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Immunoinhibition
CK-MB is composed of the two moieties CK-M and CK-B. A specific antibody inhibits the CK-M moiety. This antibody
will bind to and inhibit the activity of the M subunit of CK-MB. This means that only the activity of the B subunit in serum
is measured by the NAC-activated creatine kinase reaction. If the activity is multiplied by a factor of 2, it will give the
activity of CKMB in serum.
Atypical macro CK may result in falsely elevated CK-MB results. For this reason, this assay is primarily used as a screening
test to eliminate negative CK-MBs, and all positive CK-MBs by immunoinhibition are further investigated.
Mass measurement
The mass assay for CK-MB is an immunometric sandwich assay. Either a polyclonal, or more widely used today,
monoclonal antibody is linked to the CK-MB moiety, the CK-MM or the CK-BB is also covalently linked to a poly or
monoclonal antibody bound to a solid surface or paramagnetic particles, then eluted by a series of washes, and finally, CKMB is measured through production of fluorogenic substrate (e.g. Stratus, Dade Division, IMX, Abbott Laboratories) or
using chemiluminescence (ACS:180, Ciba Corning).
REFERENCE:
http://www.chronolab.com/point-of-care/index.php?option=com_content&view=article&id=418&Itemid=67
http://www.ncbi.nlm.nih.gov/pubmed/2178803
http://www.i-stat.com/products/ctisheets/716675-00G.pdf