Alpha-fetoprotein: Functions & Clinical Application

Alpha-fetoprotein (AFP) has many applications across various disciplines. This oncofetal protein is routinely used by clinicians for antenatal testing as well for the screening and treatment monitoring of certain malignances. Innovative research using AFP has also been very promising. Recent developments include the use of AFP or its recombinant fragments for drug delivery to cancer cells, as well as for the engineering of cancer vaccines and T cell immunotherapies. The anti-estrogenic potential of AFP has also been utilised to develop drugs directed against estrogen receptor positive malignancies. This book is divided into five sections. In Section One, the history of AFP is recollected, and the role of AFP in normal and pathological conditions is explored. Section Two and Three focus on the utility of AFP during pregnancy. In Section Two, the use of routine maternal serum AFP screening for detection of chromosomal aneuploidies and neural tube defects in normal pregnancies and pregnancies with pre-existing disease is discussed; the potential use of AFP for the detection of preeclampsia is also reviewed. Section Three explores the pathogenesis and data linking unexplained elevations of AFP to adverse obstetrical outcomes. Section Four presents chapters that discuss AFP ligand binding, receptor targeting, and drug delivery strategies. Finally, Section Five serves to explain the regulatory roles of AFP, its use in immunotherapy, and in the development of cancer vaccines. The aim of this book is to bring together some of the great research and clinical insights that currently surround AFP. The target audiences for this book are basic science researchers as well as clinicians. About the Author Nisha A Lakhi, M.D. is a board certified Obstetrician and Gynecologist with extensive background in both basic science and clinical research. As an undergraduate and medical student, she worked in a research laboratory at The Ohio State University, Columbus, Ohio, developing and synthesizing compounds to selectively target tumor cells for use in Boron Neutron Capture Therapy. Dr.Lakhi completed her residency in Obstetrics and Gynecology at the New York Medical College/Richmond Program, followed by a fellowship, with specialized training in minimally invasive surgery, at Atlanta Gynecologic Oncology, Northside Hospital. During fellowship, she worked extensively with the Da Vinci surgical robotic system, and conducted clinical studies on the use of the Da Vinci robot for the staging and treatment of ovarian cancer and advanced stage uterine malignancies. Following completion of her fellowship, she joined the faculty of Richmond University Medical Center in Staten Island, New York, where she is the Director of Research, as well as a practicing clinician and an educator. She has served as the principal investigator of multiple studies within the institution. She regularly presents her data in peer reviewed journals and at several national and international conferences. Some of her research interests include oxidative stress in pregnancy, pregnancy complications, treatment of gynecological malignancies, and minimally invasive surgery.