Red blood cell acetylcholinesterase activity among healthy dwellers of an agrarian region in Sri Lanka: a descriptive cross-sectional study

Devarajan Rathish,Channa Jayasumana,Indika Senavirathna,Suneth Agampodi

doi:10.1186/s12199-018-0717-0

Abstract

BackgroundAssessment of acetylcholinesterase-inhibitor insecticide (AChEII) toxicity depends on the measurement of red blood cell acetylcholinesterase (RBC-AChE) activity. Its interpretation requires baseline values which is lacking in scientific literature. We aim to find the measures of central tendency and variation for RBC-AChE activity among dwellers of Anuradhapura, where the use and abuse of AChEIIs were rampant for the last few decades.MethodsA descriptive cross-sectional study with a community-based sampling for 100 healthy non-farmers (male:female = 1:1) was done using pre-determined selection criteria. Duplicate measurements of RBC-AChE activity were performed according to the modified Ellman procedure. Pearson’s correlation and regression analysis were sort for RBC-AChE activity against its possible determinants.ResultsRBC-AChE activity had a mean of 449.8 (SD 74.2) mU/μM Hb with a statistical power of 0.847. It was similar to values of “healthy controls” from previous Sri Lankan toxicological studies but was low against international reference value [586.1 (SD 65.1) mU/μM Hb]. None of the possible determinants showed a significant strength of relationship with RBC-AChE activity.ConclusionThe baseline RBC-AChE activity among people of Anuradhapura is low in comparison with international reference values. This arises a need to find a causative mechanism.

Highlights

Assessment of acetylcholinesterase-inhibitor insecticide (AChEII) toxicity depends on the measurement of red blood cell acetylcholinesterase (RBC-AChE) activity
Assessing acute or occupational toxicity to AChE inhibitors requires an understanding of the baseline Red blood cell (RBC)-AChE activity for the geographical area, which is lacking in scientific literature
The standard error of kurtosis and skewness were 0.490 [√(24/n)] and 0.245 [√(6/n)] respectively. Absolute values of both kurtosis and skewness fall within ± 2 times of its standard errors, which indicate that the data are symmetric and showing near normality

Summary

Introduction

Assessment of acetylcholinesterase-inhibitor insecticide (AChEII) toxicity depends on the measurement of red blood cell acetylcholinesterase (RBC-AChE) activity. Acetylcholinesterase (AChE) hydrolyses acetylcholine (ACh) at the cholinergic pathways of central and peripheral nervous systems. This leads to a resting state which is essential for further uninterrupted neurotransmission [1]. AChE inhibitors lead to accumulation of ACh and subsequent overstimulation of cholinergic receptors which disrupts neurotransmission. AChE inhibitor-insecticides (AChEIIs) lead to acute or chronic poisoning in human. Red blood cell (RBC) AChE activity is used as a marker of toxicity, as it correlates better with the central nervous system AChE [5]. OP poisoning has a case fatality rate of 5– 20% in Asia, whereas it is 5.8% for Anuradhapura [7, 8]

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