What is the role of acetylcholinesterase (AChE) in the pathophysiology of organophosphate (OP) toxicity?

Updated: Dec 31, 2020
  • Author: Kenneth D Katz, MD, FAAEM, ABMT; Chief Editor: Sage W Wiener, MD  more...
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Once an organophosphate binds to AChE, the enzyme can undergo one of the following:

  • Endogenous hydrolysis of the phosphorylated enzyme by esterases or paraoxonases

  • Reactivation by a strong nucleophile such as pralidoxime (2-PAM)

  • Irreversible binding and permanent enzyme inactivation (aging)

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