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Plasma Cholinesterase Activity in Alzheimer's Disease

Misa Hosoi1, Koji Hori, Kimiko Konishi

  • 1Department of Psychiatry, Showa University Northern Yokohama Hospital, Yokohama, Japan.

Neuro-Degenerative Diseases
|July 4, 2015
PubMed

Insights

Plasma cholinesterase activity (pChE) can guide Alzheimer's disease (AD) treatment selection between rivastigmine and donepezil. High pChE may indicate rivastigmine is best, while low pChE suggests donepezil is more appropriate.

Area of Science:

  • Neuroscience
  • Pharmacology
  • Biochemistry

Background:

  • Cholinesterase inhibitors (ChEIs) are a cornerstone therapy for Alzheimer's disease (AD).
  • Current clinical practice lacks quantitative guidance for selecting among available ChEIs, such as rivastigmine and donepezil.
  • Plasma cholinesterase activity (pChE) is influenced by AD-related inflammation, metabolic dysfunction, and liver health.

Purpose of the Study:

  • To propose plasma cholinesterase activity (pChE) as a biomarker for differentiating the optimal prescription of rivastigmine (Riv) versus donepezil (Don) in Alzheimer's disease (AD) management.
  • To investigate the relationship between pChE levels and patient characteristics in the context of AD treatment.

Main Methods:

  • Retrospective analysis of 11 patients with Alzheimer's disease (AD) treated with either rivastigmine (Riv) 18 mg (n=6) or donepezil (Don) 5 mg (n=5).
  • Measurement and correlation of plasma cholinesterase activity (pChE) with patient conditions and treatment outcomes.

Main Results:

  • Plasma cholinesterase activity (pChE) levels were observed to correlate with underlying conditions such as low-grade inflammation, diabetes mellitus, and lipid metabolic dysfunction.
  • Low pChE levels were associated with impaired liver function, highlighting the importance of monitoring pChE.
  • Preliminary data suggest a potential differential response based on baseline pChE levels.

Conclusions:

  • Plasma cholinesterase activity (pChE) may serve as a valuable clinical tool to personalize ChEI selection in AD.
  • Rivastigmine (Riv) may be more suitable for AD patients with relatively high pChE.
  • Donepezil (Don) might be a preferred option for AD patients presenting with relatively low pChE.

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