Creatine Kinase Isoenzymes

1 Introduction.- 1.1 Creatine Kinase in Muscular Metabolism.- 1.2 Creatine Kinase in Clinical Chemistry.- 1.3 Creatine Kinase Isoenzymes.- 1.4 Scope and Summary of this Book.- 2 Creatine Kinase Isoenzymes.- 2.1 The Cytoplasmic Isoenzymes from Human Tissues.- 2.1.1 Preparation of CK Isoenzymes.- 2.1.2 Properties of CK Isoenzymes.- 2.2 The Mitochondrial Isoenzyme from Human Heart Muscle.- 2.2.1 Introduction.- 2.2.2 CK Isoenzymes in Human Heart Muscle.- 2.2.3 Purification and Characterization of the Mitochondrial Isoenzyme from Human Heart Muscle.- 2.2.4 Concluding Remarks.- 3 Methods for Differentiation and Quantitation of Creatine Kinase Isoenzymes.- 3.1 Methods for Determination of Creatine Kinase Activity.- 3.1.1 “Forward” Reaction.- 3.1.2 “Reverse” Reaction.- 3.1.3 Reactivators.- 3.1.4 Interferences.- 3.1.5 Fluorescence and Bioluminescence.- 3.2 Differentiation of Isoenzymes by Non Immunological Methods..- 3.2.1 Electrophoresis.- 3.2.2 Ion Exchange Chromatography.- 3.2.3 Other Physicochemical Methods.- 3.2.4 Biochemical Methods.- 3.2.5 Evaluation of Non Immunological Methods.- 3.3 Measurement of Isoenzyme Activity by Immunological Methods..- 3.3.1 Immunoprecipitation.- 3.3.2 Immunoinhibition.- 3.3.3 Comparison of Immunoprecipitation with Immunoinhibition.- 3.3.4 Discussion.- 3.4 Experimental Comparison of Methods for Differentiation of Isoenzymes.- 3.4.1 Ion Exchange Chromatography vs. Immuno-inhibition.- 3.4.2 Differential Activation vs. Immunoinhibition.- 3.4.3 Electrophoresis vs. Immunoinhibition.- 3.4.4 Summary.- 3.5 Measurement of Isoenzyme Concentration by Immunoassay..- 3.5.1 Scope.- 3.5.2 Methodology.- 3.5.3 Methodological Criteria.- 3.5.4 Comparison of Methods.- 3.5.5 Clinical Results.- 3.5.6 Summary.- 4 Tissue Specific and Subcellular Distribution of Creatine Kinase Isoenzymes.- 4.1 Tissue Specific Distribution.- 4.1.1 Investigations with Non Immunological Methods.- 4.1.2 Investigations with Immunological Methods.- 4.1.3 Results Obtained with Radioimmunoassay.- 4.1.4 Summary.- 4.2 Subcellular Distribution.- 4.2.1 Introduction.- 4.2.2 Cell Nucleus.- 4.2.3 Microsomes.- 4.2.4 Myofibrillar Localization.- 4.2.5 Other Subcellular Localizations.- 4.3 Ontogeny.- 4.3.1 Introduction.- 4.3.2 CK Isoenzymes in Developing Human Tissue.- 4.3.3 Concluding Remarks.- 5 Clinical Results: Myocardium.- 5.1 Myocardial Infarction.- 5.1.1 Activity Kinetics of CK-MB Isoenzyme after Myocardial Infarction.- 5.1.2 Differential-Diagnostic Validity of CK-MB Determination in Suspected Myocardial Infarction.- 5.2 Infarct Size Estimation from Serial Analyses of CK and Isoenzyme Activity..- 5.3 Perioperative Infarction.- 5.3.1 Work with Non Immunological Methodology.- 5.3.2 Work with Immunological Methodology.- 5.4 Complications, Differential Diagnosis, and Diagnostic/ Therapeutic Procedures Associated with Myocardial Infarction..- 5.4.1 Cardiogenic Shock.- 5.4.2 Shock (Other than Cardiogenic).- 5.4.3 Pulmonary Embolism and Bronchial Asthma.- 5.4.4 Diagnostic and Therapeutic Procedures.- 5.5 Heart Failure and Inflammation..- 5.5.1 Introduction.- 5.5.2 Patients and Methods.- 5.5.3 Results.- 5.5.4 Discussion.- 6 Clinical Results: Skeletal Muscle.- 6.1 Direct Skeletal Muscle Damage..- 6.1.1 Exercise.- 6.1.2 Intramuscular Injections.- 6.1.3 Surgical Operations.- 6.1.4 Multiple Trauma.- 6.1.5 Cerebral Arterial Embolism and Convulsive Diseases.- 6.1.6 Malignant Hyperthermia.- 6.1.7 Summary.- 6.2 Muscular Dystrophies..- 6.2.1 Screening.- 6.2.2 Diagnosis.- 6.2.3 Possibilities for Determination of the Carrier.- Status.- 6.2.4 Prenatal Diagnosis of Duchenne Muscular Dystrophy.- 6.2.5 Possible Importance of Estimation of CK Isoenzymes for Diagnosing some Other Diseases..- 6.3 Hypothyroidism..- 6.3.1 CK in Hypothyroidism.- 6.3.2 Results of CK-MB Investigations.- 6.4 Various Muscular Diseases..- 6.4.1 Myasthenia Gravis.- 6.4.2 Myositis (Associated with Infectious or Parasitic Disease).- 6.4.3 Acute Rhabdomyolysis.- 6.4.4 Degenerative Diseases of the Nervous System.- 6.4.5 Sarcoidosis.- 6.4.6 Acromegaly.- 6.5 Collagen Diseases..- 6.5.1 Introduction.- 6.5.2 Patients and Methods.- 6.5.3 Results.- 6.5.4 Discussion.- 7 Clinical Results: Central Nervous System.- 7.1 Cerebral Diseases..- 7.1.1 CK Isoenzyme Activity in Serum.- 7.1.2 CK Isoenzyme Activity in Cerebrospinal Fluid.- 7.1.3 Reye’s Syndrome.- 7.2 Acute Psychosis..- 7.2.1 Introduction.- 7.2.2 Patients and Methods.- 7.2.3 Results.- 7.2.4 Discussion.- 8 Clinical Results: Gastrointestinal Tract, Liver, and Pancreas..- 8.1 Gastrointestinal Tract Diseases.- 8.2 Liver Diseases.- 8.3 Pancreatic Diseases.- 9 Clinical Results: Kidney and Urogenital Tract..- 9.1 Renal Diseases.- 9.2 Prostatic Carcinoma.- 10 Clinical Results: Intoxication.- 10.1 Exogenous Intoxication..- W. Prellwitz.- 10.1.1 Serum CK Isoenzyme Activity in Patients with Exogenous Intoxication.- 10.1.2 Serum CK-MB as Measure of Myocardial Damage in Patients with Exogenous Intoxication.- 10.1.3 Other Complications of Exogenous Intoxication.- 10.2 Alcoholism..- 10.2.1 Introduction.- 10.2.2 Patients and Methods.- 10.2.3 Results.- 10.2.4 Discussion.- 11 Clinical Results: Perinatal Period..- 11.1 Enzymes in Pregnancy.- 11.2 Myometrium and Placenta.- 11.3 Maternal Serum During Pregnancy, Labor, and After Delivery.- 11.4 Cord Blood.- 11.5 Discussion.- 11.6 Summary.- 12 The Creatine Kinase 242 BB Isoenzyme..- 12.1 Distribution ofCK-BB in Human Tissues.- 12.2 Problems in Evaluation of Published Data.- 12.3 Serum CK-BB Activity.- 12.4 CK-BB in Cerebrospinal Fluid.- 12.5 “Idiopathic” and “Macro” Serum CK-BB.- 12.6 Genetic Variants.- 12.7 Summary.- References.- List of Abbreviations.