ENZYMOLOGY
PURPOSE TISSUE DX SIGNIFICANCE ASSAY SOURCES OF
SOURCES ERROR
CREATININE KINASE
● Associated with ATP ● Skeletal muscle ● Elevated in disorders of cardiac and skeletal ● CK catalyzes both forward ● Hemolysis
regeneration in ● Heart muscle muscle (myocardial infarction [MI], and reverse reactions - Erythrocytes are
contractile or ● Brain tissue rhabdomyolysis, and muscular dystrophy) involving phosphorylation of virtually devoid of
transport systems. ● Bladder, placenta, ● Sensitive indicator of AMI and muscular creatine or ADP. CK; but are rich in
● Involved in the gastrointestinal dystrophy, particularly the Duchenne type. ● Change in absorbance at 340 AK activity, which
storage of tract, thyroid, ● Early diagnostic tool to identify patients with nm reacts with ADP to
high-energy creatine uterus, kidney, Vibrio vulnificus infections and ectopic ● Reverse reaction proposed by produce ATP,
phosphate. lung, prostate, pregnancies Oliver and modified by which is then
● Isoenzymes: spleen, liver, and ● Seen in: Rosalki is the most commonly available to
○ CK-BB (brain type) pancreas ○ Strokes, seizures, nerve degeneration, and performed method participate in
○ CK-MB (hybrid central nervous system shock, damage to ● Reverse is faster than forward assay reaction,
type) BBB ● Optimal pH for causing falsely
○ CK-MM (muscle ● Increased in: reverse reaction= 6.8; elevated levels.
type) ○ Hypothyroidism forward reaction = 9.0. ● Hemoglobin
○ Malignant hyperpyrexia ● Unstable releases sufficient
○ Reye’s syndrome ● Inactivation can be partially AK to exhaust the
● MM form reversed by the addition of AK inhibitors in the
- Majority of CK activity in heart muscle N-acetylcysteine, reagent.
- Major isoenzyme fraction found in striated mercaptoethanol, thioglycerol, ● Vary with muscle
muscle and normal serum or dithiothreitol mass and, therefore,
- Hypothyroidism ● Reverse Rxn= Oliver Rosalki may depend on
- Predominant isoenzyme ● Forward rxn= Tanzer Givarg gender, race, degree
of physical
conditioning, and
age.
● Mild to strenuous
activity may
contribute to
elevated CK levels,
as may
intramuscular
injections.
● CK is inactivated by
light.
● Rapidly inactivated
because of oxidation
of sulfhydryl groups.
,
PURPOSE TISSUE DX SIGNIFICANCE ASSAY SOURCES OF
SOURCES ERROR
CREATININE KINASE
● Associated with ATP ● Skeletal muscle ● Elevated in disorders of cardiac and skeletal ● CK catalyzes both forward ● Hemolysis
regeneration in ● Heart muscle muscle (myocardial infarction [MI], and reverse reactions - Erythrocytes are
contractile or ● Brain tissue rhabdomyolysis, and muscular dystrophy) involving phosphorylation of virtually devoid of
transport systems. ● Bladder, placenta, ● Sensitive indicator of AMI and muscular creatine or ADP. CK; but are rich in
● Involved in the gastrointestinal dystrophy, particularly the Duchenne type. ● Change in absorbance at 340 AK activity, which
storage of tract, thyroid, ● Early diagnostic tool to identify patients with nm reacts with ADP to
high-energy creatine uterus, kidney, Vibrio vulnificus infections and ectopic ● Reverse reaction proposed by produce ATP,
phosphate. lung, prostate, pregnancies Oliver and modified by which is then
● Isoenzymes: spleen, liver, and ● Seen in: Rosalki is the most commonly available to
○ CK-BB (brain type) pancreas ○ Strokes, seizures, nerve degeneration, and performed method participate in
○ CK-MB (hybrid central nervous system shock, damage to ● Reverse is faster than forward assay reaction,
type) BBB ● Optimal pH for causing falsely
○ CK-MM (muscle ● Increased in: reverse reaction= 6.8; elevated levels.
type) ○ Hypothyroidism forward reaction = 9.0. ● Hemoglobin
○ Malignant hyperpyrexia ● Unstable releases sufficient
○ Reye’s syndrome ● Inactivation can be partially AK to exhaust the
● MM form reversed by the addition of AK inhibitors in the
- Majority of CK activity in heart muscle N-acetylcysteine, reagent.
- Major isoenzyme fraction found in striated mercaptoethanol, thioglycerol, ● Vary with muscle
muscle and normal serum or dithiothreitol mass and, therefore,
- Hypothyroidism ● Reverse Rxn= Oliver Rosalki may depend on
- Predominant isoenzyme ● Forward rxn= Tanzer Givarg gender, race, degree
of physical
conditioning, and
age.
● Mild to strenuous
activity may
contribute to
elevated CK levels,
as may
intramuscular
injections.
● CK is inactivated by
light.
● Rapidly inactivated
because of oxidation
of sulfhydryl groups.
,
