Cholinesterase is a substance that is responsible for proper neural function and has been implicated as one of the reasons for the onset of Alzheimer’s disease. Cholinesterase is an enzyme that breaks down actylcholinesterase into choline and acetic acid in the body. This required as an 'off-switch' to any neurological response that has been activated. Cholinesterase in plasma or pseudocholinesterase is the other type of cholinesterase and its significance lies in a condition called plasma cholinesterase deficiency or pseudocholinesterase deficiency. This is a genetic condition that predisposes one to myocardial infarction and some birth defects as well. The most important significance of this enzyme deficiency lies in the effect of anesthetics on people with the condition. The test for the deficiency is called a plasma cholinesterase assay.
Just like any other assay, this is conducted to find out the amount of pseudo cholinesterase in the serum. This is a precursor to surgery in suspected individuals. There are some groups of ethnicities in the world that have a predisposition to the deficiency. Because of this deficiency, anesthetics take a longer time to wear off and most of the muscles in the body are paralyzed because of the anesthetic. This has special significance for the respiratory muscles and means that if the breathing pipe is removed too early, the patient could be in a life threatening condition on the operating table.
The test is performed by taking a blood sample and screening it for pseudocholinesterase levels by sending it to a lab for confirmation of the minute levels of it. It is curious to note that pseudocholinesterase and its synthetic versions are useful in the treatment of an overdose of cocaine, as it is pseudocholinesterase that metabolizes the drug.
There are no special preparations for the test at all, and all you need to do is to inform your doctor if you are specifically a member of the Arya Vysya community from India – a group that is predisposed to the disease. Apart from this, and especially if you are taking medication like anticonvulsants and sedatives like benzodiazepines, these will have an effect of changing the levels of pseudocholinesterase in the blood. Beyond this, you should tell your doctor whether you are on any kind of anticoagulant medication like heparin or warfarin that could inhibit the clotting of blood when taking a blood sample.