Acetylcholine autonomic nervous system

Parasympathetic nervous system. That portion of the autonomic nervous system that utilizes acetylcholine as the neurotransmitter at the neuro-effector junctions. 

Neurohumoral transmitters are chemicals that facilitate the transmission of nerve impulses across nerve synapses and neuroeffector junctions. Acetylcholine is a neurohumoral transmitter that is present in the peripheral autonomic nervous system, in the somatic motor nervous system, and in some portions of the central nervous system. 

Enteric nerves control intestinal smooth muscle action and are connected to the brain by the autonomic nervous system. IBS is thought to result from dysregulation of this brain-gut axis. The enteric nervous system is composed of two gan-glionated plexuses that control gut innervation the submucous plexus (Meissner s plexus) and the myenteric plexus (Auerbach s plexus). The enteric nervous system and the central nervous system (CNS) are interconnected and interdependent. A number of neurochemicals mediate their function, including serotonin (5-hydroxytryptamine or 5-HT), acetylcholine, substance P, and nitric oxide, among others. 

Both the G- and V-agents have the same physiological action on humans. They are potent inhibitors of the enzyme acetylcholinesterase (AChE), which is required for the function of many nerves and muscles in nearly every multicellular animal. Normally, AChE prevents the accumulation of acetylcholine after its release in the nervous system. Acetylcholine plays a vital role in stimulating voluntary muscles and nerve endings of the autonomic nervous system and many structures within the CNS. Thus, nerve agents that are cholinesterase inhibitors permit acetylcholine to accumulate at those sites, mimicking the effects of a massive release of acetylcholine. The major effects will be on skeletal muscles, parasympathetic end organs, and the CNS. 

Figure 14.1 Effect of autonomic nervous system stimulation on action potentials of the sinoatrial (SA) node. A normal action potential generated by the SA node under resting conditions is represented by the solid line the positive chronotropic effect (increased heart rate) of norepinephrine released from sympathetic nerve fibers is illustrated by the short dashed line and the negative chronotropic effect (decreased heart rate) of acetylcholine released from parasympathetic nerve fibers is illustrated by the long dashed line.

The concept of chemical neurotransmission originated in the 1920s with the classic experiments of Otto Loewi (which were themselves inspired by a dream), who demonstrated that by transferring the ventricular fluid of a stimulated frog heart onto an unstimulated frog heart he could reproduce the effects of a (parasympathetic) nerve stimulus on the unstimulated heart (Loewi Navratil, 1926). Subsequently, it was found that acetylcholine was the neurotransmitter released from these parasympathetic nerve fibers. As well as playing a critical role in synaptic transmission in the autonomic nervous system and at vertebrate neuromuscular junctions (Dale, 1935), acetylcholine plays a central role in the control of wakefulness and REM sleep. Some have even gone as far as to call acetylcholine a neurotransmitter correlate of consciousness (Perry et al., 1999). 

Fig. 3. Diagram of the working of the autonomic nervous system. AC, liberation of acetylcholine AD, liberation of adrenaline or noradrenaline.

We will conclude this chapter by referring to a term often used for those symptomatic drugs inhibiting the action of the autonomic nervous system by interfering with the effect of the chemical mediators involved. There are two groups. (1) Para-sympatholytic drugs block the action of acetylcholine. These are included within the wider class of spasmolytics which, as the name suggests, check or eliminate spasms. (2) Sympatholytics inhibit the action of adrenaline, noradrenaline and the sympathetic nervous system. 

Adrenaline (epinephrine)-producing (adrenergic) and acetylcholine secreting (cholinergic) neurones of the autonomic nervous system have direct and complimentary effects on the tone of blood vessels. 

The concept of chemical transmission in the nervous system arose in the early years of the century when it was discovered that the functioning of the autonomic nervous system was largely dependent on the secretion of acetylcholine and noradrenaline from the parasympathetic and sympathetic nerves respectively. The physiologist Sherrington proposed that nerve cells communicated with one another, and with any other type of adjacent cell, by liberating the neurotransmitter into the space, or synapse, in the immediate vicinity of the nerve ending. He believed that transmission across the synaptic cleft was unidirectional and, unlike conduction down the nerve fibre, was delayed by some milliseconds because of the time it took the transmitter to diffuse across the synapse and activate a specific neurotransmitter receptor on the cell membrane. 

Acetylcholine, the acetic acid ester of the cationic alcohol choline (see p. 50) acts at neuromuscular junctions, where it triggers muscle contraction (see p. 334), and in certain parts of the brain and in the autonomous nervous system. 

Acetylcholine is the primary neurotransmitter in the parasympathetic division of the autonomic nervous system, which mainly innervates the gastrointestinal tract, eyes, heart, respiratory tract, and secretory glands. Although its receptors are crucial for maintaining all normal functions of the body, an extremely small number of illnesses can be explained by the dysfunction of cholinergic regions of the peripheral autonomic system. 

Atropine, an alkaloid from Atropa belladonna, is the classical parasympatholytic compound. It competes with acetylcholine for the binding at the muscarinic receptor. Its affinity towards nicotinic receptors is very low, so that it does not interfere with the ganglionic transmission or the neuromotor transmission, at least in therapeutic dosages. However, in the central nervous system muscarinic receptor do play an important role and while atropine can penetrate the blood-brain barrier it exerts pronounced central effects. Atropine, like all other antagonists of the muscarinic acetylcholine receptor inhibit the stimulatory influence of the parasympathetic branch of the autonomous nervous system. All excretory glands (tear, sweat, salivary, gasto-intestinal, bronchi) are... 

Beside this there are some major differences with the neurotransmission in the autonomous nervous system The contractile activity of the skeletal muscle is almost completely dependent on the innervation. There is no basal tone and a loss of the innervation is identical to a total loss in function of the particular skeletal muscle. In contrast to the target organs of the parasympathetic nervous system the skeletal muscle cells only have acetylcholine receptors at the site of the so-called end-plate, the connection between neuron and muscle cell with the rest of the cell surface being insensitive to the transmitter. The release of acetylcholine results in a postjunctional depolarization which is either above the threshold to induce an action potential and a contraction or below the threshold with no contractile response at all. In contrast to the graduated reactions of the parasympathetic target organs, this is an all or nothing transmission. 

D. Acetylcholine and norepinephrine are important neurotransmitters in the peripheral autonomic nervous system but are not nearly as prominent in the CNS. Glycine is a major inhibitory neurotrans-... 

Nature is economical in her means. She uses many of the same chemicals to accomplish her nervous purposes within the brain that she has already used to the same ends throughout the body. The good news is that once you have worked out the biochemistry and pharmacology of a neuromodulator in the body, you can apply a lot of what you know to its action in the brain. The bad news is that every time you target, for example, the acetylcholine system of the brain, you also hit the body. That means that the heart, the bowel, the salivary glands, and all the rest of the organs innervated by the autonomic nervous system are influenced. What is worse, the target sites within the brain may not only be as spatially dispersed as in the periphery, but may also be as functionally differentiated ... 

Studies of neuromuscular junctions of the autonomic nervous system as early as 1904 led to the suggestion that adrenaline might be released at the nerve endings. Later it was shown that, while adrenaline does serve as a transmitter at neuromuscular junctions in amphibians, it is primarily a hormone in mammals. Nevertheless, it was through this proposal that the concept of chemical communication in synapses was formulated. By 1921, it was shown that acetylcholine is released at nerve endings of the parasympathetic system, and it later became clear the motor nerve endings of the somatic system also release acetylcholine. 

FIGURE 18-2 Receptor classifications and subclassifications for acetylcholine (ACh] and norepinephrine [NE], the two primary neurotransmitters used in the autonomic nervous system. 

Acetylcholine A neurotransmitter in the somatic and autonomic nervous systems principal synapses using acetylcholine include the skeletal neuromuscular junction, autonomic ganglia, and certain pathways in the brain. 

Acetylcholine is a neurotransmitter that functions in conveying nerve impulses across synaptic clefts within the central and autonomic nervous systems and at junctures of nerves and muscles. Following transmission of an impulse across the synapse by the release of acetylcholine, acetylcholinesterase is released into the synaptic cleft. This enzyme hydrolyzes acetylcholine to choline and acetate and transmission of the nerve impulse is terminated. The inhibition of acetylcholineasterase results in prolonged, uncoordinated nerve or muscle stimulation. Organophosphorus and carbamate pesticides (Chapter 5) along with some nerve gases (i.e., sarin) elicit toxicity via this mechanism. 

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