Cholinesterase

Cholinesterase is an enzyme that supports the proper functioning of the nervous system. There are two types of cholinesterase:

• Acetylcholinesterase: These are found in RBCs of lungs, spleen, nerve endings, and the brain’s grey matter.
• Pseudocholinesterase: You can find them in serum, liver, muscle, pancreas, the white matter of the brain, and the heart.

The enzyme plays a vital role in transmitting the nerve impulse by breaking down the neurotransmitter acetylcholine. A reduction in the activity of the cholinesterase leads to an excess of acetylcholine in the nerve ending, leading to overstimulation of nerves within the body.

A serum cholinesterase test identifies the efficacy of the nervous system function to avoid overstimulation of post-synaptic nerves, exocrine glands, and muscles. Your doctor may suggest the cholinesterase test to:

• Detect liver disorders.
• Rule out the possibility of apnea before administering anaesthesia.
• Find an infection in the body. 
• Determine the possibility of liver damage, heart attack, and obstructive jaundice. 
• Diagnose metastasis of a cancerous growth.
• Check pesticide or insecticide poisoning.
• Diagnose inflammation due to a severe disease. 
• Assess chronic malnutrition in an individual.
• Examine a family history of postoperative paralysis.
• Manage the occupational hazard of working around chemicals like organophosphates.

Apollo 24|7 has an all-inclusive panel for blood cholinesterase test to measure the following parameters: 
Organophosphate pesticide exposure: Most insecticides and pesticides contain organophosphates that inhibit the activity of cholinesterase and pseudocholinesterase. These chemicals can enter the system by inhalation, ingestion, or epidermal exposure. Hence, finding out the levels through a blood cholinesterase test can estimate the level of poisoning in the body. This further aids in reducing occupational exposure to the chemicals.

Pseudocholinesterase deficiency: Some individuals have a genetic disorder that causes the lack of pseudocholinesterase. As a result, the individual experiences a long-lasting effect of powerful drugs. In such a case, muscle relaxants and anaesthesia lead to apnea and muscle paralysis. Hence, the more extended bioavailability of drugs could cause severe complications in the body.

A blood cholinesterase test is essential because inactivity of the enzyme causes impairment of neuromuscular junction. The muscles remain at the contracted stage until the enzyme breaks down the molecule into choline and acetic acid. This tension in the muscle could lead to severe conditions, which might become permanent.

Below are some of the symptoms that can be taken as a sign to go for a serum cholinesterase test: 

• Nausea, dizziness, and headache
• Watery eyes with irritation
• Excessive salivation or sweating
• Diarrhoea or vomiting
• Constriction in pupils leading to vision problems 
• Impaired muscle coordination 
• Constantly in need of ventilation due to breathing difficulties

In addition, many severe cases may lead to seizures, coma, and death. The starting signs of going for a blood cholinesterase test could be the twitching of muscles.