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BCHE gene


Normal Function

The BCHE gene provides instructions for making the pseudocholinesterase enzyme, also known as butyrylcholinesterase, which is produced by the liver and circulates in the blood. The pseudocholinesterase enzyme is involved in the breakdown of certain drugs, including muscle relaxant drugs called choline esters that are used during general anesthesia. These drugs are given to relax the muscles used for movement (skeletal muscles), including the muscles involved in breathing, and are often employed in emergencies when a breathing tube must be inserted quickly.

Pseudocholinesterase also helps protect the body by breaking down certain toxic substances before they reach the nerves. These substances include certain pesticides, poisons that attack the nerves, and specific natural toxins including a compound called solanine found in green potato skin. It is likely that the enzyme has other functions in the body, but these functions are not well understood. Studies suggest that the enzyme may be involved in the transmission of nerve signals.

Health Conditions Related to Genetic Changes

Pseudocholinesterase deficiency

More than 50 mutations in the BCHE gene have been identified in people with pseudocholinesterase deficiency, a condition that results in increased sensitivity to choline esters and certain other drugs. Some of these mutations replace single protein building blocks (amino acids) in the pseudocholinesterase enzyme, resulting in an abnormal enzyme that does not function properly. Other mutations prevent the production of pseudocholinesterase. A lack (deficiency) of functional pseudocholinesterase enzyme impairs the body's ability to break down choline ester drugs efficiently, leading to abnormally prolonged drug effects.

More About This Health Condition

Other Names for This Gene

  • acylcholine acylhydrolase
  • butyrylcholine esterase
  • CHE1
  • choline esterase II
  • cholinesterase
  • cholinesterase 1
  • cholinesterase precursor
  • E1
  • pseudocholinesterase

Additional Information & Resources

Tests Listed in the Genetic Testing Registry

Scientific Articles on PubMed

Catalog of Genes and Diseases from OMIM

Gene and Variant Databases


  • Garcia DF, Oliveira TG, Molfetta GA, Garcia LV, Ferreira CA, Marques AA, Silva WA Jr. Biochemical and genetic analysis of butyrylcholinesterase (BChE) in a family, due to prolonged neuromuscular blockade after the use of succinylcholine. Genet Mol Biol. 2011 Jan;34(1):40-4. doi: 10.1590/S1415-47572011000100008. Epub 2011 Mar 1. Citation on PubMed or Free article on PubMed Central
  • Gatke MR, Bundgaard JR, Viby-Mogensen J. Two novel mutations in the BCHE gene in patients with prolonged duration of action of mivacurium or succinylcholine during anaesthesia. Pharmacogenet Genomics. 2007 Nov;17(11):995-9. doi: 10.1097/FPC.0b013e3282f06646. Citation on PubMed
  • Howard TD, Hsu FC, Grzywacz JG, Chen H, Quandt SA, Vallejos QM, Whalley LE, Cui W, Padilla S, Arcury TA. Evaluation of candidate genes for cholinesterase activity in farmworkers exposed to organophosphorus pesticides: association of single nucleotide polymorphisms in BCHE. Environ Health Perspect. 2010 Oct;118(10):1395-9. doi: 10.1289/ehp.0901764. Epub 2010 Jun 8. Citation on PubMed or Free article on PubMed Central
  • Levano S, Ginz H, Siegemund M, Filipovic M, Voronkov E, Urwyler A, Girard T. Genotyping the butyrylcholinesterase in patients with prolonged neuromuscular block after succinylcholine. Anesthesiology. 2005 Mar;102(3):531-5. doi: 10.1097/00000542-200503000-00009. Citation on PubMed
  • Yen T, Nightingale BN, Burns JC, Sullivan DR, Stewart PM. Butyrylcholinesterase (BCHE) genotyping for post-succinylcholine apnea in an Australian population. Clin Chem. 2003 Aug;49(8):1297-308. doi: 10.1373/49.8.1297. Citation on PubMed
  • Zelinski T, Coghlan G, Mauthe J, Triggs-Raine B. Molecular basis of succinylcholine sensitivity in a prairie Hutterite kindred and genetic characterization of the region containing the BCHE gene. Mol Genet Metab. 2007 Feb;90(2):210-6. doi: 10.1016/j.ymgme.2006.10.009. Epub 2006 Dec 12. Citation on PubMed

The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.