Creatine kinase isoenzymes : pathophysiology and clincial application

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.