Serum creatine kinase isoenzyme pattern in nervous system atrophies and neuromuscular disorders

Jockers-Wretou, Evangelia; Grabert, Kathleen; Müller, Erich; Pfleiderer, G.

doi:10.1016/0009-8981(76)90322-3

Cited by 27 publications

(9 citation statements)

References 8 publications

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“…The data were obtained by immunotitration (5). On the basis of the present results, complexing of creatine kinase-BB with immunoglobulins might also have caused the stability of creatine kinase-BB in that case.…”

Section: Discussionsupporting

confidence: 50%

“…Creatine kinase isoenzyme measurements were done by the immunotitration assay developed in this laboratory and modified as reported previously (4,5), using purified IgG from sheep antisera against human creatine kinase-MM and creatine kinase-BB (Merck, Darmstadt). Creatine kinase-BB activity in column eluates was assayed by the immunoinhibition test "CK-MB, NAC activated" (Merck).…”

Section: *I Qnnnnrteh Hv the Deutsche Forschungsgemeinschaftmentioning

confidence: 99%

“…Crystalline creatine kinase-MM from human muscle was purified as reported previously (4 Immunological techniques: Double diffusion, immunoelectrophoresis and two dimensional "rocket" immunoelectrophoresis were carried out on agarose gels (8 g/l) according to the corresponding techniques by Ouchterlony (9), Grabar (10) and Laurett (11). The agarose plates were washed twice in 9 g/l NaCl and stained for creatine kinase activity as described for the electropherograms.…”

Section: Creatine Kinase Isoenzymesmentioning

confidence: 99%

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Atypical Serum Creatine Kinase Isoenzyme Pattern Caused by Complexing of Creatine Kinase-BB with Immunoglobulins G and A

Jockers-Wretou¹,

Plessing²

1979

Clinical Chemistry and Laboratory Medicine

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In commemoration of Professor Dr. Gabor SzaszSummary: 12 cases are described, which show high serum creatine kinase-BB levels, as well as atypical creatine kinase activity band located between normally migrating creatine kinase-MM and creatine kinase-MB. It is shown that the altered properties of the serum creatine kinase-BB, namely its molecular size, heat resistance, electrophoretic mobility, but not its immunological behavior, are caused by complexing with kappa-chains of immunoglobulins G or A. The complex occurring in vivo could also be produced in vitro by using purified patients' IgG and human creatine kinase-BB.The interaction of creatine kinase-BB with immunoglobulins possibly protects the enzyme against intravascular degradation in vivo, and may therefore account for the high creatine kinase-BB levels observed in these patients. Atypisches Isoenzymmuster von Kreatinkinase im Serum infolge Komplexbildung von Kreatinkinase-BB mit Immun· globulin G und AZusammenfassung: Es werden 12 Falle beschrieben, die eine erhöhte Kreatinkinase-BB-Aktivität im Serum als auch eine atypische Kreatinkinase-Bande zwischen Kreatinkinase-MM und Kreatinkinase-MB aufweisen. Es wird gezeigt, daß die veränderten Eigenschaften der Serum-Kreatinkinase-BB, nämlich Molekulargewicht, Hitzestabilität, elektrophoretische Mobilität, aber nicht das immunologische Verhalten, auf die Bindung des Enzyms an kappa-Ketten der Immunpglobuline G und A zurückzuführen sind. Der in vivo auftretende Komplex konnte auch in vitro reproduziert werden und zwar mit gereinigtem Patienten-IgG und humaner Kreatinkinase-BB.Die Bindung zwischen Kreatinkinase-BB und Immunoglobulinen schützt möglicherweise das Enzym in vivo gegen intraväsale Degradation und könnte somit die bei diesen Patienten auftretende erhöhte Kreatinkinase-BB-Aktivität hervorrufen.

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Section: Discussionsupporting

confidence: 50%

Section: *I Qnnnnrteh Hv the Deutsche Forschungsgemeinschaftmentioning

confidence: 99%

Section: Creatine Kinase Isoenzymesmentioning

confidence: 99%

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Atypical Serum Creatine Kinase Isoenzyme Pattern Caused by Complexing of Creatine Kinase-BB with Immunoglobulins G and A

Jockers-Wretou¹,

Plessing²

1979

Clinical Chemistry and Laboratory Medicine

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“…However, a release of CK-BB might be possible in different diseases, at least in view of tissue analyses [5]. Additionally one research group working with the immunological method also did find CK-BB activities in one patient with a chronic mental disease [6]. In studies with non-immunological CK-BB measurements significant amounts of this isoenzyme have been found [13,19] confirming the principle considerations made above.…”

mentioning

confidence: 66%

Differential diagnostic importance of the creatine kinase isoenzyme pattern in delirium tremens

et al. 1979

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Total CK and CK-MB (by the inhibition test, Merck-1-CK-MB) were measured in 33 patients which had to be admitted to the department of psychiatry due to acute withdrawal symptoms (predelirium, delirium) caused by chronic alcohol abuse. The results were evaluated together with the routinely performed laboratory determinations as well as clinical examination and morphologic investigations (ECG, X-ray examination of the thorax, EEG, CT). The results show that the CK-MB/total CK relationship represents also in these patients the most reliable parameter to discriminate elevated total CK values. In no but one case a substantial CK-BB release from the central nervous system could be demonstrated by the inhibition test. In 83% of the patients with elevated total CK activities it was possible to exclude an affection of the heart muscle (CK-MB portion below 6%). The CK-MB/total CK-quotient was clearly superior to the total CK/GOT relationship, by which a myocardial affection could be excluded in less than 40%. In four patients the CK-MB portion was above the critical decision limit of 6%: three obtained between 6% and 7%, one even 17%. The results suggest that the CK-MB/total CK-quotient may represent the most sensitive and reliable parameter of myocardial affection in patients with an alcohol intoxication and/or a delirium tremens.

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“…A number of investigators, using conventional methods such as electrophoresis and anion-exchange column chromatography, have reported increased CK-BB in the muscle [ l l , 13, 16, 191 and serum [8,9,13, 141 of patients with D M D and several other neuromuscular disorders. Using RIA, Bell et a1 [ 3 ] found normal serum levels of CK-BB in 2 patients with amyotrophic lateral sclerosis and 1 with myasthenia gravis, and Fang et a1 [6] reported very high concentrations of serum CK-BB in 11 patients with DMD.…”

Section: Discussionmentioning

confidence: 99%

Serum creatine kinase BB and MM concentrations determined by radioimmunoassay in neuromuscular disorders

Zweig

Adornato

Steirteghem

et al. 1980

Annals of Neurology

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We measured the MM and BB isoenzymes of serum creatine kinase (CK) by radioimmunoassay in 89 patients with neuromuscular disorders and 44 definite or possible carriers of Duchenne muscular dystrophy (DMD). The CK-MM isoenzyme was closely associated with total CK enzymatic activity. CK-BB was not as closely correlated with total CK but was usually increased in the inflammatory myopathies and DMD and normal in myasthenia gravis, Guillain-Barré syndrome, and amyotrophic lateral sclerosis as well as in neuropathies in which CK is usually normal. In myopathies, CK-BB may be useful for assessing the level of disease activity or the regenerative component. More study is necessary to assess the role of CK-BB in detection of DMD carriers.

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Serum creatine kinase isoenzyme pattern in nervous system atrophies and neuromuscular disorders

Cited by 27 publications

References 8 publications

Atypical Serum Creatine Kinase Isoenzyme Pattern Caused by Complexing of Creatine Kinase-BB with Immunoglobulins G and A

Atypical Serum Creatine Kinase Isoenzyme Pattern Caused by Complexing of Creatine Kinase-BB with Immunoglobulins G and A

Differential diagnostic importance of the creatine kinase isoenzyme pattern in delirium tremens

Serum creatine kinase BB and MM concentrations determined by radioimmunoassay in neuromuscular disorders

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