BCHE and hyperhomocysteinemia: Butyrylcholinesterase and Hyperhomocysteinemia: Interaction with Homocysteine Thiolactone - BChE appears to play a complex role in the context of elevated homocysteine and its toxic metabolite, homocysteine thiolactone (Hcy-thiolactone), which is increasingly recognized as a contributor to cardiovascular and neurological disorders.