Thymidine kinases: the enzymes and their clinical usefulness.

Thymidine kinases (TK) convert thymidine, or deoxythymidine (dT) to the respective monophosphate. TK occurs in many different procaryotic and eucaryotic species and different TK isoenzymes are found within the same eucaryotic cell. One isoenzyme (foetal, cytoplasmic, TK1) is associated with cell division while the other (adult, mitochondrial, TK2) is cell cycle independent. The relative isoenzyme activities in a tissue thus reflect the fraction of proliferating cells. The gene encoding TK1 has been cloned for many species and regulation of its expression is known to be complex. Increases in TK activity appear to correlate with the presence of human neoplasia and disease progression and regression have been reported to correlate with TK levels in many cancer types. TK estimations in human lymphoproliferative diseases have implicated this enzyme as an early marker of maldifferentiation. TK levels may also be increased in non-dividing mammalian cells infected with RNA or DNA viruses. Some virus encoded TK has been shown to differ biochemically, immunologically and in substrate specificity from the corresponding TK isoenzymes in target host cells thus facilitating the development of specific antiviral therapeutics. Further, TK1 in leukemic cells may differ biochemically from normal cellular TK1 such that tumor-specific TK may provide a target for tumor detection and therapy. TK quantitation has conventionally been performed in assays of enzyme activity using radiolabeled (3H or 125I) nucleoside substrates. The development of TK1-specific, non-radioisotope based immunoassays and the measurement of TK mRNA in tumour tissue using TK (DNA or RNA) probes may prove sufficiently valuable to be incorporated into the routine clinical management of human cancer.