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Speaking of PSA, what organ removes it from your blood?

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Posted 7/22/2011 12:46 AM (GMT 0)
We have all this talk about PSA, but I have never read anything on how PSA is removed from your blood.  Obviously, something removes it because when your prostate is taken out your PSA goes down after time.  So here is my question, what organ does this and what does wash out of different people at different rates? 

Let's say two guys have PCa that just happen to produce PSA at the exact same rate, whatever that may be, but their bodies filter PSA at different rates.  Would this not give the appearence of a faster PSA velocity in one person then the other, even though the tumor growth rate is exactly the same in both guys?   

Also, if PSA is constantly being removed from your blood as it is being produced and your body does not clear the PSA at the same rate as someone else, over time you would appear to have a higher PSA then your counter part, but you have the same tumor volume.  

So it seems that there is some question as to the value of PSA and PSA velocity if everyones body filters PSA at different rates?

Sometimes I stay up too late thinking about this crap.

Any comments? 

Post Edited (ChrisR) : 7/21/2011 6:50:01 PM (GMT-6)

Posted 7/22/2011 12:55 AM (GMT 0)
It's not in the urine so I eliminate kidneys. I believe is the liver as that is usually one of the organs that usually shows lesions and many prostate cancer patients die of hepatic failure.

But it's only an educated guess...

Tony
Posted 7/22/2011 1:00 AM (GMT 0)
I believe the liver ends up with a lot of different cancers, due to the fact that all of the blood in your body runs through it all the time, but Tony you may be correct about the liver. It does filter a lot of waste. This might be a good question for Mike at Prostate Info. Link.
Posted 7/22/2011 1:00 AM (GMT 0)
There are no bad questions IMO but you may want to access some reading material seen in the upper part of this site. There isn't any organ that filters PSA as it is a test for Prostate Specific Antigen only produced by the prostate gland.
Posted 7/22/2011 1:09 AM (GMT 0)
O.K. I probably should have just looked this up.  Here is what I think. It is our immune system.

Antigen
A toxin or other foreign substance that induces an immune response in the body, esp. the production of antibodies

Antibodies
A blood protein produced in response to and counteracting a specific antigen. Antibodies combine chemically with substances that the body recognizes as alien, such as bacteria, viruses, and foreign substances in the blood.

So, when your body detects "Prostate Specific Antigen" your immune system produces "antibodies" that couteract the "antigen" and neutrizes it from your blood.

I guess if you have a weak immune system it will take longer to remove the antigen......

Post Edited (ChrisR) : 7/21/2011 7:20:25 PM (GMT-6)

Posted 7/22/2011 1:10 AM (GMT 0)
Now I'm almost 100% sure...

www.fca.com/articles/UP164.html

This article shows a condition in the liver ~ hepatitis ~ causes elevated PSA. I know that a liver with hepatitis is usually not working well. It makes sense that PSA would then increase...

Mike's email is [email protected]. If you write him let him know I tried Yorkshire Pudding finally and I still will never use British and Cuisine in the same sentence.

To all our Anglo friends here please allow me this one jab. Mike Scott is a brilliant mind who moved to the states years ago and regularly receives abuse from me...

Tony
Posted 7/22/2011 1:12 AM (GMT 0)
Yep I like that answer. But I think the liver removes the toxin thus lowering the PSA...

Tony
Posted 7/22/2011 1:19 AM (GMT 0)
Tony,

I by no means am anything close to a medical science type person. I am sure you are probably correct as well and it is a combination of things........
Posted 7/22/2011 1:27 AM (GMT 0)
I think the liver would be the only potential organ that could do that, its a good question you came up with, never heard that asked before.

tony - with a british mother, i grew up all my life with Yorkshire Pudding, taste great for sure if made properly.

david
Posted 7/22/2011 1:35 AM (GMT 0)
David,
I can't say publicly that I liked it because it would ruin a long standing exchange that Mike and I have been having now for more than three years now...But since he never checks in here I will say it wasn't as bad as I make it sound...

Another potential participant is the spleen (for lowering PSA not upgrading Yorkshire Pudding) . This organ is part of our immune system and it works with antigens. After reading more about it, it can indeed be the first filter that segregates toxins and sends them to the liver...

Tony
Posted 7/22/2011 1:48 AM (GMT 0)
Chris this can end up being like that song you don't really like but can't get out of your head.

I am getting ready to head to the NoCal Redwoods tomorrow...I have a four hour drive from Oakland to Willits. I hope all I am thinking about is wine country and not how PSA lowers in the body...;-)

Tony
Posted 7/22/2011 3:00 AM (GMT 0)

wikipedia said...
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion.
This organ plays a major role in metabolism and has a number of functions in the body, including glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification.

I would think that the Liver would remove PSA, being an undesirable, that would otherwise just keep building and building.. and so - Liver-Failure could present as a rising PSA along with all the other problems.

I'de be making sure the WILL was current were that the case..idea
Posted 7/22/2011 4:21 AM (GMT 0)
Here is the answer:

www.ncbi.nlm.nih.gov/pubmed/8632567?dopt=Abstract&holding=npg

PSA is a glycoprotein, and is too big a molecule to be filtered by the kidneys. It is metabolized (broken down) in the liver.

Here is one study that showed that the rate of PSA elimination is similar in Caucasians and African Americans:

www.nature.com/pcan/journal/v5/n2/full/4500567a.html

Post Edited (Postop) : 7/21/2011 10:25:01 PM (GMT-6)

Posted 7/22/2011 5:15 AM (GMT 0)
Thanx Postop.
I knew you would have some excellent insight. I think this is perhaps why hepatic failure caused by prostate cancer is a top cause of death in prostate cancer mortality (however I am unable to find that paper I saw).

Shoulda stuck to my guns. Stupid spleen.

Tony
Posted 7/22/2011 12:37 PM (GMT 0)
I went a different route and had the doctor give me all new blood while he was removing the prostate. smilewinkgrin
Posted 7/22/2011 2:04 PM (GMT 0)
I would put forward a slight modification of Postop’s response which was based on a 1996 study which concluded with this statement that “ the liver appears to be the most likely site of its metabolism .” [underlining added by me to emphasize the uncertainty at the time]   Since that time, others have reported more granular results to this very interesting question…interesting because it turns out that the elimination for free and complexed PSA components are not the same based on the understanding that the cPSA has a molecular weight which is 2-3x greater than the fPSA. fPSA (with a weight similar to other proteins/albumin) is filtered by the kidney (so you pee it out).   The cPSA is too large for glomerular filtration (circulation in the kidney) and instead undergoes hepatic metabolism, which is chemical degradation process in the liver . One of the scientific findings, as previously reported in numerous threads about measurement after RP, is that the total PSA (tPSA) half-life is typically 2-3 days…but because of the completely different elimination kinetics, the fPSA half-life through the kidneys has been separately measured to be only about 110 minutes.   The tPSA, of course, consists of fPSA+cPSA. Postop’s 2nd article link makes this same conclusion in 2002 with this statement from the Discussion portion, “ Several researchers found that the liver is the most likely site of metabolism for conjugated PSA, while the kidney excretes most of the free PSA .”
Posted 7/22/2011 3:45 PM (GMT 0)
Yeah, I saw those articles, too. Some protein do leak out into urine, especially if they have a molecular weight <15,000. Protein in your urine make it foamy. How much depends on how good your kidney function is. Kidney disease can make more and bigger proteins leak out, so really foamy urine is a sign of kidney disease.

Free PSA has a molecular weight of about 28,000:

www.novatec-id.com/products/tumor-markers/free-psa/

That's sort of borderline for renal excretion if someone has good kidney function...if it's bound to other proteins, then it's really big and really can't get out until the liver chews it up.
Posted 7/22/2011 6:36 PM (GMT 0)
Postop,

That was an intersting post. Didn't know that about the foamy urine, will keep that in the back of my mind.

david
Posted 7/22/2011 8:22 PM (GMT 0)
Yes, so if one's urine is foamy, it's not from drinking beer . . .
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