Serum Pseudocholinesterase Activity Research Articles

Pseudocholinesterase as a prognostic marker for liver disorder

Background: Liver is the main source of pseudo cholinesterase. It is a non-specific cholinesterase found in the blood plasma and may be reduced in patients with advanced liver diseases. Measurement of serum pseudo cholinesterase activity serves as a sensitive indicator of synthetic capacity of the liver and can be used as a prognostic marker for carcinoma.Objective: To study pseudo cholinesterase activities in liver diseases.Method: A prospective study was conducted at College of Medical Sciences Teaching Hospital (CMS-TH), from May 2011 to May 2013 with 25 controls and 25 diagnosed cases each of carcinoma of liver, cirrhosis of liver, infective hepatitis and obstructive jaundice among both sexes of same age group attending medical outpatient and inpatient departments. Serum pseudo cholinesterase and other liver function tests were performed with semi-auto analyzer and Roche Hitachi 902 respectively.Results: Pseudo cholinesterase level was markedly decreased in carcinoma of liver (mean ± SD = 1369.48 ± 276.64 IU/L) followed by cirrhosis of liver (mean ± SD = 1735.16 ± 433.82 IU/L), infective hepatitis (mean ± SD = 3800.69 ± 764.17 IU/L), obstructive jaundice (mean ± SD = 5539 ± 791.05 IU/L) when compared with controls (mean ± SD = 6865.12 ± 928.41 IU/L). The difference in the means was statistically significant (p <0.001).Conclusion: There was significant decrease in pseudo holing esterase level in carcinoma of liver followed by cirrhosis of liver while less so in infective hepatitis. In obstructive jaundice the enzyme level was found to be decreased but higher than other liver diseases. The results indicated that with more severe liver cell destruction or cell degeneration, there was corresponding significant decrease in the level of pseudo cholinesterase, which could be used as diagnostic marker of liver disease.Journal of Kathmandu Medical College Vol. 3, No. 4, Issue 10, Oct.-Dec., 2014Page: 131-135

Reduced Pseudocholinesterase Activity in Patients With HELLP Syndrome

The authors previously reported a case of decreased pseudocholinesterase activity in a patient with HELLP syndrome. It was assumed that the reduced pseudocholinesterase activity in HELLP syndrome is associated with impaired liver function. The present study assesses the prevalence of low pseudocholinesterase in patients with HELLP syndrome. Serum pseudocholinesterase activity was determined with spectrophotometer in 15 patients with HELLP syndrome. Two control groups matched for gestational age were recruited: 15 healthy women with uncomplicated pregnancy and 15 women with severe preeclampsia without HELLP. The prevalence of reduced pseudocholinesterase activity lower than normal limit was 60.0% (9/15) in patients with HELLP syndrome, 33.3% (5/15) in patients with severe preeclampsia, and 6.6% (1/15) in women with normal pregnancy, respectively (P =.009). The pseudocholinesterase activity was found to correlate with serum alanine aminotransferase levels (r = 0.417, P = .006) and with serum aspartate aminotransferase levels (r = 0.462, P = .002). Considering the increased prevalence of reduced pseudocholinesterase activity in patients with HELLP syndrome, the authors suggest that whenever general anesthesia is applied in these patients, the anesthesiologist should be aware that the patient may show slow metabolic degradation of choline-ester drugs.

Organophosphate poisonings with parathion and dimethoate

Organophosphate toxicity is the leading cause of morbidity and death in poisoning by insecticides. The clinical symptoms of pesticide toxicity range from the classic cholinergic syndrome to flaccid paralysis and intractable seizures. The mainstays of therapy are atropine, oximes, benzodiazepines and supportive care. The toxicokinetics vary not only with the extent of exposure, but also with the chemical structure of the agent. We report two cases of poisoning with parathion-ethyl and dimethoate. The patients developed a cholinergic syndrome immediately, accompanied by bradycardia and hypotension. The patients were admitted to the intensive care unit (ICU) a few hours after ingestion. Atropine was administered according to the cholinergic symptoms. The patients recovered in the ICU after 10-12 days and were discharged after 3 and 4 weeks. Organophosphate blood and urine levels were determined on admission and during hospitalisation. The pesticides were rapidly distributed and slow elimination rate of the poisons was documented. In the case of parathion-ethyl the distribution half-life estimated was t(1/2alpha) = 3.1h while the terminal half-life was t(1/2beta) = 17.9 h. Using a one-compartment model for dimethoate the elimination half-life was t(1/2beta) = 30.4 h in plasma and 23.8 h in urine. The serum pseudo-cholinesterase activity was below the limit of detection at admission and recovered during the following 3weeks.

Antioxidant Treatment With N-Acetylcysteine In Endosulfan Intoxication: Report Of Two Cases

Objective: Organochlorine compounds may cause oxidative stress by stimulating the production of reactive oxygen species. This mechanism has been implicated in the immunotoxicity, hepatotoxicity and carciogenecity of these compounds. Endosulfan is an organochlorine insecticide with potential toxicity for central nervous, cardiopulmonary system and liver and kidney. Endosulfan induces T-Cell apoptosis, mitochondrial dysfunction, oxidatif stress and lipid peroxidation. N-acetylcysteine (NAC) is an antioxidant agent replenishes the intracellular gluthathione stores. Thus, we reported the potential benefits of antioxidant treatment with NAC in endosulfan intoxication. Setting: Multidisciplinary intensive care unit of the University Hospital Patients: 16- and 17- year old comatose patients with generalized tonic-clonic convulsions, metabolic acidosis, hyperlactatemia, hypocalcemia, elevated liver and muscle enzymes, trombocytopenia, leukocytosis, normal serum pseudocholinesterase activity, tachycardia and hyperthermia. Interventions: NAC (150 mg kg-1 body weight with 15 min, 50 mg kg-1 body weight with 4 hours, 100 mg kg-1 body weight with 16 hours) intravenously and cholestyramine 16 g day-1 perorally treatment with standard intensive care unit care.

Studies of the Inhibition of Serum Pseudocholinesterase Activity In Vitro by Commonly Used Drugs

Studies of the Inhibition of Serum Pseudocholinesterase Activity In Vitro by Commonly Used Drugs

Studies of the Inhibition of Serum Pseudocholinesterase Activity In Vitro by Commonly Used Drugs

We studied the effect of 17 commonly used drugs, including prescription and over-the-counter medications, on the activity of serum pseudocholinesterase (PCE) in vitro. Normal pooled human serum was incubated for 120 minutes at 37 degrees C with therapeutic serum concentrations of prescription and over-the-counter drugs, and the postincubation PCE activity was measured. Morphine, quinidine, and thioridazine depressed PCE activity by more than 5% while no or negligible effect was noted following incubation with acetaminophen, chlordiazepoxide, chlorpromazine, desipramine, doxepin, imipramine, methamphetamine, nortriptyline, phenobarbital, phenytoin, procainamide, salicylic acid, theophylline, and valproic acid. Depression of PCE activity can prolong the half-life of coadministered agents with metabolism mediated by PCE.

Acephate in Biological Fluids of Two Autopsy Cases after Ingestion of the Chemical

Two autopsy cases, where the individuals were suspected of having ingested acephate, an organophosphorous insecticide, are reported. Acephate and its active metabolite, methamidophos (MP), were analyzed in the biological fluids by GC/MS, using the salting out method with liquid-liquid extraction columns. The first case was that of a 70-year-old man whose blood acephate was 149 microg/mL, and MP was 3.0 microg/mL. Serum pseudocholinesterase (ChE) activity was inhibited. No remarkable finding of injury or disease was determined as the cause of his death, but acute poisoning by acephate was mostly suspected. The second case was that of a 60-year-old man. A deep gash in the left neck injured the left common carotid artery in addition to the severely ischemic state of the primary organs. His blood acephate was 46 microg/mL, and MP was not detected. ChE activity was in the normal range. Hemorrhage was mainly suspected as the cause of his death. The concentrations of acephate and MP in human blood after oral ingestion are first reported here, and the acute toxic level of acephate is discussed.

Evaluation of serum enzyme activities as predictors of passive transfer status in lambs

To determine the associations between serum IgG concentration and serum activities of gamma-glutamyltransferase (GGT), alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and pseudocholinesterase for the potential use of these serum enzymes as predictors of passive transfer status in neonatal lambs. Prospective observational study. 47 Sardinian lambs from birth to 2 days old. Serum enzyme activities were measured by use of commercially available kits and a clinical biochemical analyzer. Serum IgG concentration was determined by single radial immunodiffusion. Associations between serum IgG concentration and the activity of each serum enzyme were established by use of regression analysis. A significant correlation was detected between serum IgG concentration and serum GGT activity in 1- and 2-day-old lambs. Minimal correlations were detected between serum IgG concentration and serum alkaline phosphatase activity in 1-day-old lambs and serum pseudocholinesterase activity in 1- and 2-day-old lambs. No significant associations were detected between serum IgG concentration and serum activities of aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase. A multiple linear regression model was accurate for the estimation of the natural logarithm of serum IgG concentration as a function of the natural logarithm of serum GGT activity and of the age of lambs at the time of sampling (adjusted R2 = 0.89). This model was then used to calculate the serum GGT activity equivalent to various serum IgG concentrations for 1- and 2-day-old lambs. Results suggested that passive transfer status in neonatal lambs can be successfully predicted by measurement of serum GGT activity but not by measurement of the other enzymes tested.

Further characterization of serum amyloid A4 as a minor acute phase reactant and a possible nutritional marker.

A constitutive isotype of human serum amyloid A, serum amyloid A4 (SAA4), is distributed into plasma lipoproteins, primarily in high density lipoproteins. Its physiological function is unknown; its serum concentration has no relationship with those of other major apolipoproteins. In this study, changes in SAA4 concentrations were further characterized. Variations in healthy individuals were negligible. In subjects undergoing renal allograft transplantation, SAA4 changed in parallel with acute phase SAA, although its magnitude was not larger than a three-fold increase. This confirmed that SAA4 is a minor acute phase reactant in humans. SAA4 concentrations showed a good agreement with serum pseudocholinesterase activity in healthy subjects and patients with lowered pseudocholinesterase when patients with elevated acute phase SAA were excluded. These results suggest that SAA4 can be an indicator of nutrition or of hepatic protein synthesis in the absence of inflammation.

Biochemical effects of chloral hydrate on male rats following 7-day drinking water exposure.

The biochemical and toxicological effects of chloral hydrate were investigated. Four groups (n = 7 per group) of male Sprague-Dawley rats (161-170 g) were administered chloral hydrate in drinking water at concentrations of 20, 200 or 2000 ppm for 7 days. The control group received phosphate-buffered water only. There were no treatment-related changes in the body weight gains, relative weights of major organs or haematological parameters. Trichloroacetic acid was significantly (P < 0.05) elevated in the serum of high-dose animals (7.75 +/- 5.14 mg dl(-1), mean +/- SD). In the high-dose animals there was a 36% increase in protein level in the liver homogenates but not in the corresponding 9000 g supernatants. Concurrently, there was a threefold increase in the activity of the hepatic peroxisomal enzyme palmitoyl CoA oxidase (PCO). A prominent change was the dose-related suppression in hepatic aldehyde dehydrogenase (ALDH) activity observed in all treatment groups, with the decrease ranging from 15% at 20 ppm to 68% at 2000 ppm. There were no significant decreases in the activity of hepatic enzymes ethoxyresorufin O-deethylase (EROD), benzyloxyresorufin O-dealkylase (BROD) and UDP-glucuronosyl-transferase (UDPGT). In the high-dose group there was a 30% increase in hepatic glutathione-S transferase (GST) activity, accompanied by a 13% increase in glutathione (GSH). Significant effects on lipids were observed in the liver of the high-dose animals, with a 15% decrease in hepatic cholesterol and triglyceride levels. There were no treatment-related changes in serum chemistry parameters, including cholesterol and triglyceride levels. Although in vitro assays showed chloral hydrate to be an inhibitor of serum pseudocholinesterase activity, with a 50% inhibition concentration (ic(50)( of approximately 0.7 mM at 5 mM butyrylthiocholine, no decrease in serum pseudocholinesterase activity was found in the treated animals. It was concluded that the liver is the target organ for chloral hydrate, with suppression of ALDH as the most sensitive endpoint followed by alteration in the GSH level and GST activity. Changes observed in the high-dose animals, such as increased peroxisomal PCO activity in the liver and perturbation of lipid homeostasis in the liver and blood, were likely to be associated with trichloracetic acid, the major metabolite of chloral hydrate.

The Effects of Donepezil and Neostigmine in a Patient with Unusual Pseudocholinesterase Activity

The Effects of Donepezil and Neostigmine in a Patient with Unusual Pseudocholinesterase Activity

Markedly Prolonged Paralysis After Mivacurium in a Patient Apparently Heterozygous for the Atypical and Usual Pseudocholinesterase Alleles by Conventional Biochemical Testing

Markedly Prolonged Paralysis After Mivacurium in a Patient Apparently Heterozygous for the Atypical and Usual Pseudocholinesterase Alleles by Conventional Biochemical Testing

Clinical, Biochemical and Genetic (SCE Frequency) Studies of Pesticide Sprayers

This paper presents the results of tests for sister chromatid exchange frequencies (SCEs) and serum pseudocholinesterase activity performed on a group of sprayers (10) chronically exposed to organophosphorus (0P) compounds and pyrethrin. The study group and control subjects were examined with routine chech-up procedures including clinical, haematological and biochemical tests. A significant increase in SCE frequencies of three of the exposed workers who lacked protective equipment (mean±1SD 8.9±2.6, 9.8±3.8, 11.1±5.6) was evident when compared with the results of the control group (mean±1SD 5.8±0.6). No positive linear relationship between the frequency of SCE and the duration of exposure was detectable. The serum pseudocholinesterase, SGPT, total protein, and hematocrit levels of the pesticides exposed subjects did not show any significant difference from the normal values. Based on our results, we concluded that SCE frequencies may increase in spite of normal pseudocholinesterase levels in 0P sprayers.

Modification of Atracurium or Vecuronium Blockade and Their Reversal by Succinylcholine in the Cat

The interaction between succinylcholine (SCC) and non-depolarizers, atracurium or vecuronium was investigated in 36 cats of either sex using the sciatic nerve-anterior tibialis muscle preparation. Additionally, the relation of SCC to pseudocholinesterase activity was examined. The duration of action of vecuronium (6.5 +/- 1.3 to 7.3 +/- 2.2 minutes) in cats pretreated with SCC was greater than those (2.0 +/- 0.6 minutes) in non-pretreated cats. However, SCC had no influence on the duration of atracurium. The serum pseudocholinesterase activity was decreased after the injection of atracurium or neostigmine in contrast to vecuronium. The authors conclude that the prior administration of SCC prolongs the duration of vecuronium but not that of atracurium, and pseudocholinesterase activity is not related to the prolonging effect of SCC.

Modification of atracurium or vecuronium blockade and their reversal by succinylcholine in the cat.

The interaction between succinylcholine (SCC) and non-depolarizers, atracurium or vecuronium was investigated in 36 cats of either sex using the sciatic nerve-anterior tibialis muscle preparation. Additionally, the relation of SCC to pseudocholinesterase activity was examined. The duration of action of vecuronium (6.5 +/- 1.3 to 7.3 +/- 2.2 minutes) in cats pretreated with SCC was greater than those (2.0 +/- 0.6 minutes) in non-pretreated cats. However, SCC had no influence on the duration of atracurium. The serum pseudocholinesterase activity was decreased after the injection of atracurium or neostigmine in contrast to vecuronium. The authors conclude that the prior administration of SCC prolongs the duration of vecuronium but not that of atracurium, and pseudocholinesterase activity is not related to the prolonging effect of SCC.

The Effect of Organophosphorus Compounds on Serum Pseudocholinesterase Levels in a Group of Industrial Workers

This paper presents the findings of a study of serum pseudocholinesterase activity in a group of 36 industrial workers chronically exposed to organophosphorus (OP) compounds. The mean pseudocholinesterase level of the workers was significantly lower than that of 36 other workers without a history of similar exposure. Although there was a high incidence of clinical features suggestive of OP compound toxicity in the exposed workers, no significant correlation between serum pseudocholinesterase levels and clinical symptoms and signs was found. Six exposed workers, found to have low serum pseudocholinesterase levels, were transferred for 6 months to work areas which did not involve OP exposure, whereupon their levels rose significantly back to the normal range.

Relationship between serum pseudocholinesterase and triglycerides in experimentally induced diabetes mellitus in rats

This study was designed to understand the reasons for the increase in serum pseudocholinesterase activity in diabetes mellitus. Streptozotocin-induced diabetic rats were used for the study. Serum pseudocholinesterase activity increased with the induction of diabetes (381.5 units/l +/- 11.8) compared to the non-diabetic rats (243.1 units/l +/- 7.2). Serum triglycerides, total low density lipoprotein and glycerol also increased concurrently with the development of diabetes. Insulin treatment of the diabetic rats normalized serum glucose concomitant with the reduction of pseudocholinesterase activity, triglycerides, total low density lipoprotein and glycerol. Heparin injection appeared to activate lipoprotein lipase in the diabetic rats by showing a marked fall in serum triglyceride and total low density lipoprotein levels but not in pseudocholinesterase activity. Administration of tetraisopropylpyrophosphoramide a specific pseudocholinesterase inhibitor, inhibited serum and adipose tissue pseudocholinesterase activity by greater than 80% and liver greater than 50%. Concurrent with the inhibition of pseudocholinesterase activity serum triglyceride, low density lipoprotein and glycerol decreased significantly. In normal rats treatment with tetraisopropylpyrophosphoramide also reduced serum lipoproteins markedly, while glycerol only showed a marginal decrease. Glycerol was used as a marker of adipose tissue lipolysis and total low density lipoprotein which is defined as lipoproteins of density less than 1.063 (LDL + VLDL).(ABSTRACT TRUNCATED AT 250 WORDS)

Reducing Effects of Serum Proteins on Organic Acid-Induced Inhibition of Serum Pseudocholinesterase Activity

Reducing Effects of Serum Proteins on Organic Acid-Induced Inhibition of Serum Pseudocholinesterase Activity

Stimulating effects of calcium and magnesium on serum pseudocholinesterase activity.

Stimulating effects of calcium and magnesium on serum pseudocholinesterase activity.

Serum pseudocholinesterase in psychiatric patients

Serum pseudocholinesterase activity was measured in 123 subjects: 16 agitated depressives, 12 retarded depressives, 7 acute schizophrenics, 14 residual schizophrenics, 16 healthy individuals, 45 surgical patients, and 13 first-degree relatives of 4 agitated depressive patients. The agitated depressive and acute schizophrenic patients had significantly higher pseudocholinesterase serum activity than their retarded inmates. As first-degree relatives of agitated depressive patients showed high levels similar to their ill relatives, a genetic component might play a crucial role. The level of pseudocholinesterase activity in serum of the surgical patients was significantly lower than that of all the psychiatric patients and the controls. The implications of this observation are still obscure.