macroprolactin


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macroprolactin

A large (±100-kD), noncleaved, physiologically inactive form of prolactin, which is bound to IgG and interferes with immunoassays.
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4,5) Prolactin can be found in the circulation in one of three isoforms based on its molecular weight: monomeric PRL (small PRL; molecular weight 23 kDa), dimeric PRL (medium PRL; molecular weight 50-60 kDa), and polymeric PRL [large PRL/ macroprolactin (maPRL); molecular weight 150-170 kDa).
Macroprolactin is particularly troublesome because it cross-reacts with biologically active monomeric prolactin in all immunoassays.
The presence of macroprolactin is common and it should be excluded in all samples where elevated prolactin levels are incongruous with the clinical picture.
Conclusion: We recommend PEG precipitation test as a simple, convenient and rapid screening method for macroprolactinemia, specially for users of Elecsys 2010 immunoanalysers, because this system has high reactivity to macroprolactin.
They demonstrated the bioactivity of macroprolactin component in vitro and suggested that the absence of in vivo bioactivity might be the result of the high molecular mass of the complex preventing passage through the capillary endothelium to its target cells (4).
Big prolactin (60 kDa) and macroprolactin (150 kDa), which are present in serum in varying quantities, can cause apparent hyperprolactinemia, but they have no clinical importance because they exhibit little biological activity.
These include a monomer with a molecular mass of 23 kDa, which accounts for approximately 85% of PRL present in normal individuals, a 50 kDa species accounting for 10% to 15% of total PRL, and a small but variable amount of a high molecular mass form (150-170 kDa) termed "big big" prolactin or macroprolactin (1-5).
The most common form in healthy persons and in most patients with hyperprolactinemia is a monomeric prolactin (Mr 23 000), but higher molecular mass forms such as big prolactin (Mr 60 000) and big-big prolactin, or macroprolactin (Mr 150 000), sometimes predominate (1-4).
The 3 major forms of serum prolactin (PRL), identifiable by gel-filtration chromatography (GFC), are monomeric PRL (23 kDa), big PRL (45-60 kDa), and big, big PRL or macroprolactin (150-170 kDa) (1).