Association Between Acetylcholinesterase Levels and the Imbalance of Inflammatory Cytokines in Iraqi Patients With Chronic Renal Insufficiency

Background: Chronic renal insufficiency (CRI) is a dysregulation in renal function concurrently present with systemic inflammatory processes and neuroimmune interactions. Among the Iraqi cohort of patients with CRI, the present study aimed to clarify the relationship between serum acetylcholinesterase (AChE) levels and the inflammatory cytokines (IL-1α, IL-10, TNF-α). Methods: Thirty CRI patients and thirty age- and sex-matched healthy controls were recruited. All participants had blood samples collected for measurement of serum AChE and inflammatory cytokines (IL-1α, IL-10, TNF-α) using validated commercial ELISA kits. The hematological and biochemical parameters were also assessed. Results: TNF‑α was markedly elevated in Iraqi CRI patients and moderately correlated with AChE (r = 0.472, p < 0.01), while IL-1α and IL-10 were elevated but weakly correlated with AChE (r = 0.196 and 0.239, p > 0.05). Conclusion: TNF‑α may be a central mediator linking systemic inflammation with cholinergic perturbation in Iraqi CRI patients, whereas IL-1α and IL-10 have less influence on AChE. This study is the first to measure these markers simultaneously, supporting further exploration of TNF‑α and the cholinergic anti-inflammatory pathway (CAP) as potential therapeutic targets.