Organophosphates bind irreversibly to acetylcholinesterase and
plasma cholinesterase, rendering them unable to cleave acetylcholine at pre- and postsynaptic junctions and at skeletal muscle and central nervous system receptors.
In literature, numerous scoring systems were used to assess patients with poor prognoses, such as the Glasgow Coma Scale (GCS), the Acute Physiology and Chronic Health Evaluation (APACHE-II), the Simplified Acute Physiology Score (SAPS),4 Body Mass Index (BMI),5
plasma cholinesterase (PChE) levels, biochemical and inflammatory response markers and red cell distribution width (RDW).6
Association between life-threatening cocaine toxicity and
plasma cholinesterase activity.
Angiotensin converting enzyme (ACE) assay and determination of aldosterone, vasopressin and
plasma cholinesterase activity
Erythrocyte and
plasma cholinesterase activity in normal pregnancy.
Correlation of succinylcholine duration of action with
plasma cholinesterase activity in subjects with the genotypically normal enzyme.
AChE activity is an appropriate method to assess past exposures to carbamate and organophosphate pesticides because it has a long recovery time, thus reflecting longer-term exposures than
plasma cholinesterase (butyrylcholinesterase) or pesticide metabolite quantification (Lotti 1991; Mason 2000).
These agents are predominantly metabolised by
plasma cholinesterase. Metabolism may be slower in patients with genetically abnormal pseudocholinesterase.
A naturally occurring molecular form of human
plasma cholinesterase is an albumin conjugate.
With interest we read the report by Eissa and Lim describing the successful use of rocuronium reversed by sugammadex to provide muscle paralysis for electroconvulsive therapy (ECT) in a patient with a history of
plasma cholinesterase deficiency (1).
Section personnel are capable of focusing on low levels of nerve and blister agents and can also evaluate for Soldier exposure to a nerve agent by analyzing for
plasma cholinesterase. (1) The analyses and tools used are familiar to the Chemical Corps.