Cholinergic neurotransmission regulates the immune response and inhibits cytokine release after stroke. Post-stroke plasma acetylcholinesterase (AChE) and butylcholinesterase (BChE) are two major enzymes regulating the plasma level of Ach, which binds a muscarinic receptor on macrophages to regulate the inflammatory response after stroke. To date, the changes in the level/activity of blood cholinesterase (ChE) in patients with post-stroke dementia (PSD) are less known. Dr. Yu-Li Liu from the Center for Neuropsychiatric Research examined the functional activities of above mentioned two enzymes to determine whether they are biomarkers for PSD.
Dr. Liu and team recruited 30 patients with PSD, 87 post-stroke patients without dementia (PSNoD), and 117 age- and gender-matched healthy controls. Missense genetic variants AChE rs1799806 and BChE rs1803274 were genotyped. The plasma AChE level did not differ between the PSD and PSNoD groups. However, BChE levels were significantly lower in the PSD than in the PSNoD group (3300.66 +/- 515.35 vs 3855.74 +/- 677.60 ng/mL, respectively; p = 0.0033). The activities of total ChE, BChE, and AChE were all lower in the PSD group (19,563.33 +/- 4366.03, 7650.17 +/- 1912.29, 11,913.17 +/- 2992.42 mU/mL, respectively) than in the PSNoD group (23,579.08 +/- 5251.55, 9077.72 +/- 1727.28, and 14,501.36 +/- 4197.17 mU/mL, respectively). When further adjusting for age and sex, significance remained in BChE level and activity and in total ChE activity. BChE rs1803274 was associated with reduced BChE activity, while AChE rs1799806 did not influence AChE activity.
The level and activity of BChE, but not of AChE, were decreased in PSD patients and may therefore aid in PSD diagnosis. This finding has been published in Journal of Clinical Medicine (2019 Oct 24;8(11):Article number 1778).
Citation: Chen, YC; Chou, WH; Fang, CP; Liu, TH; Tsou, HH; Wang, Y; Liu, YL. Serum level and activity of butylcholinesterase: A biomarker for post-stroke dementia. Journal of Clinical Medicine. 2019 Oct 24;8(11):Article number 1778.