II. Physiology
- Transferase class enzyme activated by Magnesium
- Catalyzes ATP energy storage as Phosphocreatine
- Phosphocreatine stored in Muscle and brain
- Phosphocreatine keeps ATP constant at Exercise start
III. Increased
- Myocardial Infarction
- Myocarditis
- Rhabdomyolysis
- Myositis
- Crush injury or Trauma
- Dermatomyositis or Polymyositis
- Muscular Dystrophy
- Myxedema (Hypothyroidism)
- Seizure
- Malignant Hyperthermia
- Intramuscular Injections
- Cerebrovascular Accident
- Pulmonary Infarction
- Pulmonary Embolus
- Acute Aortic Dissection
- Vigorous Exercise
- CPK levels increase with common exertional activities (e.g. >20x normal at 1 day after marathon)
- Siegel (1981) JAMA 246(18): 2049-51 +PMID: 7288991 [PubMed]
- Kenney (2012) Muscl Nerve 45(30: 356-62 +PMID:22334169 [PubMed]
- Clarkson (2006) Med Sci Sports Exerc 38(4): 623-7 +PMID:16679975 [PubMed]
IV. Isoenzymes:
V. Protocol: Acute Coronary Syndrome Evaluation (listed for historical reasons)
- Older protocol - replaced in United States with Troponin
- Obtain Serial CPK every 6 hours for total of 3 values
- Fractionate to CK-MB only if CPK increased
- CK-MB >5% of total CPK suggests Myocardial Infarction
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| Definition (NCI) | An enzyme complex that can reversibly convert ATP and creatine to phosphocreatine and ADP. Cytosolic creatine kinases are comprised of homodimers or heterodimers of creatine kinase B-type protein and creatine kinase M-type protein. Mitochondrial creatine kinases are octomers comprised of either four homodimers of creatine kinase U-type, mitochondrial protein or four creatine kinase S-type, mitochondrial protein homodimers. |
| Definition (MSH) | A transferase that catalyzes formation of PHOSPHOCREATINE from ATP + CREATINE. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic ISOENZYMES have been identified in human tissues: the MM type from SKELETAL MUSCLE, the MB type from myocardial tissue and the BB type from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins. |
| Concepts | Amino Acid, Peptide, or Protein (T116) , Enzyme (T126) |
| MSH | D003402 |
| SnomedCT | 75828004 |
| LNC | LP15510-8, MTHU006937 |
| English | ADP Phosphocreatine Phosphotransferase, ATP Creatine Phosphotransferase, Creatine Kinase, Creatine Phosphokinase, Creatine Phosphotransferase, ATP, Kinase, Creatine, Phosphocreatine Phosphotransferase, ADP, Phosphokinase, Creatine, Phosphotransferase, ADP Phosphocreatine, Phosphotransferase, ATP Creatine, creatine kinase, ATP:creatine N-phosphotransferase, Creatine Kinase [Chemical/Ingredient], creatine kinase (CK), creatine phosphokinase (CPK), creatine phosphokinase, Phosphocreatine Kinase, ATP:Creatine N-Phosphotransferase, Creatine Phosphotransferase, CPK, CK, Adenosine Triphosphate-Creatine Transphosphorylase, ATP:Creatine Phosphotransferase, Creatine kinase, Creatine phosphokinase, CK - Creatine kinase, CPK - Creatine phosphokinase, Creatine kinase (substance) |
| Swedish | Kreatinkinas |
| Czech | kreatinfosfokinasa, kreatinkináza, kreatinkinasa |
| Finnish | Kreatiinikinaasi |
| Russian | KREATINFOSFOKINAZA, KREATINKINAZA, IZOFERMENTY KREATINKINAZY, KREATINKINAZY IZOFERMENTY, ИЗОФЕРМЕНТЫ КРЕАТИНКИНАЗЫ, КРЕАТИНКИНАЗА, КРЕАТИНКИНАЗЫ ИЗОФЕРМЕНТЫ, КРЕАТИНФОСФОКИНАЗА |
| Japanese | クレアチンキナーゼ, クレアチンホスホキナーゼ, ローマン酵素 |
| Italian | ADP fosfocreatina fosfotransferasi, ATP creatina fosfotransferasi, Creatina fosfochinasi, Creatinchinasi |
| Croatian | KREATIN KINAZA |
| Polish | Fosfokinaza kreatynowa, Kinaza fosfokreatynowa, Kinaza kreatynowa |
| Portuguese | Creatinoquinase, Creatina Fosfoquinase, Creatina Quinase |
| Spanish | creatina cinasa (sustancia), creatina cinasa, creatina fosfocinasa, creatincinasa, creatinquinasa, Creatina Fosfoquinasa, Creatina Quinasa |
| French | CPK, Creatine kinase, ATP créatine N-phosphotransférase, Créatine phosphokinase |
| German | Creatin-Kinase, Creatinkinase-Isoenzyme, Creatinkinase-Isozyme, Creatinphosphokinase, Kreatinase-Isoenzyme, Kreatinase-Isozyme, Kreatinase, Kreatinphosphokinase, Creatinkinase, Kreatinkinase, Kreatinkinase-Isoenzyme |
Ontology: Creatine Kinase, BB Form (C0010289)
| Definition (MSH) | A form of creatine kinase found in the BRAIN. |
| Concepts | Amino Acid, Peptide, or Protein (T116) , Enzyme (T126) |
| MSH | D052276 |
| SnomedCT | 66128009 |
| English | CKBB-Creatine kinase BB isoenz, Creatine kinase isoenzyme, CK1 fraction, Creatine kinase isoenzyme, CK<sub>1</sub> fraction, Creatine Kinase, BB Form [Chemical/Ingredient], ck bb, Creatine kinase isoenzyme, BB fraction, CKBB - Creatine kinase BB isoenzyme, Creatine kinase BB isoenzyme, Creatine kinase isoenzyme, CK>1< fraction, Creatine kinase isoenzyme, BB fraction (substance), BB Creatine Kinase, Brain Creatine Kinase, Creatine Kinase, BB, Creatine Kinase, Brain, Kinase, BB Creatine, Kinase, Brain Creatine, Creatine Kinase, BB Form |
| Spanish | Forma BB de la Creatina-Quinasa, isoenzima de creatinquinasa, fracción CK<sub>1</sub>, isoenzima de creatinquinasa, fracción CK1, Forma BB de la Creatina-Cinasa, Forma BB de la Creatincinasa, isoenzima de creatina cinasa, fracción BB (sustancia), isoenzima de creatina cinasa, fracción BB, isoenzima de creatinquinasa, fracción CK>1< |
| Italian | Creatina chinasi, forma BB, Creatina chinasi del cervello, Creatina chinasi BB |
| Swedish | Kreatinkinas, BB |
| Czech | kreatinkinasa - forma BB, kreatinkinasa - isoenzym BB |
| Finnish | CK-BB |
| Russian | KREATINKINAZY BB FORMA, КРЕАТИНКИНАЗЫ BB ФОРМА |
| Polish | Kinaza kreatyninowa forma BB |
| Japanese | 脳クレチンキナーゼ, BB型クレアチンキナーゼ, クレチンキナーゼ-脳, クレアチンキナーゼ-BB型 |
| Portuguese | Creatina Quinase Forma BB |
| German | BB-Kreatinkinase, Gehirn-Kreatinkinase, Kreatinkinase, BB-Form |
| French | BB Creatine kinase, Brain creatine kinase, CK-BB, CPK-BB, Créatine kinase du cerveau, Créatine kinase-BB, Créatine phosphokinase du cerveau, Isoenzyme CKBB, Isoenzyme CPK-BB |
Ontology: Creatine Kinase MB Isoenzyme (C0010290)
| Definition (MSH) | An isoenzyme of creatine kinase found in the CARDIAC MUSCLE. |
| Concepts | Amino Acid, Peptide, or Protein (T116) , Enzyme (T126) |
| MSH | D052279 |
| SnomedCT | 12016004 |
| LNC | LP32033-0, LP15513-2, MTHU003587 |
| English | CKMB-Creatine kinase MB isoenz, Creatine kinase isoenzyme, CK2 fraction, Creatine kinase isoenzyme, CK<sub>2</sub> fraction, Creatine Kinase MB Isoenzyme, Creatine Kinase, MB Form [Chemical/Ingredient], ck mb, Creatine kinase.MB, Creatine kinase isoenzyme, MB fraction, CKMB - Creatine kinase MB isoenzyme, Creatine kinase MB isoenzyme, Creatine kinase isoenzyme, CK>2< fraction, Creatine kinase isoenzyme, MB fraction (substance), CPK-MB, Isoenzyme, Creatine Kinase, MB Form, Isoenzyme CPK-MB, Isoenzyme CPK MB, Creatine Kinase, MB, Kinase, MB Creatine, Kinase, Myocardial Creatine, MB Creatine Kinase, Myocardial Creatine Kinase, Creatine Kinase, Myocardial |
| Spanish | Forma MB de la Creatina-Quinasa, isoenzima de creatinquinasa, fracción CK2, isoenzima de creatinquinasa, fracción CK<sub>2</sub>, Forma MB de la Creatina-Cinasa, Forma MB de la Creatincinasa, isoenzima de creatina cinasa, fracción MB (sustancia), isoenzima de creatina cinasa, fracción MB, isoenzima de creatinquinasa, fracción CK>2< |
| Italian | Creatina chinasi, forma MB, Creatina chinasi MB, Creatina chinasi miocardica, Isoenzima CPK-MB |
| Swedish | Kreatinkinas, MB |
| Czech | isoenzym CPK-MB, kreatinkinasa - isoenzym MB, kreatinkinasa - forma MB |
| Finnish | CK-MB |
| Russian | KREATINKINAZY MB FORMA, КРЕАТИНКИНАЗЫ MB ФОРМА |
| Polish | Kinaza kreatyninowa forma MB |
| Japanese | 心筋クレアチンキナーゼ, MB型クレアチンキナーゼ, クレアチンキナーゼ-MB型, クレアチンキナーゼ-心筋 |
| Portuguese | Creatina Quinase Forma MB |
| German | Isoenzym CPK-MB, Kreatinkinase, MB-Form, MB-Kreatinkinase, Myokardiale Kreatinkinase |
| French | CK-MB, CPK-MB, Créatine kinase du myocarde, Créatine kinase-MB, Créatine phosphokinase du myocarde, Isoenzyme CKMB, Isoenzyme CPK-MB, MB Creatine kinase, Myocardial creatine kinase |
