3 . 2 Choline and Its Products Acetylcholine and Phosphatidylcholine Choline

Choline, a quaternary amine obtained largely from the diet but also synthesized in the brain and, especially, liver, is an essential precursor of the neurotransmitter acetylcholine (ACh) and of the major membrane constituent phosphatidylcholine (PC). Plasma choline concentrations can vary over a fivefold range depending on the choline contents of the foods being digested. Since choline readily crosses the blood–brain barrier (BBB) through an unsaturated facilitated‐diffusion system, these plasma changes can produce parallel changes in brain choline levels. In addition, since the enzymes that convert choline to ACh [choline acetyltransferase (ChAT)] and PC’s precursor phosphocholine [choline kinase (CK)] are also poorly saturated with their choline substrate, increases in plasma choline can enhance the formation of ACh and phosphocholine, and the release of ACh. The subsequent conversion of phosphocholine to PC is increased if PC’s other circulating precursors (uridine and omega‐3 fatty acids) are provided. This leads to an increase in the levels of synaptic membrane within the brain. Choline is principally metabolized in the liver to betaine, which provides a source of methyl groups for the regeneration of methionine and S‐adenosylmethionine.