Cholinesterase

Cholinesterase analysis at IntroLab in Vrachar is recommended for individuals who show symptoms of poisoning by organophosphate pesticides or are at risk of such poisoning. Additionally, this analysis is useful for people whose family members have experienced episodes of prolonged apnea and muscle paralysis after the administration of the anesthetic succinylcholine. This blood laboratory analysis is also relevant for individuals with liver damage, including those with viral hepatitis, liver cirrhosis, or liver metastases.

Cholinesterase – Definition

Cholinesterase is an enzyme present in various parts of the body, including the liver, pancreas, heart, white brain matter, and serum. This enzyme plays a crucial role in the hydrolysis of cholinergic compounds. Unlike acetylcholinesterase, which is found in erythrocytes and has a preference for acetylcholine (a neurotransmitter), serum cholinesterase shows a greater affinity towards butyrylcholine and breaks it down more rapidly. Although the biological purpose of cholinesterase is still unclear, its serum level can serve as an indicator of potential insecticide poisoning.

Cholinesterase is often used as a measure of liver function, as part of liver enzyme analysis, with a half-life between 10 and 14 days. A significant prolongation of neuromuscular blockade by succinylcholine requires a reduction in cholinesterase concentration greater than 75%. Preoperative cholinesterase tests are used to identify patients with atypical forms of the enzyme to avoid prolonged apnea caused by the slow elimination of muscle relaxants.

Cholinesterase analysis – Interpretation of results

Decreased cholinesterase values may indicate:

• acute or chronic hepatocellular insufficiency
• collagen disease
• organophosphate poisoning
• cirrhosis
• heart attack
• acute infections and atypical enzyme phenotypes.

Conversely, causes of elevated values can include alcoholism, asthma, and psoriasis.

Sampling procedure

Sampling for cholinesterase analysis at IntroLab is done by taking blood from a vein. This procedure is quick and painless. A medical professional will sterilize an area of your arm and place an elastic band around the upper part of your arm to make the vein more visible. Then, they will use a needle to take a blood sample, which is then sent for analysis.

After taking the sample, sterile gauze is applied to the puncture site to stop bleeding. Blood drawing for cholinesterase analysis does not require special preparation, and you can continue with your usual activities immediately after the sample is taken.