Nicol P D, Matsueda G R, Haber E, Khaw B A
Cardiac Unit, Massachusetts General Hospital, Boston.
J Nucl Med. 1993 Dec;34(12):2144-51.
To determine if the presence of cardiac light chains in blood could be used to detect acute myocardial infarction, we developed a specific light chain immunoassay. A synthetic peptide sequence specific for human cardiac ventricular myosin light chain 1 (VLC1) was synthesized and designated P348. This peptide coupled to keyhole limpet hemocyanin was used as an immunogen to obtain murine monoclonal antibodies specific for VLC1. Five monoclonal antibodies were obtained. One of these designated Mab-8E3 reacted equally well with both the synthetic peptide and VLC1. Although the 8E3 antibody is specific for VLC1, the use of HPLC purification of skeletal muscle myosin light chain 1 demonstrated that VLC1 is present in human skeletal muscle. The clinical utility of the assay was tested in 18 patients with creatine kinase (CK) and ECG documented acute myocardial infarction. VLC1 was below the limit of detection (< 1 ng/ml) in sera obtained from healthy volunteers and patients without myocardial infarction or chest pain. In contrast VLC1 was elevated in the serum of all 18 patients with acute myocardial infarction. Combining the two test results at the time of admission resulted in 83% of patients having detectable serum levels of one or both markers.
为了确定血液中是否存在心肌轻链可用于检测急性心肌梗死,我们开发了一种特异性轻链免疫测定法。合成了一段对人心室肌球蛋白轻链1(VLC1)特异的合成肽序列,并命名为P348。将该与钥孔血蓝蛋白偶联的肽用作免疫原,以获得对VLC1特异的鼠单克隆抗体。获得了五种单克隆抗体。其中一种命名为Mab - 8E3的抗体与合成肽和VLC1的反应同样良好。尽管8E3抗体对VLC1特异,但使用高效液相色谱法纯化骨骼肌肌球蛋白轻链1表明VLC1存在于人体骨骼肌中。在18例有肌酸激酶(CK)和心电图记录的急性心肌梗死患者中测试了该测定法的临床实用性。在从健康志愿者以及无心肌梗死或胸痛的患者获得的血清中,VLC1低于检测限(<1 ng/ml)。相比之下,所有18例急性心肌梗死患者的血清中VLC1均升高。入院时将两项检测结果相结合,83%的患者血清中可检测到一种或两种标志物。