Clinical evaluation of immunoinhibition determination of creatine kinase B subunits in coronary care.

1983 ◽  
Vol 29 (2) ◽  
pp. 353-355 ◽  
Author(s):  
J Booth ◽  
P J McCarthy ◽  
R N Walmsley

Abstract One hundred patients with chest pain of cardiac origin were evaluated on the basis of clinical findings, electrocardiograph results, and total creatine kinase (CK) and creatine kinase B-subunit (CK-B) activity (as determined by immunoinhibition with the Boehringer CK-MB kit) in serum. All patients diagnosed as having had an acute myocardial infarction had increased values for both CK-B and total CK. In no case was normal total CK activity associated with an increased CK-B, nor was normal CK-B associated with an increased total CK. During collection of data for reference ranges, we found 10 patients who had no evidence of cardiac disease but had various other diseases, who exhibited high values for CK-B in serum; four of these had normal values for total CK. We conclude that estimations of CK-B in serum by this method added no more diagnostic information than did data on total CK in the evaluation of chest pain.

1980 ◽  
Vol 26 (7) ◽  
pp. 861-866 ◽  
Author(s):  
H A Homburger ◽  
G L Jacob

Abstract We compared, in 116 patients, the relative usefulness of results of tests for creatine kinase B isoenzymes, as measured by radioimmunoassay, and the MB isoenzyme, as measured by electrophoresis, in diagnosis of acute myocardial infarction. The radioimmunoassay was specific for isoenzymes of creatine kinase containing the B subunit. All patients with acute transmural infarcts had positive test results by both techniques, but concentrations of B-isoenzymes were more frequently above normal than were MB bands in the case of patients with acute subendocardial infarcts and in the case of all patients with acute myocardial infarcts from whom sera were collected more than 24 h after onset of chest pain. Concentrations of B-isoenzymes also were increased, even when MB bands were not electrophoretically detectable, in specimens from several patients without documented actue myocardial infarcts. These abnormal results presumably were caused by increased concentrations of the BB isoenzyme in serum. Accordingly, an increased concentration of B-isoenzymes had less diagnostic specificity and predictive value for acute myocardial infarction than did a detectable MB band. Results of isoenzyme electrophoresis were more reliable for establishing this diagnosis, but the results of radioimmunoassay were more reliable for excluding it in patients with chest pain as the primary symptom.


1980 ◽  
Vol 26 (1) ◽  
pp. 78-83
Author(s):  
H A Homburger ◽  
L Wold ◽  
G L Jacob ◽  
J O'Brien

Abstract Metastable creatine kinase MM isoenzyme was isolated and partially purified from homogenates of myocardium and skeletal muscle by gradient elution on carboxymethyl cellulose. This variant isoenzyme migrated between the MM and MB isoenzymes on agarose electrophoresis, accounted for 3.5% of the total creatine kinase activity in each tissue, was not a macromolecule, and had stable electrophoretic mobility only in borate buffer (0.02 mol/L). By comparison, the creatine kinase isoenzymes with similar "atypical" electrophoretic mobility in serum specimens were complexes of the BB isoenzyme and immunoglobulin G. These complexes were measured by a radioimmunoassay specific for the creatine kinase B-subunit and eluted predominantly with the MB isoenzyme in a commercial anion-exchange reagent system.


1979 ◽  
Vol 12 (6) ◽  
pp. 214-215 ◽  
Author(s):  
A. Lundin ◽  
W. Gerhardt ◽  
K. Lindberg ◽  
T. Lövgren ◽  
R. Nordlander ◽  
...  

1982 ◽  
Vol 28 (8) ◽  
pp. 1796-1796
Author(s):  
Steven D Stroop ◽  
Gerard Helinek ◽  
Harry L Greene

Abstract Vol. 28 p 79: See response in Letter of Cornelisand Versieck, p 1709. p 91: In the note added in proof, "131" should read "1.31." p 241: In Table 1, "6.5" should read "65"; in the footnote to Table 2, "0.05" should read "0.5" and the next to last paragraph should read: "Finally, in a few instances we have compared the glucose values obtained by using a drop of sample according to the instructions, versus dipping the strips into the sample, and found some variance between the values obtained by the two methods." p 344: Under "staining reagent," the correct concentration of orthophosphoric acid is 160 g/L (not 80 g/L). It is prepared by diluting 95 mL of the concentrated acid (850 g/kg, relative density 1.69 g/mL) to 1 L with distilled water. p 418: ref. 94, cited in the first full paragraph, should read "84." p 419: The volume number of ref. 1 should be 50, not 19. p 502: Corrections to two equations: the term (S2y - S2x) should read (S2y - S2x)2 and in the third equation in the second column delete the repetition of the term "(wx4)," which should only appear once. p 531: In last full paragraph in column one, the word "propionate" in the next to last line should instead read "dimethyl sulfoxide." p 614: References 21 and 22 are missing 21: Gerhardt, W., Ljungdahl, L., Borjesson, J., et al., Creatine kinase B-subunit activity in human serum. I. Development of an iminunoinhibition method for routine determination of S-creatine kinase B-subunit activity. Clin. Chim. Acta78, 29-41 (1977). 22: Neumeier, D., Prellwitz, W., Wurzburg, U., et al., Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity: Activity kinetics and diagnostic significance in myocardial infarction. Clin. Chim. Acta73, 445-451 (1976). p 727: With regard to this Letter, the authors later pointed out that although the first sentence states that glycosylated hemoglobins have a higher isoelectric point, glycosylation actually decreases the isoelectric point. Later (p 728) they speculated that the fast hemoglobin variant might be HbN-Baltimore (α2β295Lys→Glu), but two reference laboratories identified it as the slightly slower HbJ-Baltimore (α2β216Gly→Asp). p 735: In the middle column, the third full paragraph, "Department of Internal Medicine" should read "Department of Laboratory Medicine." p 736: In column one, under Awards, the citation should have stated "in recognition of his contribution in the, field of clinical chemistry." p 1199: Table 1 folate concentrations should be "mg/L," not rg/L.


1979 ◽  
Vol 25 (7) ◽  
pp. 1274-1280 ◽  
Author(s):  
W Gerhardt ◽  
J Waldenström

Abstract Creatine kinase (EC 2.7.3.2) B-subunit activity in serum may be routinely measured as residual activity after specific immunoinhibition of the M-subunit. We assessed the inhibition kinetics, specificity, completeness of inhibition, and inhibitory capacity of three different anti-M preparations, with use of isolated human BB, MM, and MB isoenzymes. The Scandinavian-recommended reaction system was used. We suggest a set of tentative quality requirements for anti-M for use in diagnosing acute myocardial infarction. The need to measure and subtract sample residual adenylate kinase activity was demosntrated. We describe a routine photometric method for determining B-subunit activity in serum. With the Scandinavian CK method the upper reference value for total creatine kinase in serum was found to be 150 U/L for women, 270 U/L for men. By bioluminescence, we found the upper reference value for B-subunit activity to be 6 U/L for both sexes. We discuss three different modes for applying B-subunit determinations to the diagnosis of acute myocardial infarction.


1984 ◽  
Vol 30 (1) ◽  
pp. 42-45 ◽  
Author(s):  
I Docherty ◽  
J S Harrop ◽  
K R Hine ◽  
M R Hopton ◽  
H L Matthews ◽  
...  

Abstract Changes in values for myoglobin, total creatine kinase (EC 2.7.3.2), and creatine kinase B-subunit in the serum of patients with thyroid disease are compared with values for these during the 24-h after myocardial infarction. Concentrations of all three of these muscle-derived proteins were significantly higher than normal in patients with primary hypothyroidism, and declined with treatment. Values for total creatine kinase activity were below-normal in hyperthyroid patients, but increased after treatment. Values for total creatine kinase and, to a lesser extent, myoglobin in hypothyroidism extend into the range of values observed after myocardial infarction. The mechanism of the changes in these analytes in hypothyroidism may be related to increased leakage from skeletal-muscle cells or diminished clearance from the circulation, or both.


1983 ◽  
Vol 29 (7) ◽  
pp. 1411-1414 ◽  
Author(s):  
P V Whelan ◽  
H Malkus

Abstract Activity of creatine kinase B subunit, as measured by an immunoinhibition assay, is persistently increased in certain healthy, asymptomatic adults, whose values for total CK activity are within normal limits. Serum samples from two such individuals were investigated by electrophoresis, heat inactivation, determination of activation energies, and immunosorption (on protein A). The results demonstrated the presence of a circulating complex of IgG and CK-BB, which has been described as macro CK, type I. To our knowledge, this is the first report of such macro CK isoenzymes in healthy individuals.


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