Illuminating the Unseen: Dynamic Butyrylcholinesterase Detection Driving Precision Medicine and Environmental Toxicology

Abstract

Butyrylcholinesterase (BChE), an essential serine hydrolase playing critical functions in both neurobiological processes and toxicological responses, has gained recognition as a crucial biomarker for detecting hepatic impairment, Alzheimer's disease (AD), and exposure to organophosphates. Fluctuations in BChE activity are closely linked to pathological progression, and decreased levels can indicate hepatic impairment, while elevated BChE in the brain is associated with β-amyloid plaque deposition in AD. Therefore, this review critically examines state-of-the-art detection technologies for BChE, categorizing them into traditional direct enzymatic assays and advanced next-generation platforms. These include near-infrared fluorescent probes, CRISPR-coupled biosensors, and nanomaterial-enhanced systems, which offer enhanced sensitivity and specificity. Besides, the diverse applications of these technologies span precision diagnostics, such as PET imaging for AD-associated BChE, high-throughput drug discovery for inhibitors and reactivator screening, and analytical screening of agroecosystems to quantify organophosphate pesticide residues in harvested crops. Hence, this study provides a strategic framework for selecting appropriate BChE detection methods tailored to specific clinical, pharmacological, or environmental applications. Furthermore, it advocates for interdisciplinary collaborations to effectively translate laboratory innovations into impactful real-world solutions.

Keywords

butyrylcholinesterase / detection / environmental toxicology / precision medicine

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