Creatine kinase BB isoenzyme levels by radioimmunoassay in patients with neurological disease

Bell, Rodney; Rosenberg, Roger N.; Ting, Ruby; Mukherjee, Amal; Stone, Marvin J.; Willerson, James T.

doi:10.1002/ana.410030108

Cited by 71 publications

(21 citation statements)

References 56 publications

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“…An elevated total CK activity and a small increase of CK-MB activity was re ported by Prellwitz [8] in a group of 8 epilep tic patients, but no clinical details were men tioned. The contrast between these previous studies [6,8] and our results may be due to differences in the patient's condition.…”

Section: Discussioncontrasting

confidence: 99%

“…Bell et al [6] reported an ele vated CK-BB activity in 9 patients with sei zures followed by 'prolonged alteration of consciousness'. This finding was thought to reflect either an altered metabolic condition or ischaemic changes of neurones as a result of the prolonged impairment of conscious ness.…”

Section: Discussionmentioning

confidence: 99%

“…Some data given in the literature for mul tiple sclerosis indicate that, in a limited number of cases, CK-B levels are mildly ele vated [6][7][8], However, in these reports no systemic investigation of these conditions has been carried out and, in addition, it should be noted that usually the results are evaluated under the aspect of an elevation and not of a decrease.…”

Section: Discussionmentioning

confidence: 99%

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Serum Creatine Kinase B Levels in Diseases of the Central Nervous System

Vassilopoulos¹,

Jockers-Wretou²

1987

Eur Neurol

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The creatine kinase B (CK-B) subunit was determined by our own highly sensitive solid-phase direct immunoassay in three neurological diseases which represent models of central nervous system (CNS) involvement: (1) idiopathic epilepsy (18 patients), a disease characterised by a transient neuronal hyperactivity; (2) Parkinson’s disease (17 patients), a degenerative disorder of the CNS, and (3) multiple sclerosis (21 patients), which represents a model of demyelination of the CNS. A group of 50 controls was also studied. The results showed that in patients with epilepsy and multiple sclerosis the CK-B activity was considerably lower than in the controls (p < 0.01 and p < 0.005, respectively), while no differences were found between the controls and the patients with Parkinson’s disease. It is suggested that the low CK-B activity observed might be due to the medication taken or to the disease process itself. The present findings have to be considered as an indication for further CK isoenzyme studies in systematic disorders of the nervous system.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Serum Creatine Kinase B Levels in Diseases of the Central Nervous System

Vassilopoulos¹,

Jockers-Wretou²

1987

Eur Neurol

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“…While BB-CPK isoenzyme levels have been report ed elevated in patients with acute cerebrovascular acci dents, 22 no correlation was found between isoenzyme levels and CNS complications in this study. Normally, no BB-CPK is found in human serum.…”

contrasting

confidence: 75%

Central nervous system complications of coronary artery bypass graft surgery: prospective analysis of 421 patients.

Breuer¹,

Furlan²,

Hanson³

et al. 1983

Stroke

293

103

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SUMMARY A prospective analysis of 421 patients undergoing coronary artery bypass graft (CABG) surgery as the sole cardiac procedure was carried out to assess the frequency of central nervous system (CNS) complications. In all, 451 variables were assessed in each patient. Stroke occurred in 5.2% but was severe in only 2%. Prolonged encephalopathy occurred in 11.6% but usually resolved before discharge. No statistically significant pre-or intraoperative risk variables for CNS complications were found; specifically, age or pump times in excess of two hours were not significant factors. Postoperative use of an ihtraaortic balloon pump and pressor agents were significantly correlated with prolonged encephalopathy. The fre quency of CNS injury in CABG surgery is similar to that in other forms of open heart surgery, and there has been little change in the frequency of CNS complications over the past seven years. there is little information on the neurologic difficulties encountered in patients undergoing myocardial revascularization as the sole heart procedure. [16][17][18][19] The extensive experience with myocardial revascularization at the Cleveland Clinic (over 2,000 procedures are performed annually) afforded us an opportunity to study a consecutive series of patients undergoing CABG surgery. The results of this computer-assisted prospective analysis with refer ence to central nervous system (CNS) complications form the subject of this report. Peripheral nervous sys tem complications are reported elsewhere. Each patient underwent a detailed neurologic histo ry and examination prior to surgery and one or more times afterward beginning on the fourth postoperative

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“…1 Since then, the CKBB isoenzyme has been used as a marker for central nervous system damage and as a prognostic indicator following head trauma, 2 ' 3 cardiopulmonary arrest and resuscitation 4 -5 cardiopulmonary bypass surgery, 67 acute stroke, 8 and neonatal paraventricular hemorrhage. 9 These studies utilized various assay techniques including enzymatic, electrophoretic, fluorometric and radioimmunoanalytic.…”

mentioning

confidence: 99%

Quantification of cerebral infarct size by creatine kinase BB isoenzyme.

Bell¹,

Alexander²,

Nguyễn³

et al. 1986

Stroke

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SUMMARY Creatine Kinase BB isoenzyme (CKBB) has been shown to rise in the serum and CSF following acute cerebral injury. To test the hypothesis that brain infarct size could be estimated from the appearance and disappearance of CKBB in the serum and CSF, strokes of varying size were produced in twelve mongrel dogs by silastic emboU. The rate of disappearance, Kd of CKBB ( -.00732 ± 0.001 min" 1 mean ± SE, N = 8) was determined by injecting punned CKBB (25 IU) intravenously then measuring its disappearance. Following the embolk stroke, serum samples were taken hourly for 24 hours and then at intervals for up to 160 hours for measurement of CKBB by radioimmunoassay until the animals were sacrificed. The brains were then removed, fixed in formalin, cut in 2 mm sections and photographed. The area of the mfarct was measured using high pad digitizer interfaced with an Apple computer. The infarct size was then calculated from the area and thickness. Using a one-compartment mathematical model, the infarct size was estimated from the amount of CKBB appearing in the serum, the Kd of CKBB, and the amount of CKBB depleted from tissue. The computed infarct size correlated well (r = 0.94) with the measured infarct size. This model may have value in testing therapeutic modalities in the intact animal. Stroke Vol 17, No 2, 1986 WE DESCRIBED A RISE in serum and cerebrospinal fluid (CSF) of Creatine Kinase BB (CKBB) isoenzyme as measured by radioimmunoassay following acute brain injury.1 Since then, the CKBB isoenzyme has been used as a marker for central nervous system damage and as a prognostic indicator following head trauma, 9 These studies utilized various assay techniques including enzymatic, electrophoretic, fluorometric and radioimmunoanalytic. 2~9 In addition, recent studies using immunohistologic methods have shown that CKBB is present in astrocytes and neurones. 10 This observation makes it likely that a rise in CKBB reflects damage to central nervous system tissue without reference to a particular anatomic area.Creatine Kinase MB (CKMB) depletion in myocardium and its appearance in the serum has been used in mathematical models to estimate myocardial infarct size."" 14 With the advent of more sensitive radioimmunoassays to detect the CKBB enzyme in the serum and CSF, it seemed possible that similar methods could also be used to quantify cerebral infarct size noninvasively. If this is possible, this methodology would lend itself to testing of various therapeutic modalities for the reduction of cerebral infarct size. Therefore, we developed a sensitive radioimmunoassay for canine CKBB, an embolic stroke model in the dog, and a mathematical model for estimating the amount of tissue necrosis. Methods Radioimmunoassay Development/. Isolation of Dog CKBB Dog CKBB was purified using methods modified from Roberts." l6 Brains from dogs that were sacrificed for other experiments involving other organ systems were immediately removed, frozen in liquid nitrogen, and stored at -70°C. The dog brain (150-175 g) was thawed at 4°...

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Creatine kinase BB isoenzyme levels by radioimmunoassay in patients with neurological disease

Cited by 71 publications

References 56 publications

Serum Creatine Kinase B Levels in Diseases of the Central Nervous System

Serum Creatine Kinase B Levels in Diseases of the Central Nervous System

Central nervous system complications of coronary artery bypass graft surgery: prospective analysis of 421 patients.

Quantification of cerebral infarct size by creatine kinase BB isoenzyme.

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