Isoforms of creatine kinase MM and MB in acute myocardial infarction: a clinical evaluation

Panteghini, Mauro; Cuccia, Claudio; Malchiodi, Alessandra; Calarco, Marinella; Pagnoni, Nicola

doi:10.1016/0009-8981(86)90093-8

Cited by 31 publications

(4 citation statements)

References 16 publications

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“…4) and the relatively low baseline proportion of the MM isoform from tissue documented previously (11,13), it seems likely that the profile at 0.16 M NaCl represents primarily the M-lys B+lys intermediate. Previous studies of MB isoenzyme modifications have been hampered by the inability to obtain highly purified MB from myocardium (25), by the insensitivity of assays for MB isoforms (28) and because MB is unstable at its isoelectric point leading to denaturation with loss ofactivity. MB purified by our procedure was homogeneous as assessed by SDS-polyacrylamide gel electrophoresis and had a specific activity among the highest reported to date.…”

Section: Discussionmentioning

confidence: 99%

Characterization of MB creatine kinase isoform conversion in vitro and in vivo in dogs.

Billadello¹,

Fontanet²,

Strauss³

et al. 1989

J. Clin. Invest.

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Time-dependent removal of the COOH-terminal lysine residue from each subunit of tissue MM creatine kinase by plasma carboxypeptidase N produces two additional isoforms that are readily separated, thereby permitting sensitive, early detection of acute myocardial infarction. Only two isoforms of MB creatine kinase have been detected in plasma leading to speculation that the COOH-terminal lysine on the B subunit is resistant to hydrolysis. To define the biochemical changes resulting in MB creatine kinase isoform conversion, we incubated highly purified MB creatine kinase from canine myocardium with plasma carboxypeptidase N. Quantitative anion-exchange chromatography of incubation mixtures and serial plasma samples from dogs subjected to coronary occlusion revealed a second, more acidic form evolved with time that was separated from the tissue isoform. Cyanogen bromide digestion of the two isoforms followed by amino acid sequencing of COOH-terminal peptides showed that MB creatine kinase undergoes removal of the COOH-terminal lysine residue from both M and B subunits. An intermediate form lacking lysine on the M subunit was delineated during incubations by the combined use of anion-exchange chromatography and conventional electrophoretic techniques. Thus, sequential cleavage of lysine from subunits of MB creatine kinase produces an intermediate isoform that has not been detected previously because of difficulties separating it from the tissue and fully converted isoforms.

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Section: Discussionmentioning

confidence: 99%

Characterization of MB creatine kinase isoform conversion in vitro and in vivo in dogs.

Billadello¹,

Fontanet²,

Strauss³

et al. 1989

J. Clin. Invest.

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“…Other approaches have been recently suggested, such äs creatine kinase isoform analysis (19), particularly the serum MM3/MM1 ratio, whose alteration is a very early event in acute myocardial infarction patients. However, the use of this approach is limited, since serum creatine kinase isoforms can only be analysed by electrophoresis, isoelectric focusing and liquid Chromatographie methods, which are inadequate for a rapid routine analysis.…”

Section: Discussionmentioning

confidence: 99%

Plasma Myoglobin in the Early Diagnosis of Acute Myocardial Infarction

Ercolini¹,

Forino²,

Basevi³

et al. 1994

CCLM

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Summary: Serum and plasma myoglobin and creatine kinase-MB catalytic activity were analysed in 157 patients admitted within 2 hours of the onset of ehest pain (58 were retrospectively recognized s acute myocardial infarction).Serum and plasma values were highly correlated for both myoglobin and creatine kinase-MB.Plasma myoglobin appared to be more sensitive than creatine kinase-MB for the early diagnosis of acute myocardial infarction; using a cut-off value of 100 μ §/1, 90% of acute myocardial infarction cases were correctly recognized by plasma myoglobin 6 hours after the onset of ehest pain, with a diagnostic specificity of 100% for non-acute myocardial infarction ehest pain subjects. Plasma creatine kinase-MB showed a diagnostic sensitivity of 62% and a diagnostic specificity of 95% in the same group of patients.We suggest the inclusion of the plasma myoglobin immunonephelometric assay together with plasma creatine kinase-MB activity analysis in protocols for the early diagnosis of acute myocardial infarction.

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“…CK hat ein hö heres Molekulargewicht, ist mitochondrial an das kontraktile Muskelsystem gebunden und wird erst bei einem weitergehenden Strukturverlust der Muskeln freigesetzt [19]. Der unterschiedliche Zeitpunkt des Auftretens der Maxima mit MB am ersten postoperativen Tag und dem CK-Gipfel 24 Std spä ter kann in der unterschiedlichen Lokalisation der Proteine begrü ndet sein.…”

Section: Diskussionunclassified

Erfassung regionaler und systemischer Toxizität der isolierten, hyperthermen Extremitätenperfusion mit Tumor-Nekrose-Faktor α und Melphalan

Hohenberger

Haier

Kettelhack

et al. 1997

Chirurg

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Following isolated limb perfusion (ILP) with TNF alpha and melphalan the damage to muscle tissue and its systemic consequences in terms of myoglobinemia and myoglobinuria as well as the activation of the cytokine cascade were investigated. We measured the compartmental pressure of the limb during and after perfusion and determined the serum changes of myoglobin, creatine kinase (CK), interleukin (IL)-6, IL-1, s-IL-2-receptor, TNF-receptor, and ICAM-1 levels. The compartmental pressure rose significantly during ILP and decreased after reperfusion. Following its course, the decision whether to perform a fasciotomy or not can be more reliably made. Serum myoglobin levels exceeded 200 times normal values and the increase occurred significantly earlier than that of CK, thus enabling judgement of the risk of renal failure (crush kidney syndrome). The elevation of serum IL-1 and IL-6 values correlated with the frequency of cardiopulmonary problems (hyperdynamic shock) and facilitated counter-maneuvers. Our data, although obtained from ILP with TNF alpha, could be used to monitor toxicity also when other drug regimens are administered.

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Isoforms of creatine kinase MM and MB in acute myocardial infarction: a clinical evaluation

Cited by 31 publications

References 16 publications

Characterization of MB creatine kinase isoform conversion in vitro and in vivo in dogs.

Characterization of MB creatine kinase isoform conversion in vitro and in vivo in dogs.

Plasma Myoglobin in the Early Diagnosis of Acute Myocardial Infarction

Erfassung regionaler und systemischer Toxizität der isolierten, hyperthermen Extremitätenperfusion mit Tumor-Nekrose-Faktor α und Melphalan

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