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A biological marker (or biomarker) is a substance that can indicate a change in physiological state. The specificity of a biomarker can vary from general indications of poor health to specific diagnosis of disease. Creatine kinase (CK) is a serum enzyme of clinical significance. Measurement of total CK is a general indicator of tissue damage. Elevated total CK can be observed in: - All types of muscular dystrophy - Viral myositis - Polymyositis - Acute rhabdomyolysis - Acute myocardial infarction Further studies revealed that there are three different forms, or isoenzymes, of CK. These forms have been correlated to a particular tissue type, thus increasing the specificity of CK as a biomarker! (-MM: skeletal muscle CK-MB: heart CK-BB: brain A physician ordered a CK isoenzyme profile for two patients. Below is an image of the results:
Figure 1. Image of CK isoenzyme profile results. M : markers (control ladder), P1/P2 : patients, N : normal control. Discussion questions: 1. What analytical technique was used to separate CK isoenzymes? 2. What do the + and - symbols indicate? 3. Based on elution order, what differences can you infer between CK-BB and CK-MM? 4. Would you consider the profile for P2 normal or abnormal? 5. What acute condition might be suspected for P2 ? Reference: Liu, C.; Lai, J.; Wu, Y.; Tzeng, C., Journal of the Chinese Medical Association, 2010, 73(1), 35-39.