title: Immunoglobulin response to intravenous streptokinase in acute myocardial infarction.
abstract: OBJECTIVE
  To devise assays to assess and follow the specific antibody response in patients treated with streptokinase for acute myocardial infarction.
  
  
  METHODS
  Venous blood samples were collected before treatment with streptokinase started and subsequently at regular intervals over one year. Specific IgG and subclass IgG1 were assessed by an enzyme linked immunosorbent assay.
  
  
  METHODS
  Coronary care unit in a general hospital.
  
  
  METHODS
  48 patients with acute myocardial infarction: 22 patients had venous blood samples taken at presentation only; serial blood samples were taken from 20 patients who then received thrombolytic therapy with streptokinase and six patients who were unsuitable for thrombolytic therapy.
  
  
  RESULTS
  Titres of antibodies to streptokinase were low at presentation in 36 (75%) of the 48 patients. Serial measurements made in 20 patients showed the virtual disappearance of antibody within the first 24 hours. This was followed by a steady increase in the specific IgG1 titre, which peaked at day 14 before gradually declining. Values at one year remained significantly higher than baseline values. There was no evidence of an IgM response in the patients studied.
  
  
  CONCLUSIONS
  Low titres of antibodies to streptokinase were widespread in the population. Antibody was consumed after treatment and the subsequent immunoglobulin rise suggested a secondary immune responses; the recently described neutralising capacity to streptokinase is probably related to this antibody.
authors.affiliation: Department of Cardiology, General Hospital, Birmingham.
authors.forename: M
authors.initials: M
authors.lastname: Lynch
authors.forename: W A
authors.initials: WA
authors.lastname: Littler
authors.forename: B L
authors.initials: BL
authors.lastname: Pentecost
authors.forename: R A
authors.initials: RA
authors.lastname: Stockley
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000097:blood; D000917:Antibody Formation / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000276:immunology*; D013300:Streptokinase / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors
chemical_list: D000906:Antibodies; D007074:Immunoglobulin G; D013300:Streptokinase