Evaluation and comparison of immunoinhibition and immunoprecipitation methods for differentiating MB and BB from macro forms of creatine kinase isoenzymes in patients and healthy individuals
Wu, A.H.; Bowers, G.N.
Clinical Chemistry 28(10): 2017-2021
1982
ISSN/ISBN: 0009-9147 PMID: 7127730 Document Number: 189990
We compared results for measurements of creatine kinase isoenzyme MB (CK-MB) by immunoinhibition vs immunoprecipitation, using sera from 53 normal healthy individuals, 55 patients with increased CK-MB associated with acute myocardial infarction, and 42 patients whose blood exhibited one or more abnormal forms of CK by electrophoresis. These last 42 patients, selected from a group of 91 cases exhibiting abnormal forms as detected in a screening of 5000 hospitalized and clinic patients, include: (a) CK-BB bound to IgG (macro CK type 1), (b) a polymeric complex of mitochondrial CK (macro CK type 2), (c) abnormally high activity of free CK-BB isoenzyme, and (d) persistent increases of CK-MB from patients without myocardial infarction. These abnormal forms occur in less than 2% of all patients and are exceedingly rare in patients with acute myocardial infarction. Therefore, the vast majority of CK-MB analyses can be performed rapidly and efficiently by immunoinhibition, which has analytical sensitivity, is associated with high clinical sensitivity, and is easily automated for a low cost per test. In contrast, immunoprecipitation is a more specific analytical measurement of CK-MB but is less efficient and more costly.