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Acetylcholinesterase is an enzyme primarily found in cholinergic nerve endings. Its main function is to break down acetylcholine, a crucial neurotransmitter. This enzyme is also present in red blood cells, though its role there is not yet understood.1

Acetylcholine is an ester of choline and acetic acid, acting as a neurotransmitter in both the central and peripheral nervous systems. It plays a key role in the parasympathetic nervous system, influencing smooth muscle contraction, blood vessel dilation, bodily secretions, and heart rate. Acetylcholine can either stimulate or inhibit responses.2

The rapid breakdown of acetylcholine by acetylcholinesterase ensures its effects are brief. Drugs that inhibit this enzyme, known as anticholinesterases, prolong acetylcholine's presence and action. These drugs have therapeutic uses, including treating conditions like myasthenia gravis and Alzheimer disease. Some anticholinesterases are also potent insecticides or nerve agents.23

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