized to form an oxime, and reextracted by solid-phase extraction. Instrumental analysis was performed on an API 4000 HPLC tandem mass spectrometer in the multiple-reaction monitoring (MRM) mode. The MRM transitions (m/z) were 304→124 and 304→112 for Te and 307→124 and 307→112 for d3-Te.

Results: Within- and between-run CVs were <12% and 7.9%, respectively. The limit of quantification was 0.0346 nmol/L (1 ng/dL). Reference intervals for sex hormone–binding globulin and total, free, and bioavailable Te were established for children of Tanner stages 1 through 5 and adult males and females.

Conclusions: The sensitivity and specificity of the method are adequate for analysis of Te in samples from women and children. The method requires small sample volumes, has adequate precision, and is not subject to interferences.