Blood Cholinesterase Levels Research Articles

Clinical sighificance of Blood glucose, AFP and cholinesterase levels on the early diagnosis and prognosis of severe hepatitis patients

Objective To study clinical value of blood glucose, AFP and cholinesterase levels on the diagnosis and prognosis of severe hepatitis. Methods Retrospective analysis of chronic hepatitis B, cirrhosis, chronic severe hepatitis, subacute severe hepatitis was carried out. In severe hepatitis patients, between the improved group and death group, blood glucose, AFP, cholinesterase differences, evaluate blood glucose, alpha-fetoprotein, cholinesterase levels on the diagnosis and prognosis of severe hepatitis value were compared. Results Subacute severe hepatitis, chronic severe hepatitis patients and blood cholinesterase levels were significantly lower than that in patients with chronic hepatitis B and liver cirrhosis(all P ＜ 0.05) ;and alpha-fetoprotein level was significantly higher than the level of chronic hepatitis B patients(P ＜ 0. 01) ;improved levels of blood glucose in patients with severe hepatitis, AFP, cholinesterase levels were significantly higher than the level of death group (all P ＜ 0.05). Conclusion Blood glucose, AFP, cholinesterase levels of liver disease progression and prognosis were important to determine the value. Key words: Hepatitis; Glucose; Alpha-fetoprotein; Cholinesterase

Serum creatine phosphokinase: A probable marker of severity in organophosphorus poisoning

Organophosphorus (OP), the commonest agent for poisoning in India due to its easy availability, acts by inhibiting acetylcholinesterase at muscarinic and nicotinic receptors. Erythrocyte cholinesterase (EchE) and plasma cholinesterase (PchE) are reduced in OP poisoning, but their estimation is costly and not regularly performed. There are emerging options for new cheaper biochemical markers in relation to OP poisoning. Serum level of creatine phosphokinase (CPK) is often found to be elevated in OP poisoning. This study was conducted to see if CPK may be used as an alternative of cholinesterase levels in blood to assess the severity of OP poisoning. This was a prospective and observational study. Sixty-three patients of OP poisoning without any prior treatment, presenting within 6 hours, were selected and their clinical severity was categorized according to Peradeniya organophosphorus poisoning (POP) scale. Level of serum CPK, blood EchE and pH were measured following admission, and total dose of atropine (mg) until the final clinical outcome (complete recovery or death) was calculated. Student's t-test and Pearson's correlation coefficient was used for the assessment of statistical significance. According to POP scale, clinical severity was mild (score 0–3) in 17 (27%), moderate (score 4–7) in 32 (50.8%) and severe (score 8–11) in 14 (22.2%) patients. Serum CPK, EchE level, blood pH and total atropine dose strongly correlated with clinical severity. Our study recommends serum CPK as an alternative marker.

Altered Levels of Acetylcholinesterase in Alzheimer Plasma

BackgroundMany studies have been conducted in an extensive effort to identify alterations in blood cholinesterase levels as a consequence of disease, including the analysis of acetylcholinesterase (AChE) in plasma. Conventional assays using selective cholinesterase inhibitors have not been particularly successful as excess amounts of butyrylcholinesterase (BuChE) pose a major problem.Principal FindingsHere we have estimated the levels of AChE activity in human plasma by first immunoprecipitating BuChE and measuring AChE activity in the immunodepleted plasma. Human plasma AChE activity levels were ∼20 nmol/min/mL, about 160 times lower than BuChE. The majority of AChE species are the light G1+G2 forms and not G4 tetramers. The levels and pattern of the molecular forms are similar to that observed in individuals with silent BuChE. We have also compared plasma AChE with the enzyme pattern obtained from human liver, red blood cells, cerebrospinal fluid (CSF) and brain, by sedimentation analysis, Western blotting and lectin-binding analysis. Finally, a selective increase of AChE activity was detected in plasma from Alzheimer's disease (AD) patients compared to age and gender-matched controls. This increase correlates with an increase in the G1+G2 forms, the subset of AChE species which are increased in Alzheimer's brain. Western blot analysis demonstrated that a 78 kDa immunoreactive AChE protein band was also increased in Alzheimer's plasma, attributed in part to AChE-T subunits common in brain and CSF.ConclusionPlasma AChE might have potential as an indicator of disease progress and prognosis in AD and warrants further investigation.

Comparison of selected skin decontaminant products and regimens against VX in domestic swine

An anesthetized domestic swine model was used to compare the efficacy and cross-contamination potential of selected skin decontaminant products and regimens against the chemical warfare agent, VX. Animals topically exposed to 2x, 3x or 5x LD(50) VX showed typical signs of organophosphate nerve agent poisoning, including miosis, salivation, mastication, dysrhythmias, and respiratory distress prior to death. Animals were exposed to 5x LD(50) VX and then decontaminated 45 min later with the reactive skin decontamination lotion (RSDL), Fuller's earth (FE), 0.5% hypochlorite, or soapy water. Survival was 100% when the reactive skin decontamination lotion or FE was utilized, although 50% of Fuller's earth-decontaminated animals exhibited serious signs of VX poisoning. Decontamination of VX-treated animals with 0.5% hypochlorite was less effective but also increased survival. Soapy water was ineffective in preventing lethality. Blood cholinesterase levels were not predictive of clinical outcome in decontaminated animals. The potential of "decontaminated" VX in open wounds to cause poisoning was assessed by vigorously mixing 5x LD(50) VX with the test decontaminants for 5 min and then placing the mixture onto a full-thickness skin wound. Soapy water was ineffective in preventing lethality. Although treatment with dry Fuller's earth prevented death and all signs of organophosphate poisoning, a significant proportion of treated animals decontaminated with Fuller's earth in aqueous suspension exhibited serious signs of organophosphate poisoning, suggesting that live agent may be desorbed from Fuller's earth when it is exposed to a liquid environment. Animals treated with reactive skin decontamination lotion or 0.5% hypochlorite-VX mixtures showed no signs of organophosphate poisoning during the 6- h test period.

Organophosphate Pesticides Overexposure on Children Working and Living in an Agricultural Area in Brazil

P-350 Introduction: Considerable efforts have to be made to evaluate impact of pesticides exposure on health of children working on or living near agricultural areas. This work aimed the assessment of epidemiological and biological monitoring data to evaluate pesticides exposure in a group of children directly involved with working activities in the field at an agricultural community in Brazil. Methods: A group of 73 children, age 13,65 ± 2,36 (mean ± s.d), under multiple exposure to pesticides, including organophosphates methamidophos, methyl parathion and fenitrothion, were selected at this study. Plasma and erythrocyte acetylcholinesterase activities were measured using EQM testmate kit. Blood cholinesterase levels were dichotomized into low and normal categories for statistical analyses, which was performed using bivariate and multivariate models (student’s t-test, linear and logistic regression). Urinary p-nitrophenol and p-aminophenol levels were analysed by an HPLC method developed and validated in our laboratory. Urine and blood samples were obtained by the same time, in the morning after one usual spraying shift. Interviews were also performed to assess important occupational exposure variables and to investigate possible associations between biological monitoring and epidemiological data. Results: In relation to erythrocyte acetylcholinesterase, our results showed significant associations in the low category group as compared to the normal category group in the following situations: 1- Activity of applying or mixing pesticides (OR=2.33 - 95% CI =1.13–4.44) and 2- More than 6 hours work shift spraying pesticides OR=3.67 (1.79–6.32). Results from plasma cholinesterase activity showed significant associations with: 1- No protective measures to mix pesticides formulations OR=4.24 (1.62–7.87); 2- More than 6 hours work shift spraying pesticides OR=2.88 (1.08–5.49) and 3- Skin contact with pesticides while applying formulations on crop OR=2.48 (1.39–8.43). Urinary analyses of p-nitrophenol and p-aminophenol (respective ending products from methyl parathion and fenitrothion metabolism) from 12 urine samples showed significant detection levels of p-nitrophenol, which was significantly correlated with lower levels of cholinesterases. Conclusion: Evaluation of organophosphate pesticides overexposure has to be determined with as many sensitive indicators as possible to assess an actual profile of health status of exposed individuals. Children overexposure to pesticides becomes a major threat in rural communities as they are disproportionally exposed in comparison to adults due to their great intake of food, water and air per unit of body weight, and different metabolism rates. More studies and public health policies have to address the minimization of impact of pesticides exposure on health of children working in agriculture.

The effect of tobacco consumption on blood cholinesterase levels among workers exposed to organophosphorus pesticides

This is a cross-sectional study of workers in the pesticide industry, engaged in the formulation and packaging of organophosphorus compounds. A detailed history was taken of all study participants. Investigations carried out were the measurement of haemoglobin levels and estimation of whole blood cholinesterase levels. The prevalence of tobacco consumption in the industry is 76.09%. The mean age of employees was 42.8 years and the mean duration of service was 16.6 years. The study concludes that tobacco consumption increases the risk of toxicity due to organophosphorus pesticides, as indicated by a decrease in the blood cholinesterase levels. In this study, the age of employees and duration of service in the pesticide industry played no role in increasing the risk of toxic effects when exposed to organophosphorus pesticides.

Neurologic and Immunologic Effects of Exposure to Corticosterone, Chlorpyrifos, and Multiple Doses of Tri-Ortho-Tolyl Phosphate Over a 28-Day Period in Rats

An animal (rat) model of chronic stress (corticosterone in the drinking water) was used to study the interaction of stress and the organophosphorus (OP) neurotoxicants chlorpyrifos (60 mg/kg subcutaneously in a single dose) and tri-ortho-tolyl phosphate (TOTP, at 75, 150, or 300 mg/kg given 7 times orally in a 2-wk period). Adult male Long-Evans rats were provided with cortico-sterone in drinking water (400 μg/ml, w/v) for a total of 28 d, which led to significantly decreased weight and decreased cellularity of the thymus and spleen. Seven days after initiation of cortico-sterone treatment, half of the rats were given chlorpyrifos, and an additional 7 d later the 2-wk, 7-dose treatment of TOTP was initiated. During the 28-d test period, behavior of rats was evaluated using a functional observational battery (FOB), motor activity, and passive avoidance. Reductions in body weight, grip strength, and ambulatory movements occurred as a result of corticosterone treatment. Decreased body weight and grip strength were also elicited by TOTP, and the inter-actions of corticosterone and TOTP enhanced the effects on body weight and grip strength. Blood cholinesterase levels were obtained during the 28-d study period and found useful for monitoring OP exposure. At the end of the 28-d testing period, rats were sacrificed and activities of cholinesterase, neurotoxic esterase (neuropathy target esterase), and/or carboxylesterase were evaluated in blood, liver, and/or brain regions (basal forebrain, caudate putamen, cerebral cortex, hippocampus). All these esterases in brain were inhibited in a dose-related manner by TOTP, with some enhancement in rats drinking corticosterone-containing water. In addition, choline acetyltransferase, glial acidic fibrillary protein (GFAP), glutathione peroxidase, and superoxide dismutase were evaluated in one or more of the brain regions already identified. Choline acetyl-transferase, glutathione peroxidase, and superoxide dismutase activities were unaffected by treatments. However, GFAP was elevated above control levels in the cerebral cortex of rats by all treatments (corticosterone, chlorpyrifos, TOTP). Neuropathological examination revealed early stages of dose-related increased distal myelinated fiber axonal degeneration seen in the medullary fasciculus gracilis at only the highest dose of TOTP (300 mg/kg).

Evaluation of cholinesterase level in an endemic population exposed to malathion suspension formulation as a vector control measure.

The manuscript describes a study on the blood cholinesterase (ChE) level in an exposed population at different interval of time after spraying with malathion suspension (SRES) use for kala-azar vector control in an endemic area of Bihar, India. The toxicity of a 5% malathion formulation in the form of a slow release emulsified suspension (SRES) was assessed by measuring serum ChE levels in spraymen and in the exposed population. The study showed a significant decrease in ChE levels in the spraymen (p < 0.01) after one week of spraying and in exposed population one week and one month after of spraying (p < 0.01), but was still within the normal range of ChE concentration, one year after spraying, the ChE concentration in the exposed population was the same as prior to spraying (p > 0.01). On no occasion was the decrease in ChE level alarming. A parallel examination of the clinical status also showed the absence of any over toxicity or any behavioural changes in the exposed population. Hence, it may be concluded that 5% malathion slow release formulation, SRES, is a safe insecticide for use as a vector control measure in endemic areas of kala-azar in Bihar, India so long as good personal protection for spraymen is provided to minimize absorption and it can substitute the presently used traditional DDT spray.

The recognition and treatment of the intermediate syndrome of organophosphate poisoning in a dog

AbstractObjective: To discuss a new clinical presentation of organophosphate toxicity called the intermediate syndrome in a dog.Case summary: A mixed breed dog presented with generalized weakness, hypoventilation and hypoxemia. The weakness was most marked in the thoracic limbs, cervical and respiratory muscles. The history revealed a likely exposure to an organophosphate compound. The other dog in the household demonstrated mild clinical signs of organophosphate toxicity. A blood cholinesterase level was markedly reduced. Therapy included placement of a tracheostomy tube and mechanical ventilation. The dog gradually improved over the following 8 days but had persistent cervical ventroflexion for a total of 4 weeks.New or unique information provided: Organophosphate toxicity can present as a paralysis following the acute cholinergic crisis. The muscular weakness predominantly affects the thoracic limb and neck muscles but cranial nerve deficits can also occur. Dogs can die from the associated respiratory depression. Oxime therapy is indicated in the treatment of this syndrome.

CORRELATION OF BLOOD CHOLINESTERASE LEVELS WITH TOXICITY OF SARIN IN RATS

The dose-mortality response curve for sarin when administered to pregnant rats is extremely steep. The pregnant animal either died during the treatment or survived with no observable fetal toxicity. Animals that died displayed many symptoms characteristic of anticholinesterase toxicity. The present study was conducted to determine whether the maternal deaths, clinical observations, and/or weight loss could be correlated with baseline blood cholinesterase levels in individual animals. Cholinesterase levels (plasma and erythrocyte) were obtained prior to, during, and following treatment of nonpregnant rats by gavage with 380 µg/kg/d sarin for 10 d. After the first dose, there was a drop in the plasma cholinesterase levels, which then remained low throughout the dosing period. There was a statistically significant correlation between body weight loss and plasma cholinesterase levels of the sarin dosed animals. The surviving animals also had lower plasma cholinesterase levels and lower body weights, both of which recovered on the cessation of dosing. The erythrocyte cholinesterase levels were not different between treated and nontreated rats. Neither plasma or erythrocyte baseline cholinesterase levels nor relative or absolute cholinesterase decline values could be used as predictors of mortality from sarin administration in rats.

Monitoring Acetylcholinesterase Levels In Migrant Agricultural Workers and Their Children Using a Portable Test Kit

The EQM Research, Inc., portable test kit was evaluated as a surveillance tool for blood cholinesterase levels among migrant workers and their children. Laboratory validation demonstrated a linear relationship between the reference Ellman and kit methods (Ellman = 0.95 x kit result + 0.82, r2 = 0.98). Pre- and post-season cholinesterase levels measured in 70 farm workers were within normal ranges, but significantly different at 28.5 and 29.7 U/g Hb, respectively (paired t-test, p = 0.014). Results from 98 migrant farm worker children and a comparison group of 53 age-matched non-agricultural children showed that cholinesterase levels were not significantly different between the agricultural and non-agricultural children (ANOVA, p = 0.69). These data demonstrate that a portable test kit can provide useful data pesticide exposures when measurements are made in a temperature-controlled setting.

Sintomatología persistente en trabajadores industrialmente expuestos a plaguicidas organofosforados

To describe the patterns of persistent symptomatology in workers industrially exposed to organophosphate pesticides. An observational, descriptive and cross-sectional study was performed. A questionnaire was applied to managers of a factory and to 89 workers, whose erythrocytic cholinesterase level was measured with the Magnotti and Lovibond method. Information is described through rates, central tendency measures and dispersion. Differences between groups were evaluated with the chi 2 test and the odds ratio was calculated. Persistent symptomatology was found in 6.3 per 10 workers. 50% had six or more symptoms. No significant differences were found as to the risk of suffering from persistent symptomatology with respect to age, length of service or position at work. However, the highest proportion of symptoms was found in workers of 31 to 40 years of age, with 6 to 13 years of service, from the maintenance area, working as general operators or supervisors. Among the 13 workers with previous intoxication, the prevalence of persistent symptomatology was 6.9 against 6.1 in workers who had not been intoxicated before. The risk of acute poisoning in workers with more than 14 years of service was 4 times greater than in workers with less than 14 years of service (p < 0.005). Average level of blood cholinesterase was normal (4.4 u/ml). Results show a relationship between exposure to organophosphate pesticides and presence of persistent symptoms. It is necessary to study the prevalence of this symptomatology in exposed and non-exposed populations.

Rapid Assessment of Organophosphate-Induced Cholinesterase Depression: A Comparison of Laboratory and Field Kit Methods to Detect Human Exposure to Organophosphates

Summary The National Institute for Occupational Safety and Health (NIOSH) recommends monitoring blood cholinesterase levels among workers who handle pesticides as a means of detecting exposure to organophosphate compounds that inhibit these enzymes. Traditionally this medical surveillance involves collecting venipuncture blood samples that are sent to a laboratory for analysis. Because this can be a time-consuming process, and because workers often object to serial venipuncture sampling, rapid-assay technology is being developed. To test the reliability of an on-site finger-stick system, we tested 97 workers for cholinesterase inhibition using the standard venipuncture method and using a spectrophotometric field kit. We also assessed exposure by analyzing urine samples for para-nitrophenol (p-NP). The workers, who were cleaning private residences contaminated with the organophosphate methyl parathion, were tested before starting work and then repeatedly over a 7-week period. We compared results of the two methods to determine the kit's ability to accurately predict cholinesterase levels in humans.

Effect of systemic exposure to parathion on the dark adapted pupil dilation of cynomolgus monkeys

The constriction of pupil dilation following dark adaptation was studied as a potentially useful biological monitor of systemic exposure to organophosphorus pesticides (OPs). Pupil dilation and blood cholinesterase levels were monitored in 4 cynomolgus monkeys following oral administration of 2.0 mg/kg parathion in corn oil. No consistent pattern of change in pupil/iris diameter ratios following exposure was found despite depressions in blood cholinesterase activities of 27-50% for red cells and 65-80% for plasma. A slight mydriasis was observed in one of the monkeys, who appeared the most affected behaviorally by the exposure. Results of this work suggest that the measurement of pupil dilation after dark adaptation is not a sensitive indicator for systemic exposure to OPs. However, in situations where direct exposure to the eyes may occur, such as during aerial or airblast pesticide applications, other studies indicate that constriction of pupil dilation can occur at exposure levels below those resulting in systemic effects.

Acute Organophosphorus Food Poisoning Caused by Contaminated Green Leafy Vegetables

An outbreak of food poisoning in which 105 persons from various parts of Singapore were affected was traced to one type of green leafy vegetable (Brassica alboglabra) that had been imported. The clinical symptoms were generally mild and the incubation period short (median 2.5 h). The etiology was confirmed when excessive levels of two organophosphorus pesticides--methamidophos (Tamaron/Monitor; 2.4 ppm-31.7 ppm) and profenofos (Selecron/Curacron; 1.1 ppm-5.4 ppm) were detected in the implicated food, and blood cholinesterase levels of the hospitalized patients were depressed by 26.1%-81.4% based on the lower limit of the reference range. All consignments of the implicated vegetables were immediately sealed and destroyed. Monitoring of imported vegetables for excessive pesticide residues has been enhanced.

Maternal serum cholinesterase levels in pregnant women in healthy and diseased states.

AbstractMaternal serum cholinesterase estimation was done in pregnant women in gesta‐tional‐wise, during labour and pathological states by spectrophotometric method. Sera from non‐pregnant women was used as controls (190 units/ml). During normal pregnancy, cholinesterase levels in maternal serum increased abruptly from 8 weeks (220 units/ml) to 20 weeks (380 units/ml) and fell gradually to low levels (210 units/ ml) at &lt;42 weeks (post‐mature pregnancy). Serum cholinesterase levels were significantly increased during second and third stage of labour. In the post partum period, serum cholinesterase levels in the maternal blood rapidly reached the non‐pregnant levels (180 units/ml) by 2nd day after delivery. Significant variation of maternal serum cholinesterase levels were found in pregnancy with patients undergoing induced abortions, cases of threatened abortions, congenital anomalies of foetus, pre‐eclampsia, eclampsia, nephrotic syndrome, tuberculosis, infectious hepatitis, anaemia, diabetes mellitus, Rh‐incompatibility, placenta praevia, etc. These observations may have an important bearing because this may lead to a better understanding of serum cholinesterase's basic biochemical function and application in clinical medicine.

Physiological Response of Grub-infested (Diptera: Oestridae) and Grub-free Steers to Treatments of Systemic Insecticides

The effect of recommended dosages of trichlorfon, fenthion, famphur, and phosmet on physiological and nutritional indices of steers infested and not infested with Hypoderma spp. were evaluated under laboratory conditions. The parameters used as indicators of general stress were heart and respiration rate, rectal temperature, blood cholinesterase, blood urea nitrogen, serum glutamic oxalacetic transaminase, serum creatine phosphokinase and packed cell volume. Feed utilization indices included dry matter and nitrogen digestibilities. Heart rates, respiration rates, and rectal temperatures increased rapidly after treatment of grub-free steers and returned to normal within 3 h after treatment. Treatments of grub-infested steers with trichlorfon and phosmet resulted in significantly increased respiration rates, and rectal temperatures were significantly increased after exposure to trichlorfon, phosmet, and fenthion. Treatment with phosmet significantly reduced heart rates through 1 week after treatment. Blood cholinesterase levels were decreased after all treatments and blood urea nitrogen was significantly lowered after treatments with trichlorfon, famphur, and phosmet.

Pertinent aspects of pesticide usage in Mauritius

Two questionnaire-based surveys were carried out amongst the small vegetable planting community in order to evaluate the effectiveness with which pesticides are being used and the ensuing health and environmental hazards. Good practice was assessed by a certain number of indicators based on various parameters. Data on health hazards were obtained from cases of poisoning and from surveys on blood Cholinesterase levels.

血中ＣｈＥ活性値に及ぼす農薬散布の影響に関する研究

The present study was conducted for the purpose of investigating the influence of agricultural chemicals such as organic phosphoric compounds and carbamate derivatives on the blood cholinesterase levels of farmers working with the chemicals. The subjects of the investigation were 30 farmers (18 males and 12 females) who had worked with agricultural chemicals. Levels of cholinesterase (CHE) in their whole blood, plasma and hematocytes were measured for one year. The results were as follows: 1) Remarkable decreases in the CHE levels were observed in both males and females during the months when they worked with the agricultural chemicals. The females showed more remarkable decreases than the males. 2) Remarkable decreases in the ChE levels in Erythrocytes were observed in both males and females during the months when they worked with the agricultural chemicals. There was no difference in the decrease between the males and the females. 3) The ChE levels in plasma revealed such small decreases that the values were not suitable for utilization as indicators of the health condition of farmers exposed to agricultural chemicals. In consideration of these results, the CHE levels in whole blood and erythrocytes were regarded as suitable indicators of the influence of exposure to agricultural chemicals. As a relationship was observed between CHE levels and time of exposure to agricultural chemicals, it was concluded that the agricultural chemicals did influence the physical conditions of farmers exposed to them.

Effect of blockade of the reticuloendothelial system on the carbaryl toxicity in the rat

The time dependence of the level of blood cholinesterase was determined in rats with the reticulo-endothelial system (RES) inhibited with colloidal carbon and in control rats after i.v. administration of 2 doses of carbaryl: 0.75 mg and 1.50 mg/100 g body wt. Pretreatment with colloidal carbon had no effect on the blood cholinesterase activity when compared with the controls. Carbaryl rapidly inhibits cholinesterase; the time of “reactivation” of this enzyme increases with the administered dose. However, when the RES is inhibited with colloidal carbon, “reactivation” of cholinesterase is significantly slowed down, to a varying degree, depending on the dose of carbaryl. Our results bring to light a relationship between the inhibition of the RES and the toxicity of carbaryl, inhibition increasing the anticholinesterase effect of the insecticide.