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Blood acetylcholinesterase and butyrylcholinesterase as biomarkers of cholinesterase depression among pesticide handlers
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    Agricultural pesticide handlers are at an elevated risk for overexposure to organophosphate (OP) pesticides, but symptoms can be difficult to recognize, making biomarkers invaluable for diagnosis. Occupational monitoring programs for cholinesterase depression generally rely on measuring activity of either of two common blood cholinesterases which serve as proxy measurements for nervous-system acetylcholinesterase activity: red blood cell acetylcholinesterase (AChE) and plasma butyrylcholinesterase (BChE). These biomarkers, however, may be affected differentially by some OPs and the relationship between them has not been well characterized. We aim to determine the association between blood acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activity levels and assess whether they produce comparable classifications of clinical cholinesterase depression among organophosphate pesticide handlers.


    Using blood samples from 215 participants of the Washington State Cholinesterase Monitoring Program, we quantified changes in AChE and BChE activity from before and after exposure to OP pesticides and calculated Pearson correlation statistics for correlation of AChE and BChE changes in activity, as well as weighted Kappa statistics for agreement of classification of clinical cholinesterase depression based on AChE versus BChE measurements.


    AChE and BChE activity measurements are weakly negatively correlated in our study population. Reaching a clinical threshold for diagnosis of cholinesterase depression based on the AChE marker did not correlate with reaching clinical depression based on the BChE marker.


    Both AChE and BChE should be measured in monitoring programs because they may both give potentially important but disparate classifications of clinical cholinesterase depression.

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    5T32ES007018-37/ES/NIEHS NIH HHS/United States
    ES009883/ES/NIEHS NIH HHS/United States
    P30 ES007033/ES/NIEHS NIH HHS/United States
    P30ES07033/ES/NIEHS NIH HHS/United States
    P42ES04696/ES/NIEHS NIH HHS/United States
    T32 ES007018/ES/NIEHS NIH HHS/United States
    T32ES07262/ES/NIEHS NIH HHS/United States
    T42OH008433/OH/NIOSH CDC HHS/United States
    U50OH07544/OH/NIOSH CDC HHS/United States
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