Determination Of Serum Cholinesterase Research Articles

Organophosphorus Poisoning: Acute Respiratory Distress Syndrome (ARDS) and Cardiac Failure as Cause of Death in Hospitalized Patients

Industrial production of food for animals and humans needs increasing amounts of pesticides, especially of organophosphates, which are now easily available worldwide. More than 3 million cases of acute severe poisoning are estimated to occur worldwide every year, and even more cases remain unreported, while 200,000-350,000 incidentally or intentionally poisoned people die every year. Diagnostic and therapeutic procedures in organophosphate poisoning have, however, remained unchanged. In addition to several neurologic symptoms (miosis, fasciculations), hypersecretion of salivary, bronchial, and sweat glands, vomiting, diarrhea, and loss of urine rapidly induce dehydration, hypovolemia, loss of conscience and respiratory distress. Within hours, signs of acidosis due to systemic hypoxia can be observed at first laboratory investigation after hospitalization. While determination of serum-cholinesterase does not have any diagnostic value, it has been established that hypoalbuminemia alone or accompanied by an increase in creatinine, lactate, or C-reactive protein serum levels has negative prognostic value. Increased serum levels of C-reactive protein are a sign of systemic ischemia. Protective mechanical ventilation should be avoided, if possible. In fact, acute respiratory distress syndrome characterized by congestion and increased weight of the lung, accompanied by heart failure, may become the cause of death. As the excess of acetylcholine at the neuronal level can persist for weeks until enough newly, locally synthesized acetylcholinesterase becomes available (the value of oximes in reducing this time is still under debate), after atropine administration, intravenous albumin and fluid infusion should be the first therapeutic interventions to reestablish normal blood volume and normal tissue oxygenation, avoiding death by cardiac arrest.

Determination of oxidative stress markers and serum cholinesterase among pesticide sprayers in southern Brazil

Small farmers generally spray pesticides manually and often do not use complete protective equipment. The standard test to detect pesticide exposure, which may be associated with toxicity, is the determination of serum cholinesterase, but in chronic exposure to low doses, this test is less sensitive. In this study, in a group sampled among pesticide sprayers without signs of intoxication, cholinesterase, thiobarbituric acid reactive substances (TBARS), catalase (Cat), and superoxide dismutase (Sod) activities were analyzed. Cholinesterase activity was only slightly lower in the farmer group in relation to the control group. However, TBARS and Cat activities were 3-fold increased in the farmers in comparison to the controls. Sod activity was similar in both groups. The group of pesticide sprayers that did not use the complete protective equipment presented a significantly higher level of TBARS than the group that used the complete protective equipment. Therefore, the determination of TBARS and catalase can be useful to identify individuals that are chronically exposed to low doses of pesticides.

Quantification and phenotyping of serum cholinesterase by enzyme antigen immunoassay: methodological aspects and clinical applicability

An enzyme antigen immunoassay for a specific determination of serum cholinesterase is described. Polyclonal and monoclonal antibodies against cholinesterase have been used. Hydrophobic binding of the specific antibody to a microtitre plate was followed by incubation with the samples, and the activity of the bound cholinesterase was assayed by the Ellman method. The procedure has been optimized and characterized, with respect to antigen specificity, and the applicability of the assay for cholinesterase phenotyping is demonstrated. The cholinesterase activities, dibucaine-, scoline-, fluoride- and urea numbers were comparable with established reference values. The high sensitivity and specificity of the assay has been used for determination of cholinesterase in amniotic and cerebrospinal fluids, and its applicability in clinical medicine is indicated.

Two Modifications of the Colorimetric Procedure for Determination of Serum Cholinesterase, Application to Trithion and Phosdrin.

Two Modifications of the Colorimetric Procedure for Determination of Serum Cholinesterase, Application to Trithion and Phosdrin.