Serum Aldolase Research Articles

Prognostic factors in polymyositis/dermatomyositis. A computer-assisted analysis of ninety-two cases.

An effort was made to identify all patients with polymyositis/dermatomyositis (PM/DM) admitted to hospitals in Israel from 1956-1976. The diagnosis of PM/DM was retrospectively reviewed in 92 (46 definite, 26 probable, and 20 possible) cases. The most common complaints and physical findings in the course of the disease were muscle weakness (86 patients), rash (53 patients), arthritis or arthralgia (39 patients), and dysphagia (35 patients). Elevated serum aldolase levels were found in 64% of the patients for whom data were available; 92% had abnormal electromyogram results, and 60.9% had muscle histopathology consistent with PM/DM. Malignancy was diagnosed in 13 patients. Malignancy, ischemic heart disease, and pulmonary complications were the most common causes of death. The actuarial survival curve was heterogeneous, with an accelerated mortality during the first year after diagnosis and a slower mortality during the following 7 years. Independent unfavorable prognostic signs were: failure to induce remission, leukocytosis, fever, older age, a shorter disease history, and dysphagia.

Serum myoglobin in acute cerebrovascular diseases.

Concentration of myoglobin in serum was measured from 114 patients with acute cerebrovascular diseases and compared with serum creatine phosphokinase (CPK) and aldolase activities. The results obtained were as follows : (1) Elevated activity of myoglobin was observed in various types of stroke as well as CPK and aldolase. (2) The myoglobin level was significantly higher in patients with thalamic hemorrhage than in those with cortical infarction, while no difference was observed in other types of stroke. (3) The level of myoglobin was correlated well with the CPK level, but not with aldolase. (4) Correlation between myoglobin and level of consciousness was not observed. (5) No difference in myoglobin concentration in patients was observed between the died within four weeks and the survived. These results indicated that measurement of serum myoglobin in acute cerebrovascular diseases would not be useful for determining the type, severity and prognosis of the diseases.

A case of D-Penicillamine induced polymyositis

A case of D-Penicillamine induced polymyositis in progressive systemic sclerosis.Nowadays D-Penicillamine (D-PC) is widely used for treatment of rheumatoid arthritis. It is also employed to treat patients with progressive systemic sclerosis (PSS) from viewpoints of favorable pharmacological effects on such as inhibition of collagen synthesis and modulation of deranged immune functions.Although various side-effects have been reported up-to-date, much attention has not paid on occurrence of polymyositis in D-PC treatment.We experienced a case of PSS who had manifested a typical polymyositis during D-PC treatment and bad recovered completely from it on discontinuance of the drug.A 51-year-old woman was admitted to another hospital because of Raynaud's phenomenon and sclerodactylia. She was treated with glucocorticoids for several months. With a slight improvement of the symptoms she discharged from it and stayed at home. She, thereafter, became gradually aggravated and started to complain of severe dyspnea. She was admitted to our University Hospital. As chest X-ray showed a marked pulmonary fibrosis, D-PC was given in a dose of 100mg daily for 4 weeks and then in a dose of 200mg daily. During the treatment, she complained of myalgia and muscle weakness accompanied with elevated values of serum creatinine phosphokinase (CPK) and aldolase (ALD). Electromyogram and muscle biopsy showed findings compatible with polymyositis. One month after discontinuation of D-PC, physical and laboratory abnormalities of polymyositis were completely normalized.We concluded that polymyositis seen in this patient could have been induced with D-PC, aparting from a notion that D-PC had manifested latent polymyositis included in a morbid spectrum of PSS.

Human aldolase B serum levels: a marker of liver injury.

A solid-phase, noncompetitive radioimmunoassay has been developed for aldolase B in human serum and tissues. Aldolase B was purified from human liver, and specific antisera to purified aldolase B were obtained from chickens. Specific antihuman aldolase B IgG was purified by affinity chromatography. Disposable polypropylene plates were coated with affinity purified specific IgG antibody and used for radioimmunoassay with 125I-specific IgG antibody to aldolase B. The nonspecific binding was minimized by saturating the binding sites of the plates with 2% ovalbumin in 0.1% Tween 20. This radioimmunoassay is specific for the aldolase B subunit, with no cross-reactivity with human aldolase A or aldolase C subunits. Aldolase B is predominantly found in normal liver. Relatively high aldolase B levels are also observed in kidney. Serum levels of aldolase B in 21 normal subjects ranged from 21 to 39 ng per ml, with a mean of 28.7 +/- 8.6 (2 S.D.) ng per ml. Forty of 42 (95%) patients with acute and chronic hepatitis without cirrhosis had serum aldolase B levels greater than 40 ng per ml. Serum aldolase B levels correlated well with total serum aldolase enzyme activities (r = 0.967) and SGPT (r = 0.951) in patients with liver diseases. In cancer patients, serum aldolase B was slightly elevated in 15 of 26 (58%) patients with cancer metastatic to the liver or primary liver cell carcinoma, whereas no elevation of serum aldolase B was observed in 16 cancer patients without liver metastasis. Measurements of aldolase B serum levels by radioimmunoassay appear to be a useful measure of liver cell necrosis from benign or malignant liver diseases.

The enzymology of skeletal muscle disorders.

In myopathic disorders, abnormal serum enzyme activities are seen primarily in diseases of skeletal muscle where the condition involves the muscle fibers themselves. In denervation myopathies, serum enzyme activities are usually normal. The most dramatic increases of serum enzymes, particularly creatine kinase, are found in the dystrophic diseases, particularly Duchenne dystrophy. A review is given here of the many causes of abnormal serum enzyme activities where the source of enzymes is believed to be skeletal muscle. These include the dystrophies, various types of trauma, exercise, drug- and poison-induced causes including alcohol, malignant hyperthermia, inflammatory diseases, and miscellaneous causes. Tissue and serum activities are summarized for the commonly performed serum enzymes, i.e., CK, LD, AST, and aldolase. An extensive tabular and current description of the various types of dystrophies is given along with serum CK and pyruvate kinase activities.

Subunit-specific radioimmunoassay for aldolase A, B, and C subunits: clinical significance.

Radioimmunoassays specific for fructose-1, 6-diphosphate aldolase isozymes were developed for the quantification of human aldolase A, B and C. The method is a double-antibody radioimmunoassay using radioiodinated purified aldolase A, B and C as ligand, chicken antibodies to aldolase A, B and C, and rabbit antibodies to chicken IgG. The Iodogen method was used for the iodination of aldolase A, B and C in this study. Aldolase A was predominantly high in concentration in muscle, aldolase B was high in normal adult liver, and aldolase C was high in adult brain. Aldolase A was elevated in hepatoma tissue and hepatoma cell lines, where aldolase B was distinctly low. Normal serum levels for the three isozymes were determined. The aldolase A levels in serum obtained from 41 normal subjects were 170 +/- 39 ng/ml. Serum aldolase A levels were increased in many patients with cancer and muscle diseases, but were not increased in patients with hepatitis or other benign diseases. Serum aldolase B levels obtained from 11 normal subjects were 28.5 +/- 9.2 ng/ml. Serum aldolase B levels were increased in patients with hepatitis and correlated well with serum GPT levels. Serum aldolase C levels obtained from 12 normal subjects were 2.4 +/- 0.7 ng/ml. The determination of aldolase A, B and C by radioimmunoassay may be a valuable tool in biochemical and clinical studies of aldolase isozymes.

Aldolase A Isoenzyme Levels in Serum and Tissues of Patients With Liver Diseases

A radioimmunoassay specific for human aldolase A was used to measure human aldolase A levels in human tissue and serum of patients with various liver diseases. The method was a double-antibody technique using radio-iodinated purified aldolase A, chicken antibody to aldolase A, and rabbit antibody to chicken immunoglobulin G. Normal liver tissue contains only a small amount of aldolase A. In contrast, aldolase A predominates in liver cell carcinoma tissue. Aldolase A levels in the sera of normal subjects were 171 +/- 39 ng/ml (mean +/- 2 SD). In almost all of the nonmalignant liver diseases, the aldolase A levels remained less than 210 ng/ml. The serum aldolase A levels increased remarkable only in fulminant hepatitis. in contrast, 32 of 34 patients with liver cell carcinoma and all of 29 patients with metastatic liver carcinoma showed clearly increased serum aldolase A levels. More patients with primary liver cell carcinoma had increased serum aldolase A levels than elevations of serum alpha-fetoprotein. These results suggest that the determination of aldolase A by radioimmunoassay may be useful to differentiate malignant form nonmalignant liver diseases.

Studies on the serum aldolase activity in workers with muscle disorders caused by vibration work

Recently, vibrating tools such as chain saws, pneumatic hammers, rock drills, riveters, and grinders have been widely introduced in various industries in order to increase efficiency and to reduce the burden of labor. The disease due to hand-arm vibration often causes serious damages to the operator's body, more particularly of the circulatory, peripheral nervous, osteo-articular and muscular systems. Many kinds of examinations such as roentgenography, electromyography, and sthenometry have been used to diagnose the damage to the musculoskeletal systems. Among these, the measurement of muscular strength, evaluated by grip and pinch strength, is widely used in mass examinations of vibration hazards but this is not always effective in precise recognition of the decrease in muscular strength. In the present study, therefore, in order to diagnose the severity of muscle disorders objectively, serum activities of aldolase (ALD), creatine phosphokinase (CPK) and lactate dehydrogenase (LDH), which are called "muscle enzymes," were determined in 260 chain saw operators aged 40 to 59 years. The same tests were performed for 46 healthy subjects (controls) of a similar age-range, who had a very short experience handling bush cleaners. All chain saw operators were classified into four groups according to the total chain saw operating time (TOT): 1) 58 operators with up to 2,500 hours' experience, 2) 70 with 2,500-5,000 hours' experience, 3) 74 with 5,000-10,000 hours' experience, and 4) 58 with over 10,000 hours' experience. The relationships were investigated in their enzyme activities on the one hand, and their TOT, muscular strength and numbness and pain symptoms related to muscle disorders of the upper extremities on the other hand. The following results were obtained: 1) Serum ALD and LDH activities in chain saw operators increased in proportion to the decrease in muscular strength. The activity of ALD showed a tendency to increase with increased TOT. The ALD activity in the group with over 5,000 hours' experience was significantly higher than that in the control group. However, no relationships were observed between CPK, LDH activities and TOT. 2) In chain saw operators with numbness and pain symptoms, ALD activity in the group with 2,500 hours' experience was significantly higher than that in the control group. However, no obvious relationships were found between CPK, LDH activities and numbness and pain symptoms. 3) In chain saw operators with muscular weakness in addition to numbness and pain symptoms, ALD activity in the group with over 2,500 hours' experience was significantly higher than that in the control group.(ABSTRACT TRUNCATED AT 400 WORDS)

A non-competitive solid-phase radioimmunoassay for human aldolase A

A solid-phase, non-competitive radioimmunoassay for aldolase A in human serum has been developed. Human aldolase A was purified from muscle, and specific antisera to the purified aldolase A were obtained from chickens. Specific IgG anti-human aldolase A was purified by affinity chromatography. Disposable polypropylene plates were coated with specific IgG antibody and used for radioimmunoassay with 125I-specific IgG antibody to aldolase A. The non-specific binding was minimized by saturating the binding sites of the plates with 2% ovalbumin in 0.1% Tween 20. This radioimmunoassay is specific for the aldolase A subunit, with no cross-reactivity with human aldolase B subunit or homopolymeric human aldolase C (C 4). The serum aldolase A immunoreactivities of 33 normal subjects ranged from 124 to 212 ng/ml with a mean of 178 ±41 ng/ml (±2 SD). Ninety-three patients' sera were assayed with both a solid-phase non-competitive radioimmunoassay and a competitive double antibody radioimmunoassay developed in our laboratory and the results showed a high degree of correlation ( r = 0.912; p < 0.001). Rapidity and simplicity of the solid-phase assay makes it superior to other methods for the measurement of serum aldolase isozymes.

Muscle Involvement in Systemic Lupus Erythematosus

Of 228 patients with systemic lupus erythematosus (SLE) admitted to our inpatient service during a 6.5-year period, 18 (8%) had prominent muscle disease. In the majority of these patients, myositis occurred at the time of diagnosis of SLE. The creatine phosphokinase level was normal in all but one of these patients; however, the serum aldolase level was frequently elevated. All patients responded promptly to corticosteroid treatment. (<i>JAMA</i>1981;246:766-768)

Serum aldolase isoenzymes in athletes at rest and after long-lasting exercise.

Athletes in training have significantly higher levels of serum aldolase activity at rest when compared to nonathletes. This is due to the higher level (and higher proportion) of aldolase isoenzyme A, predominant in muscle. At rest, athletes with a history of infectious hepatitis show significantly higher proportional and absolute levels of aldolase B, predominant in liver. Long-lasting exercise leads to a rise in serum aldolase activity, which must be ascribed to the increase in isoenzyme A. Significant post-exercise changes in isoenzyme B were not observed. There was no correlation between changes in serum hemoglobin, as reflecting intravascular hemolysis, and changes in serum aldolase activity. The data are discussed in regard to the existing hypotheses regarding increases in serum enzyme activity after physical exercise.

Protein adsorption on glass surfaces using porous glass

Comparison of amino acid composition and other properties of proteins (horseradish peroxidase, bovine serum albumin, hemoglobin, catalase, and aldolase), which are separable on controlled-pore glass, showed that the elution order of proteins did not depend on their molecular weights, isoelectric points, hydrophobicity indices, and acidic and basic amino acid contents. The turbidity of the proteins bound on glass at 660 nm indicated the precipitated state of the proteins.

Hepatitis B Antigen Associated With Cryoglobulinemia, Peripheral Neuropathy, and Myopathy

To the Editor.— In the article Hepatitis B Antigen and Polymyositis Mihas et al (239:221, 1978) report a concomitant acute liver and muscle disease. The following case demonstrates a chronic hepatitis B virus (HBV)-positive liver disease with a concomitant muscle injury, and probably represents a less acute variant of the disease described by Mihas et al. Report of a Case.— A 38-year-old man complained of progressive weakness, muscle pains, impotence, and weight loss (18 kg in one year). No history of jaundice or any other disease was obtained. Findings from a physical examination were normal except for moderate proximal muscle wasting and reduced muscle strength. Laboratory studies showed fluctuating liver function test results (SGOT, 20 to 600 IU; SGPT, 20 to 350 IU; bromsulfophthalein retention of 12% to 30%; bilirubin, 0.3 to 2.5 mg/dL). Blood cell count and ESR were normal. The serum aldolase level was once mildly elevated (11.5

Acute renal failure due to non-traumatic rhabdomyolysis.

Summary Seventeen patients with acute renal failure of diverse aetiology showed myoglobinuria and elevated levels of serum creatine phosphokinase (mean 119·2 Sigma u./ml) and adolase (mean 88·5 Sibley-Lehninger (SL)u./ml), indicating the presence of diffuse muscle cell injury. The primary conditions which led to rhabdomyolysis and acute renal failure were burns, eclampsia, prolonged labour, crush injury, epileptiform convulsions, status asthmaticus, viral myositis and intoxication with chemicals including copper sulphate, mercuric chloride and zinc phosphide. In 10 non-myoglobinuric patients with acute renal failure, serum creatine phosphokinase was normal (mean 8·9 Sigma u./ml) and serum aldolase was only slightly elevated (mean 11·2 SL u./ml). Although uric acid was elevated in both groups, the values were significantly higher in myoglobinuric (mean 0·728 ± 0·199 mmol/l) compared to non-myoglobinuric patients (mean 0·583 ± 0·093 mmol/l). During the oliguric phase, hypocalcaemia was observed in 82·2% of myoglobinuric patients and in 20% of non-myoglobinuric patients. Ten out of 15 patients with myoglobinuric renal failure developed hypercalcaemia during the diuretic phase whereas only 3 non-myoglobinuric patients showed a transient hypercalcaemia. Although the mean serum potassium was somewhat higher in the myoglobinuric patients, the difference between the 2 groups was not significant. It is concluded that acute renal failure associated with non-traumatic rhabdomyolysis is not infrequent and may occur in a variety of conditions where gross evidence of muscle injury is lacking.

6 - Progressive Systemic Sclerosis: Skeletal Muscle Involvement

Despite the paucity of specific complaints referable to skeletal muscle, the majority of PSS patients have evidence of a primary myopathy, characterized by the insidious onset of mild proximal muscle weakness. Laboratory abnormalities include slight but significant elevation of serum aldolase and occasionally of serum CPK activity, increased urine creatine and reduced urine creatinine excretion, and increased polyphasic potentials of normal or decreased amplitude and duration. Muscle biopsy specimens tend to show increased interstitial fibrosis with less prominent inflammation or degeneration of myofibrils. Although rapid deterioration of muscle strength may occur rarely in the untreated state, most patients will have a stable or very slowly progressive course unaffected by the use of corticosteroid therapy. The unusual PSS patient with clinical and laboratory findings more in keeping with the ‘inflammatory’ myositis of PM/DM and MCTD must be identified, however, since such individuals may benefit greatly from the administration of corticosteroids.

The kinetic measurement of serum aldolase

The kinetic measurement of serum aldolase

Muscle involvement in leprosy and its correlation with serum aldolase activity.

ABSTRACT: Thirty‐six leprosy patients underwent muscle biopsy; the specimens were studied for serum aldolase activity. The authors concluded that muscle degeneration occurs only in lepromatous leprosy due to direct invasion by leprosy bacilli increasing serum aldolase activity during the active degenerative phase of the muscle fibers.

Steroid myopathy in connective tissue disease

In eight women with polymyositis (three patients), systemic lupus erythematosus (SLE) (three patients), rheumatoid arthritis (one patient) and shoulder-hand syndrome (one patient), weakness developed during high dose prednisone therapy. These women were studied using serial functional and manual muscle tests, determination of serum glutamic oxaloacetic transaminase (SGOT), creatinine phosphokinase (CPK) and serum aldolase levels, and urinary excretion of creatine. Insidious onset of weakness was characteristic. Myalgias were seen in five patients and unusual sudden weakness in two. Weakness was always most severe in the pelvic girdle muscles; there was a lesser involvement of shoulder girdle and distal muscles. Serum muscle enzyme levels were normal in all cases, but urinary creatine excretion was invariably increased and proved to be the most sensitive laboratory indicator for clinical diagnosis and for monitoring patient improvement. Serial urinary creatine excretion and serum enzyme studies were of value in differenting steroid myopathy from a flare of myositis in patients with connective tissue disease. Diagnosis and effective management were achieved by the use of readily available laboratory and clinical procedures without resorting to muscle biopsy.

Virial coefficients and intermacromolecular attraction of proteins in solution

The formal second and third virial coefficients B and C of egg albumin in the presence of various concentrations and types of the inorganic salts have been evaluated from the detailed osmotic pressure data of Bull and Breese in the region of very high protein concentrations. B for serum albumin, hemoglobin, β-lactoglobulin, myosin, hemocyanin, fibrinogen, alcohol dehydrogenase, enolase, lactate dehydrogenase, and aldolase have also been collected from the literature. The second virial coefficients obtained from the experimental data are always found to be smaller than those calculated theoretically on the basis of the volume excluded by the nonspherical molecules of proteins of known axial ratio. The difference between the calculated and experimental coefficients may represent the contribution of the intermacromolecular attraction in the solution to the virial coefficients. The attractive coefficients B a and C a are observed to depend on the nature and shape of the proteins as well as on the ionic strength and composition of the surrounding aqueous medium. The thermodynamic aspects of the intermacromolecular attraction have been discussed in the light of the values of the attraction coefficients. From the detailed mathematical analysis, the relation between the formal virial coefficients A, B, C, etc., with the empirical virial coefficients A′, B′, and C′, suggested by Bull and Breese have been established.

Development of a Thermometric Assay for Cancer Differentiation Based on Aldolase Isozyme Patterns

Abstract A microcalorimetric assay for aldolase isoenzymes in serum, using a Tian-Calvet conduction calorimeter, has been investigated for measurement of activities of serum aldolase toward fructose-1, 6-diphosphate (FDP) and fructose-1-monophosphate (FMP), and of the ratios between these activities as a function of disease state, specifically cancer. Chart deflection measures were found to be proportional to total heat involved and to bear a linear relationship to the amount of aldolase activity toward either substrate in the sample. Differentiation of a cancerous from a noncancerous population was distinct and unambiguous. The ratios of activity toward FDP and FMP were 3. 73 ± 0. 22 and 13. 20 ± 0. 80 in noncancerous and cancerous sera, respectively. The ease and rapidity of assay suggests considerable potential utility as a routine screening method for certain forms of cancer.