RESUMEN
The production, identification, and utilisation of monoclonal antibodies to enzymes are reviewed. Such antibodies may be produced in vitro by the mouse-hybridoma technique, may occur naturally in vivo as enzyme-binding immunoglobulins and may be produced in the laboratory from the lymphocytes of patients whose sera contains such immunoglobulins. The diagnostic application of monoclonal antibodies to enzymes is considered, with special reference to their use in the measurement of the MB-isoenzyme of creatine kinase, pancreatic isoamylase, prostatic acid phosphatase, and the isoenzymes of alkaline phosphatase.
Asunto(s)
Fosfatasa Ácida/sangre , Fosfatasa Alcalina/sangre , Anticuerpos Monoclonales , Creatina Quinasa/sangre , Glicósido Hidrolasas/sangre , Isoamilasa/sangre , Fosfatasa Ácida/inmunología , Fosfatasa Alcalina/inmunología , Especificidad de Anticuerpos , Creatina Quinasa/inmunología , Humanos , Isoamilasa/inmunología , Isoenzimas/sangre , Isoenzimas/inmunología , Masculino , Páncreas/enzimología , Próstata/enzimologíaAsunto(s)
Glicósido Hidrolasas/aislamiento & purificación , Isoamilasa/aislamiento & purificación , Páncreas/enzimología , Glándulas Salivales/enzimología , Adolescente , Adulto , Anciano , Especificidad de Anticuerpos , Humanos , Sueros Inmunes/análisis , Isoamilasa/inmunología , Persona de Mediana Edad , Radioinmunoensayo , Valores de ReferenciaRESUMEN
Serum total amylase, pancreatic and salivary isoamylase, lipase and trypsin-like immunoreactivity (TLI) were measured in 16 patients with acute pancreatitis, 37 patients with chronic pancreatitis, 11 patients with pancreatic cancer, and 53 control subjects in order to evaluate the relative value of these tests in the diagnosis of pancreatic disease. In acute pancreatitis patients studied within 2 days from the onset of pain all pancreatic enzymes were abnormally high. In chronic pancreatitis patients serum pancreatic isoamylase and TLI were abnormally low in 8 out of 10 patients with severely impaired pancreatic exocrine function, while lipase was abnormally low in 6 patients. During acute exacerbations of the disease elevated levels of pancreatic isoamylase and lipase, but not of TLI, were found in about one third of cases. In patients with pancreatic cancer the pattern of changes in serum pancreatic enzymes was variable since levels within, below and above the normal range were found. The results demonstrate that in acute pancreatitis all serum pancreatic enzymes had the same diagnostic sensitivity, however serum lipase determination is the most convenient because of its simplicity and low cost. In chronic pancreatitis serum pancreatic isoamylase and TLI may be useful in detecting severe pancreatic insufficiency. In pancreatic cancer serum pancreatic enzymes lack diagnostic specificity.