Definition

Alpha-fetoprotein (AFP, AFPD, FETA, HPalpha fetoprotein, α-fetoprotein; also sometimes referred to as alpha-1-fetoprotein, alpha-fetoglobulin, or alpha fetal protein) is a protein that in humans is encoded by the AFP gene. Alpha-fetoprotein (AFP) is a protein normally produced by the fetal liver, found in the fluid surrounding the fetus (amniotic fluid) and enters the mother's bloodstream through the placenta. It is a protein that is normally produced by the liver and yolk sac of a developing baby. AFP levels drop shortly after birth. Usually not found in healthy adults. After the age of 1, AFP production is almost zero. Because alpha-fetoprotein (AFP) is produced by the fetus, AFP levels are usually elevated in pregnant women. AFP is uncommon in adult blood. In men and women who are not pregnant, elevated AFP levels may indicate liver or ovarian or testicular cancer. Non-cancerous diseases can also cause elevated AFP levels.

Fig. 1 Neural tube defect and role of estimation of maternal alpha-fetoprotein

The structure of AFP is not fully resolved, and the structure predicted with alphafold is plotted as follows:

Fig. 2 alphafold predicted structure of AF-P02771-F1

Function

AFP in maternal amniotic fluid or maternal plasma AFP can be used for prenatal fetal monitoring: This test is a routine screening test recommended for expectant mothers at 14~22 weeks of gestation. It is vital to note that the AFP test is the most accurate at 16~18 weeks; therefore it is important for the pregnant woman to know the exact date of conception. For example, in neural tube defects, spina bifida, anencephaly. AFP can enter the amniotic fluid from the open neural tube, resulting in a significant increase in its amniotic fluid content. Intrauterine death, teratoma and other birth defects can also have increased AFP in amniotic fluid.

Role of AFP as a predictive in HCC: AFP is one of the most widely used tumor markers based on its use to screen for malignancy and prenatal abnormalities. A high level of AFP might mean the liver cancer. However, AFP is also elevated when there is an active liver disease but no cancer. Usually, AFP testing needs to be interpreted by a doctor in conjunction with an ultrasound or CT scan of the liver. AFP is mainly seen in liver cancer and germ cell tumors of the testes or ovaries, and is rare.

AFP as a prognostic factor in HCC: Elevated AFP serum levels are associated with a poorer prognosis in HCC, and serum AFP concentrations ≥400 ng/mL consistently denote poorer prognosis in different clinical settings. High serum AFP levels predict the risk of tumor recurrence after hepatectomy, the risk of loss awaiting liver transplantation, and the risk of tumor recurrence after liver transplantation.

Application

The measurement of alpha-fetoprotein (AFP) is commonly employed in two clinical settings. First, it is measured by the analysis of the pregnant woman's blood or amniotic fluid as a screening test for certain developmental abnormalities, such as aneuploidy. Second, serum AFP levels are elevated in some tumor people, so it is used as a biomarker to track these diseases.

In clinical laboratories, AFP is used as a postoperative tumor marker and a marker of fetal defects associated with gestational age, showing utility in screening for neural tube defects. Similar to albumin, serum AFP binds to and transports a variety of ligands such as bilirubin, fatty acids, retinoids, steroids, heavy metals, dyes, flavonoids, phytoestrogens, dioxin, and various drugs. The most important application of AFP testing in tumor management is testicular cancer. Elevated serum AFP is strongly associated with the development of non-seminomatous testicular cancer, but not in seminoma. Serum AFP testing can be used as an effective surveillance tool in people with non-seminomatous testicular cancer.

-- When used with other tests, it helps confirm or rule out cancer.

-- Predict how cancer will change over time.

-- Monitor cancer treatment. AFP levels usually rise if cancer is developing, and drop when treatment is effective.

-- Check for cancer recurrence after treatment.

Advantage

An AFP test helps doctors determine if women are at a greater risk of having a baby with a congenital disability. The purpose of this screening test is to determine the increased risk of a pregnant woman having a baby with a birth defect. A positive result will indicate the need for additional prenatal testing. This is a relatively inexpensive screening test that is available to all pregnant women.

Alpha Lifetech Inc. is dedicated to developing α-fetoprotein (AFP) diagnostic regents. Alpha Lifetech Inc. is a reputable supplier focusing on research, manufacture and sales of In Vitro Diagnostic (IVD) regents. All the IVD regents offered by Alpha Lifetech Inc. have undergone strict QC validation and are certified by the COA (certificate of analysis). Meanwhile, we can provide customized services according to customers' requirements. Alpha Lifetech Inc. is committed to supply high-quality, high-sensitivity antigen and antibody products for scientific research and industrial customers. In addition to regular small packages, Alpha Lifetech Inc.'s large-scale fermentation platform also allows us to provide raw material-grade IVD regents for the majority of industrial customers.

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