How to supplement low cholesterase

The human body contains a variety of enzymes. The enzymes in the human body can only work at the normal body temperature of 37 degrees. Cholesterase is one of the enzymes in the human body. Enzymes can play a catalytic role in the human body, and biological enzymes are also specific. If the human body lacks enzymes, it cannot carry out normal physiological reactions. Some people have relatively low levels of cholesterase in their bodies. Let’s take a look at how to replenish low cholesterase.

1. Causes of low cholesterase

In patients with hepatitis, cholesterase will be low during cirrhosis. Cholesterase is still normal during the compensated stage of cirrhosis, but begins to decrease during the decompensated stage. The phenomenon of low cholesterase is most obvious during hepatic coma.

If the patient has acute hepatitis, cholesterase will also be low. Reduced cholesterase synthesis is the reason for low serum cholesterase. When the patient has acute hepatitis, cholinesterase drops to an extremely low level and then gradually rises. However, if cholinesterase continues to decrease, it indicates a poor prognosis.

If poisoning occurs by organophosphorus pesticides, the activity of cholinesterase will decrease significantly, and the level of cholinesterase will decrease significantly. Some conditions such as malnutrition and pernicious anemia can also lead to low levels of cholinesterase.

2. What is cholesterase?

Cholesterase is a type of glycoprotein that exists in the body in the form of multiple isozymes. It can generally be divided into true cholesteryl esterase and false cholesteryl esterase. True cholesterase, also known as acetylcholine esterase, is mainly present in the synaptic cleft of choleretic nerve endings, especially in the folds of the postsynaptic membrane of the motor nerve end plate; it is also present in choleretic neurons and red blood cells. This enzyme has the strongest effect on physiological concentrations of Ach and has a high specificity. One enzyme molecule can hydrolyze 3×10 molecules of Ach and is often referred to as cholesterase. Pseudocholine esterase is widely present in glial cells, plasma, liver, kidney, and intestine. The specificity for Ach is low, and pseudocholesterolase can hydrolyze other cholesteryl esters, such as succinylcholine.

3. The role of cholesterase

There are two types of cholesterase, both of which can hydrolyze acetylcholine. One is acetylcholine esterase. Another type is hydroxycholesterase. Cholesterase is a hydrolase that hydrolyzes acetylcholine. Acetylcholine is a neurotransmitter released by the endings of choleretic nerves (such as parasympathetic nerves, motor nerves, sympathetic preganglionic fibers, etc.). When nerve endings are stimulated and become excited, acetylcholine is released and binds to choline receptors, thus playing a role in nerve-muscle excitation transmission. Subsequently, acetylcholine is hydrolyzed by cholesterase and loses its effect. If the action of cholesterase is inhibited, excess acetylcholine will occur and accumulate, causing overexcitation of the choleretic nerves and symptoms similar to organophosphorus poisoning.

Pharmacology and toxicology of cholesterase

Pharmacokinetics: Blood drug concentration can be measured in the blood 15 minutes after oral administration, reaches a peak value in 2 to 3 hours, and then gradually decreases. T1/2 is 1.7 hours, and 27% is excreted unchanged in the urine. A 10-fold dose only increased plasma concentration by 3.5 times. This product is rapidly distributed throughout the body after intravenous injection, does not bind to plasma proteins, and does not pass through the blood-brain barrier: However, after the poisoned animals were injected with this product, the activity of the suppressed choline esterase in their brain tissue and cerebrospinal fluid was restored, and the poisoned patients regained consciousness within a few minutes after treatment with this product. Therefore, there are different opinions on whether this product can pass through the blood-brain barrier. This product is rapidly metabolized in the liver, 83% is excreted by the kidneys within 4 hours, and has no accumulation effect in the body. Causes of low cholesterase

Hydroxybenzenesulfonium cannot delay the excretion of this product, but vitamin B1 can prolong its half-life. It is reported that patients with parathion poisoning were given intravenous injection of this product, 0.8g (16mg/kg). After a few minutes, the suppressed blood cholesterase activity increased. After 15 minutes, it increased from the normal value of 20% before medication to 50%-60%. The clinical poisoning symptoms were also relieved. The blood cholesterase may still increase slightly after 24-48 hours. In some poisoned patients, blood choline esterase begins to decrease 30 minutes after injection of this product and drops to about 40% of the normal value within 2 to 4 hours. It dropped to nearly the level before medication in 6 hours. The patient's clinical poisoning symptoms reappeared or worsened within 1.5 to 8 hours (average 5 hours). The blood choline esterase level was basically consistent with the clinical poisoning symptoms.

How to test cholesterase

Cholinesterase (ChE) is synthesized by the liver and secreted into the blood. Like plasma albumin, it is an indicator of the liver's protein synthesis function. There are two types of ChE in humans and animals. One type is true cholesterase (AChE), which is distributed in red blood cells and gray matter of the brain. The other type is pseudocholesterase (PChE), which is distributed in the liver, brain white matter and serum. The main function of ChE is to catalyze the hydrolysis of acetylcholine. The commonly used methods are colorimetry and continuous monitoring. Causes of low cholesterase

The color development of this method is unstable, especially when the room temperature exceeds 20℃. When adding ferric chloride for color development, it should be quickly filtered or centrifuged to obtain the supernatant for color comparison, otherwise the error will be large. When the room temperature is too high, it is best to operate and filter in an ice water bath. The filtrate of some patients is turbid and difficult to compare colors. This phenomenon is seen in liver abscess and sepsis. It may be because the serum mucin content of such patients is often very high and trichloroacetic acid fails to completely precipitate the protein. In some methods, adding phosphoric acid can overcome this shortcoming.

What to do if cholesterase is low?

When the liver's synthetic function is impaired, the synthesis of cholesterase will be reduced. At this time, it is best to find out the real cause of liver cell damage in time, and then take appropriate measures to actively treat it. If there is no abnormality in the liver after examination, it may be that the low cholesterol esterase is caused by extrahepatic disease. If it is caused by malnutrition, nutritious food needs to be supplemented.