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Mitochondrial creatine kinase. A poor prognostic sign

C J Bark

    JAMA
    |May 23, 1980
    PubMed
    Summary

    A novel mitochondrial creatine kinase (CK) isoenzyme in serum was detected in critically ill patients. Its presence indicates severe tissue damage and is associated with a poor prognosis, as many patients died shortly after detection.

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    Area of Science:

    • Biochemistry
    • Clinical Chemistry
    • Pathophysiology

    Background:

    • Creatine kinase (CK) is an enzyme crucial for cellular energy homeostasis.
    • CK exists in different isoenzyme forms, including MM, MB, and mitochondrial CK (MtCK).
    • Elevated serum CK levels are indicative of muscle damage, but specific isoenzyme analysis can provide further diagnostic information.

    Purpose of the Study:

    • To investigate the presence and significance of a specific CK isoenzyme band in patients experiencing shock.
    • To determine the clinical implications and diagnostic value of this unusual CK isoenzyme in critical illness.

    Main Methods:

    • Serum samples were analyzed for creatine kinase (CK) isoenzyme patterns using electrophoresis.
    • Patients presenting with shock were specifically monitored for the presence of a CK isoenzyme band cathodic to MM.

    Main Results:

    • A distinct CK isoenzyme band, migrating cathodically to the MM band and presumed to be mitochondrial CK (MtCK), was identified in eight patients in shock.
    • Six out of these eight patients (75%) experienced fatal outcomes within 12 days of the isoenzyme detection.
    • The detection of this MtCK isoenzyme in serum correlated with severe tissue damage.

    Conclusions:

    • The presence of a serum CK isoenzyme band cathodic to MM (likely MtCK) is a significant indicator in patients with shock.
    • Severe tissue damage is a prerequisite for the release of this specific mitochondrial CK isoenzyme into the bloodstream at detectable levels.
    • This finding suggests that serum MtCK may serve as a prognostic biomarker for severe tissue injury and mortality in critically ill patients.

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