Journal article
Natural inhibitors of cholinesterases: implications for adverse drug reactions
Canadian journal of anesthesia, Vol.44(5), pp.525-534
05/1997
DOI: 10.1007/BF03011943
PMCID: PMC2877586
PMID: 9161749
Abstract
Purpose: Acetylcholinesterase and butyrylcholinesterase are two closely related enzymes important in the metabolism of acetylcholine and anaesthetic drugs, including succinylcholine, mivacurium, and cocaine. The solanaceous glycoalkaloids (SGAs) are naturally occurring steroids in potatoes and related plants that inhibit both acetylcholinesterase and butyrylcholinesterase. There are many clinical examples of direct SGA toxicity due to cholinesterase inhibition. The aim of this study was to review the hypotheses that (1) SGAs may be the evolutionary driving force for atypical butyrylcholinesterase alleles and that (2) SGAs may adversely influence the actions of anaesthetic drugs that are metabolized by acetylcholinesterase and butyrylcholinesterase.
Source: The information was obtained by Medline search and consultation with experts in the study of SGAs and cholinesterases.
Principal findings: The SGAs inhibit both acetylcholinesterase and butyrylcholinesterase in numerous in vitro and in vivo experiments. Although accurate assays of SGA levels are difficult, published data indicate human serum SGA concentrations at least ten-fold lower than required to inhibit acetylcholinesterase and butyrylcholinesterase in vitro. However, we review evidence that suggests the dietary ingestion of SGAs can initiate a cholinergic syndrome in humans. This syndrome appears to occur at SGA levels lower than those which interfere with anaesthetic drug catabolism. The world distribution of solanaceous plants parallels the distribution of atypical alleles of butyrylcholinesterase and may explain the genetic diversity of the butyrylcholinesterase gene.
Conclusion: Correlative evidence suggests that dietary SGAs may be the driving force for atypical butyrylcholinesterase alleles. In addition, SGAs may influence the metabolism of anaesthetic drugs and this hypothesis warrants experimental investigation.
Details
- Title: Subtitle
- Natural inhibitors of cholinesterases: implications for adverse drug reactions
- Creators
- Matthew Krasowski - Department of Anesthesia & Critical Care University of Chicago 5841 S. Maryland Avenue, MC 4028 60637 Chicago IllinoisDaniel McGehee - Department of Anesthesia & Critical Care University of Chicago 5841 S. Maryland Avenue, MC 4028 60637 Chicago IllinoisJonathan Moss - Department of Anesthesia & Critical Care University of Chicago 5841 S. Maryland Avenue, MC 4028 60637 Chicago Illinois
- Resource Type
- Journal article
- Publication Details
- Canadian journal of anesthesia, Vol.44(5), pp.525-534
- Publisher
- Springer-Verlag; New York
- DOI
- 10.1007/BF03011943
- PMID
- 9161749
- PMCID
- PMC2877586
- ISSN
- 0832-610X
- eISSN
- 1496-8975
- Language
- English
- Date published
- 05/1997
- Academic Unit
- Pathology
- Record Identifier
- 9984047635202771
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