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PubMed1982

Creatine kinase.

Creatine kinase is present in significant concentrations in skeletal muscle and cardiac muscle and to a lesser extent in gastrointestinal tract and brain tissue. The enzyme has been purified from a variety of tissues and an examination of its kinetic and physical properties reveal that the enzyme consists of two subunits and can exist as three isoenzymes containing essential cysteine residues. These properties are important in understanding its stability, the assay conditions, and the techniques used to identify the different isoenzymes. The relationship between the properties and the determination of the enzyme in biological fluids will be a main thrust of the review. Creatine kinase activity in serum rises rapidly in conditions such as acute myocardial infarction and trauma to skeletal muscle. However, the interpretation of such increases is dependent upon a sound knowledge of the factors which influence both the total and isoenzyme activities. The nature of these factors will be discussed in detail.

Animals↗
PubMed1991

Serum creatine kinase and creatine kinase-MB isoenzyme activities in perinatally asphyxiated newborns.

Serum creatine kinase (CK) and creatine kinase-MB isoenzyme (CK-MB) activities were studied prospectively in serial blood samples obtained from 23 perinatally asphyxiated negroid newborns and 12 healthy controls during the first 100 h of life. The asphyxiated infants had significantly elevated mean CK and absolute CK-MB but no fractional CK-MB activities. Peak mean CK and CK-MB values (U.l-1) were 789.17 (+/- 220), P less than 0.01 and 16.36 (+/- 3.0) P less than 0.001 respectively at the 6-8 post-partum period. The healthy controls, on the other hand, showed a steady decline in the activities of these enzymes from birth. The vaginally and operatively delivered asphyxiated infants showed significantly higher CK and CK-MB activities than their respective non-asphyxiated controls, but no increase in fractional CK-MB was recorded in any of the groups. The elevation in absolute and fractional CK-MB 42.0 U.l-1 (5.1%) in respect of the infants with TTI (transient tricuspid incompetence) was significant (P less than 0.05) when compared with the controls with features of TTN (transient tachypnoea of the newborn) in the 6-8 h post-partum period. One of the infants with TTI at autopsy had hypoxic myocardial injury. The specificity of CK-MB, as a marker of myocardial injury in asphyxiated negroid neonates, is plausible but remains uncertain. Until the lack of rise of CK and CK-MB in healthy negroid newborns is confirmed in a larger series with further studies on MM, BB and MB isoenzymes, caution is urged in the interpretation of elevated CK and CK-MB activities in asphyxiated negroid newborns.

Apgar Score↗
PubMed1984

Levels of adenylate deaminase, adenylate kinase, and creatine kinase in frozen human muscle biopsy specimens relative to type 1/type 2 fiber distribution: evidence for a carrier state of myoadenylate deaminase deficiency.

Myoadenylate deaminase deficiency is believed to reflect a genetic deficiency of skeletal muscle, but its pattern of inheritance has not been established. We examined, histochemically and by quantitative biochemical assay, muscle biopsy specimens from 3 putative carriers of this disorder. Adenylate kinase and creatine kinase were assayed in parallel with adenylate deaminase in order to establish enzyme activity ratios and the variation of each enzyme with fiber-type distribution. Control tissue consisted of 34 biopsy specimens without notable abnormalities from 30 patients, and included 4 specimen pairs with disparate fiber-type contributions. By linear regression analysis, adenylate deaminase level averaged 2.8-fold higher, and adenylate kinase 4.5-fold higher, in type 2 than in type 1 fibers, whereas creatine kinase level did not differ. The slopes of the regression lines resulting from analysis of the four specimen pairs from individual patients agreed well with the overall regression line in each plot. The 3 putative carriers had adenylate deaminase levels 2.5 to 5.7 times lower than the mean control value for their fiber-type distribution, but at least 20 times higher than their enzyme-deficient kinfolk. This finding indicates that a carrier state does exist, and that the deficiency state reflects an autosomal recessive inheritance pattern. Three additional biopsy specimens were excluded from evaluation when preliminary analysis showed elevated adenylate kinase/adenylate deaminase ratios that were outliers at the 1% level. This result suggests a carrier incidence of 10% in the muscle biopsy specimen population, which would markedly bias population estimates if undetected.

AMP Deaminase↗
PubMed1990

The theory of diazymes and functional coupling of pyruvate kinase and creatine kinase.

The physical-chemical principles governing the interactions of enzymes having common metabolic products are presented. Methods for comparing the dissociation rates of the metabolic product and the rates of enzyme-enzyme interaction are given. Using muscle pyruvate kinase (PK) and creatine kinase (CK) as an example, it is shown that the probability of forming an enzyme-product-enzyme complex is much greater than the rate of ATP dissociation from either enzyme. Experimental evidence using 31P-NMR demonstrates that in the presence of both pyruvate kinase and creatine kinase, there is exchange of phosphate between phosphocreatine and phosphoenolpyruvate without a change in the intermediate, ATP. This confirms the formation of a PK.ATP.CK complex in an aqueous solution without enzyme attachment to a substructure. Enzymes capable of forming these mobile clusters are defined as diazymes, and the criteria for their formation are given. The metabolic implications of diazymes are discussed.

Adenosine Diphosphate↗
PubMed1993

Comparative enzymology of AMP deaminase, adenylate kinase, and creatine kinase in vertebrate heart and skeletal muscle: the characteristic AMP deaminase levels of skeletal versus cardiac muscle are reversed in the North American toad.

The specific activity of three characteristic enzymes, adenylate deaminase, adenylate kinase, and creatine kinase, in the skeletal muscles and heart of a variety of vertebrate land animals, including the human, are surveyed. Data from this study and available studies in the literature suggest that adenosine monophosphate deaminase in land vertebrates is quite high in white skeletal muscle, usually somewhat lower in red muscle, and 15- to 500-fold lower in cardiac muscle. Adenosine monophosphate deaminase is active primarily under ischemic or hypoxic conditions which occur frequently in white muscle, only occasionally in red muscle, and ought never occur in heart muscle, and this may therefore account for observed enzyme levels. The common North American toad, Bufo americanus, provides a striking exception to the rule with cardiac adenosine monophosphate deaminase as high as in mammalian skeletal muscle, whereas its skeletal muscle level of adenosine monophosphate deaminase is several times lower. The exceptional levels in the toad are not due to a change in substrate binding and are not accompanied by comparable change in the level of adenylate or creatine kinase. Nor do they signal any major change in isozyme composition, since a human muscle adenosine monophosphate deaminase-specific antiserum reacts with toad muscle adenosine monophosphate deaminase, but not with toad heart adenosine monophosphate deaminase. They do not represent any general anuran evolutionary strategy, since the bullfrog (Rana catesbeiana) and the giant tropic toad (Bufo marinus) have the usual vertebrate pattern of adenosine monophosphate deaminase distribution.(ABSTRACT TRUNCATED AT 250 WORDS)

AMP Deaminase↗
PubMed1985

Kinetics of serum creatine kinase and creatine kinase-MB after intracoronary thrombolysis.

The kinetics of the activity of total creatine kinase (CK) and creatine phosphokinase isoenzyme muscle-brain were investigated in 48 patients with acute myocardial infarction after successful intracoronary thrombolysis, and compared to the enzyme activities in 17 patients in whom thrombolysis failed. CK activity peaked significantly earlier after a successful thrombolysis than after an unsuccessful attempt: in patients with successful thrombolysis, CKmax = 10.5 +/- 3.7 h and in patients with an unsuccessful attempt, CKmax = 19.3 +/- 5.9 h; p less than or equal to 0.05. The area under the activity time curve after successful thrombolysis was significantly smaller than after unsuccessful thrombolysis: in patients with successful thrombolysis, CK area = 25,255 U/l per day and in patients with an unsuccessful attempt, CK area = 32,602 U/l per day; p = 0.015. There was a negative correlation between the area under the CK serum curve after successful thrombolysis, and the change of regional wall motion at the site of the acute infarct (p less than or equal to 0.05). From the smaller area under the CK curve in patients after successful thrombolysis, and the significant negative correlation of this measurement with regional left ventricular wall motion, we conclude that myocardial salvage after intracoronary thrombolysis can be assessed by serial CK measurements.

Coronary Circulation↗
PubMed1980

Photoaffinity labelling of arginine kinase and creatine kinase with a gamma-P-substituted arylazido analogue of ATP.

1. An ATP analogue with a photoactivated azide group attached to the gamma-phosphate via an amide bond, ATP gamma-p-azidoanilide, appeared to have potential use as a photoaffinity label for the nucleotide-binding regions of ATP: guanidine phosphotransferases. Upon photolysis in the presence of lobster muscle arginine kinase and rabbit muscle creatine kinase, the analogue is converted to a potent inhibito of these two kinases. This photo-dependent inhibition is specific as it cannot be induced by azidoaniline, a mixture of azidoaniline and ATP or by ATP gamma-p-aminoanilide. Preirradiated under suitable conditions, the photoanalogue still shows a transitory inhibitory effect which, however, slowly vanishes with time (t0.5 = 3 h). 2. The photoinhibition is significantly decreased by the presence of ATP or ADP but is completely prevented by the addition of a mixture of nucleotide and guanidine substrates. Differential spectroscopy and affinity chromatography on Sepharose-ATP demonstrated the inability of photoinactivated arginine kinase and creatine kinase to recognize their nucleotide substrates. 3. Experiments with [14C]ATP gamma-p-azidoanilide indicated that photolysis is associated with an irreversible and stoichiometric binding of the ATP analogue to the enzymes. Autoradiographs made with the peptide maps corresponding to the tryptic digests of each 14C-labelled photomodified enzyme showed an unexpected highly specific labelling of the proteins. 4. Thiiol titrations of the kinases which have been subjected to various photolysis conditions led to the conclusion that the arylnitrene moiety of the photoanalogue is covalently attached to the single reactive cysteinyl side chain present in the active-site region of the two homologous kinases. This amino acid residue appears, therefore, to be located near the phosphate chain binding subsite occupied by the ATP analogue and probably also by the natural nucleotide substrates.

Adenosine Triphosphate↗
PubMed1995

Time changes of creatine kinase and creatine kinase-MB isoenzyme versus discrimination values in the diagnosis of acute myocardial infarction: what is the optimal method for displaying the data?

We wanted to determine the optimal method for displaying data for the clinical evaluation of patients with possible acute myocardial infarction. Our primary question was, are the time changes (slopes) of the enzyme tests better predictors of disease than the discrimination values, i.e., the cut-off points? We studied 152 patients with and 114 without a diagnosis of acute myocardial infarction in their medical records. For patients with acute myocardial infarction, we found the most discriminating tests, in decreasing order of the area of the ROC curves, to be the creatine kinase-MB slope at 0 to 12 hours, the creatine kinase-MB slope at 12 to 24 hours, the creatine kinase-MB values between 12 and 24 hours, and the creatine kinase-MB values between 0 and 12 hours. Decreasing values of creatine kinase-MB in the first tests after admission were only slightly less discriminating than increasing ones. At 12 to 24 hours after admission, the total creatine kinase as a value or slope, or the "relative index" (a ratio of the creatine kinase-MB in microgram/l [times 100] to the total creatine kinase) as a value or slope were inferior to creatine kinase-MB presentations. From the data for 44 patients with acute myocardial infarction and a known time of onset of symptoms, we were able to estimate an approximate onset time in patients where this was not available.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Enzyme Tests↗
PubMed1984

Reduction of creatine kinase and creatine kinase-MB indexes of infarct size by intravenous verapamil.

In a prospective, controlled study, 29 patients were randomly allocated to receive intravenous verapamil, 5 to 10 mg/hour, for 2 days starting at a mean of 8 hours after the onset of myocardial infarction. Twenty-five patients received no specific treatment and served as control subjects. Left ventricular (LV) filling pressure in all patients was initially less than 15 mm Hg. Age, infarct localization and hemodynamic values on admission (Swan-Ganz catheter) were comparable in both groups. Maximal creatine kinase (CK) and creatine kinase-MB (CK-MB) values were markedly lower in the verapamil group than in the control group (CK 547 vs 703 U/liter, p less than 0.05; CK-MB 51 vs 68 U/liter, p less than 0.025), as was infarct weight (48 vs 65 g-Eq, p less than 0.03; CK-MB 31 vs 49 g-Eq, p less than 0.005). Arterial blood pressure was 10% lower in the verapamil group than in the control group. Systemic vascular resistance and LV filling pressure remained unchanged. Verapamil reduced myocardial infarction size by about 30% in patients without LV failure and the arterial pressure was reduced.

Blood Pressure↗
PubMed1984

Myoglobin concentration, creatine kinase activity, and creatine kinase B subunit concentrations in serum during thyroid disease.

Changes in values for myoglobin, total creatine kinase (EC 2.7.3.2), and creatine kinase B-subunit in the serum of patients with thyroid disease are compared with values for these during the 24-h after myocardial infarction. Concentrations of all three of these muscle-derived proteins were significantly higher than normal in patients with primary hypothyroidism, and declined with treatment. Values for total creatine kinase activity were below-normal in hyperthyroid patients, but increased after treatment. Values for total creatine kinase and, to a lesser extent, myoglobin in hypothyroidism extend into the range of values observed after myocardial infarction. The mechanism of the changes in these analytes in hypothyroidism may be related to increased leakage from skeletal-muscle cells or diminished clearance from the circulation, or both.

Creatine Kinase↗
PubMed1979

[Creatine kinase and creatine isoenzyme activities in newborn. Development of the organ-typical isoenzyme pattern during the fetal period (author's transl)].

The activity of the creatine kinase isoenzyme was measured in the serum of 133 healthy newborn. In contrast to the conditions in the adult, a normal range of 0-45 U/1 was found. No creatine kinase BMB activities were established. The increased creatine kinase-MB activities in newborn could be explained by means of an examination of the creatine kinase isoenzyme pattern in the skeleton muscle of foetuses and newborn. Depending upon the gestation age, creatine kinase-MB activity levels were found amounting to as much as a multiple of ten of the adult levels. Due to the deviation of the creatine kinase isoenzyme distribution in the organ tissue of newborn, identified in this study for the first time, creatine kinase-MB activity seems to be unsuitable as an indicator of myocardial damage during the neonatal period.

Creatine Kinase↗
PubMed2004

Isoleucine 69 and valine 325 form a specificity pocket in human muscle creatine kinase.

Creatine kinase (CK) catalyzes the reversible phosphorylation of creatine by ATP. From a structural perspective, the enzyme utilizes two flexible loop regions to sequester and position the substrates for catalysis. There has been debate over the specific roles of the flexible loops in substrate specificity and catalysis in CK and other related phosphagen kinases. In CK, two hydrophobic loop residues, I69 and V325, make contacts with the N-methyl group of creatine. In this study, we report the alteration of the substrate specificity of CK through the mutagenesis of V325. The V325 to glutamate mutation results in a more than 100-fold preference for glycocyamine, while mutation of V325 to alanine results in a slight preference of the enzyme for cyclocreatine (1-carboxymethyl-2-iminoimidazolidine). This study enhances our understanding of how the active sites of phosphagen kinases have evolved to recognize their respective substrates and catalyze their reactions.

Amino Acid Sequence↗
PubMed2000

Crystal structure of human ubiquitous mitochondrial creatine kinase.

Creatine kinase (CK), catalyzing the reversible trans-phosphorylation between ATP and creatine, plays a key role in the energy metabolism of cells with high and fluctuating energy requirements. We have solved the X-ray structure of octameric human ubiquitous mitochondrial CK (uMtCK) at 2.7 A resolution, representing the first human CK structure. The structure is very similar to the previously determined structure of sarcomeric mitochondrial CK (sMtCK). The cuboidal octamer has 422 point group symmetry with four dimers arranged along the fourfold axis and a central channel of approximately 20 A diameter, which extends through the whole octamer. Structural differences with respect to sMtCK are found in isoform-specific regions important for octamer formation and membrane binding. Octameric uMtCK is stabilized by numerous additional polar interactions between the N-termini of neighboring dimers, which extend into the central channel and form clamp-like structures, and by a pair of salt bridges in the hydrophobic interaction patch. The five C-terminal residues of uMtCK, carrying positive charges likely to be involved in phospholipid-binding, are poorly defined by electron density, indicating a more flexible region than the corresponding one in sMtCK. The structural differences between uMtCK and sMtCK are consistent with biochemical studies on octamer stability and membrane binding of the two isoforms.

Creatine Kinase↗
PubMed1988

[Functional changes in the mitochondrial site of adenylate kinase and creatine kinase systems of energy transport induced by myocardial ischemia and adriablastin].

Under effects of myocardial ischemia (30 min), the activities of the intermembrane enzymes of rabbit heart mitochondria, i.e., adenylate kinase and creatine kinase, are inhibited by 20% and 23%, respectively. Consequently, the creatine- and AMP-activated respiration of mitochondria diminishes by 52% and 39%, respectively. An inhibitory analysis of ADP-, AMP- and creatine-activated mitochondrial respiration performed in the presence of atractyloside has demonstrated that ischemia (30 min), adriblastin (0.688 mM) and succinate (10 mM) cause alterations in the functional coupling of adenylate kinase and creatine kinase with the adenine nucleotide translocator. These alterations lead to the diminution of the rate and efficiency of energy transfer from mitochondria to hexokinase, as an arbitrary site of energy consumption. An addition of cytochrome c to ischemic heart mitochondria results in an increase in the rate of ATP synthesis; however, the efficiency of this process is lowered. The toxic effect of the anticancer drug--adriblastin on heart mitochondria respiration is enhanced in the presence of creatine in the bathing solution.

Adenylate Kinase↗
PubMed1984

Anion activation of monkey muscle creatine kinase.

Creatine kinase from rhesus monkey skeletal muscle is activated by acetate and other short chain fatty acids. Activation is associated with lower Km and higher Vmax values at less than saturating substrate concentrations but does not occur when both substrates are saturating. No co-operativity between subunits is evident in the activation process. It appears that acetate promotes the mutual enhancement by substrates in their binding by inducing the optimum enzyme conformation normally associated with substrate saturation. Conservation of this activation effect through the evolution of the phosphagen kinases implies that it may well be of physiological significance.

Acetates↗
PubMed1999

Differential coupling of smooth and skeletal muscle pyruvate kinase to creatine kinase.

The interaction of pyruvate kinase from skeletal (SKPK) and smooth (SMPK) muscle with MM-creatine kinase (MMCK) and BB-creatine kinase (BBCK) was assessed using temporal absorbance changes, variations in absorbance at different wavelengths, concentration dependence, association in an electric field, and PK kinetic activity. SKPK exhibits a time course of absorbance increase in the presence of MMCK with a time constant of 29.5 min. This increase occurs at all wavelength from 240 to 1000 nm. At 195 nm, the combination of SKPK and MMCK produces a decrease in absorption with electric fields of both 0 and 204 V/cm. The change in SKPK-MMCK is saturable. SKPK activity is significantly increased by the presence of MMCK in solutions of 0-32% ethanol. These results indicate specific SKPK-MMCK interaction. SMPK and BBCK did not exhibit similar coupling when the BBCK concentration dependence of absorbance or SMPK activity in solutions of 0-32% ethanol was determined. Both MMCK and BBCK increased SKPK activity; neither MMCK nor BBCK increased SMPK activity. The ability to form diazymatic complexes with creatine kinase appears to reside in SKPK. This coupling may account for the increased flux through PK without significant substrate changes seen during skeletal muscle activation. This coupling will not occur in smooth muscle.

Animals↗
PubMed1992

Creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) activity in serum before and after intravenous salbutamol administration of patients with bronchial asthma.

The effect of salbutamol, a selective beta 2-adrenergic agonist, on creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) activity in serum of 20 asthmatic patients was investigated. Venous blood was obtained 30 min, 2 h and 4 h after 0.5 mg salbutamol intravenous injection of 0.5 mg salbutamol. Total creatine kinase activity was assayed on a Technico RA-1000 analyzer with the IFCC recommended method. CK-MB activity was determined using a centrifugal analyzer (Cobas Fera, Roche, Switzerland). Reagent kits were provided by Boehringer Mannheim (FRG). We observed no increase of CK-activity after salbutamol, and found a statistically significant increase of CK-MB activity. Serum CK-MB activity before treatment was 13 +/- 10/IU/l after 30 minutes drug, 31.8 +/- 19 IU/l after 2 h 27.2 +/- 17.79 and after 4 h 22.6 +/- 12 IU/l. We conclude that salbutamol exerts a cardiotoxic effect.

Adult↗
PubMed1981

Eastern grey kangaroo muscle creatine kinase.

Creatine kinase has been purified to homogeneity from skeletal muscle of the eastern grey kangaroo, Macropus giganteus. The procedure included ethanol fractionation followed by chromatography on DEAE-cellulose. The enzyme had a molecular weight of approximately 86 000 with two subunits of 43 500. Two sulfhydryl groups were determined for the intact molecule and a further four on unfolding. Under standardized conditions, the metal ion specificity was determined as MgADP- greater than MnADP- greater than CoADP-, CaADP-; and the substrate specificity as MgADP- greater than MgdADP- greater than MgGDP- greater than MgXDP. Initial velocity and product-inhibition studies of the reverse reaction were consistent with a rapid random equilibrium reaction as observed for the rabbit muscle enzyme. However, initial-velocity studies in the forward reaction were consistent with a rapid equilibrium-ordered mechanism with MgATP2- binding before creatine. Preliminary studies on the binding of manganese nucleotides to the enzyme have been carried out using pulsed nuclear magnetic resonance to measure relaxation times of water protons.

Animals↗