Nerves adrenergic cholinergic

There was early evidence that ATP was a neurotransmitter in non-adrenergic, non-cholinergic (NANC) nerves supplying the gut and bladder. There is now... 

Neurotoxin that produces a massive release of transmitters from cholinergic and adrenergic nerve endings resulting in continuous stimulation of muscles. It also induces formation of an ion channel allowing the inward flow of calcium ions into the nerve cell. It is a white powder obtained from the venom of the black widow spider. 

TABLE 9.1 Responses to Adrenergic and Cholinergic Nerve Stimulation... 

Transmission Step Adrenergic Nerves Cholinergic Nerves... 

External urethral sphincter muscle probably has cholinergic and adrenergic autonomic innervation as well as cholinergic striated muscle innervation (Elbadawi and Schenk, 1974). This rhabdosphincter is unique when compared to other striated muscle in that it has a higher density of neural end-plates as well as blood vessel-independent neural plexuses. Efferent rhabdosphincter innervation is probably via the pudendal nerve while the lissosphincter efferents probably emanate from the pelvic plexus (Elbadawi and Schenk, 1974). 

Peripherally, all organs are innervated sympathetically (as well as parasympatheti-cally), and in most cases the adrenergic action of this system is opposite to the cholinergic effects. The neurotransmitter secreted by the nerve endings is norepinephrine and, to a lesser extent, epinephrine. 

These drugs are best avoided in patients with cerebrovascular, cardiovascular and hepatic disorders. Some sympathomimetic effects may occur, mainly mild tremor and occasionally cardiac arrhythmias. Apparent anticholinergic effects may also occur but these are the result of sympathetic potentiation in tissues with dual cholinergic/adrenergic innervation, e.g. pupil. Sympatholytic effects can also occur, principally postural hypotension, because of synthesis of relatively inactive false transmitters, e.g. octopamine, in nerve terminals following inhibition of MAO and activation of alternative metabolic pathways. 

As previously noted, the vesicles of both cholinergic and adrenergic nerves contain other substances in addition to the primary transmitter. Some of the substances identified to date are listed in Table 6-1. Many of these substances are also primary transmitters in the nonadrenergic, noncholinergic nerves described in the text that follows. They appear to play several roles in the function of nerves that release acetylcholine or norepinephrine. In some cases, they provide a faster or slower action to supplement or modulate the effects of the primary transmitter. They also participate in feedback inhibition of the same and nearby nerve terminals. 

Beta Postsynaptic effector cells, especially heart, lipocytes, brain presynaptic adrenergic and cholinergic nerve terminals, juxtaglomerular apparatus of renal tubules, ciliary body epithelium Stimulation of adenylyl cyclase, increased cAMP... 

It has been known for many years that autonomic effector tissues (eg, gut, airways, bladder) contain nerve fibers that do not show the histochemical characteristics of either cholinergic or adrenergic fibers. Both motor and sensory NANC fibers are present. Although peptides are the most common transmitter substances found in these nerve endings, other substances, eg, nitric oxide synthase and purines, are also present in many nerve terminals (Table 6-1). Capsaicin, a neurotoxin derived from chili peppers, can cause the release of transmitter (especially substance P) from such neurons and, if given in high doses, destruction of the neuron. 

Adrenergic and cholinergic nerve terminals Inhibition of transmitter release... 

Erection occurs when adrenergic-induced sinusoid tone is antagonized by sacral parasympathetic stimulation that produces sinusoidal relaxation primarily by synthesis and release of the nonadrenergic-noncholinergic (NANC) neurotransmitter nitric oxide (NO). The contribution of acetylcholine-dependent release of NO from the vascular endothelium is uncertain. In vitro electrical stimulation of isolated corpus cavemosum strips (with or without endothelium) produces sinusoidal relaxation by release of neurotransmitters within nerve terminals that is resistant to adrenergic and cholinergic blockers. Inhibitors of the synthesis of NO or of guanosine monophosphate (GMP),... 

Klarskov (1987) studied the non-cholinergic, non-adrenergic inhibitory nerve responses of bladder outlet smooth muscle from female Danish Landrace pigs in vitro. Trigone strips were taken in an oblique direction from the internal urethral orifice and medially to one of the ureteric orifices, bladder neck strips transversal from the posterior half of the borderline between bladder and urethra, and urethral strips longitudinal from the proximal posterior part. 

Ferguson DR, Marchant IS (1995) Inhibitory actions of GABA on rabbit urinary bladder muscle strips mediation by potassium channels. Br J Pharmacol 115 81-83 Hills J, Meldrum LA, Klarskov P, Burnstock G (1984) A novel non-adrenergic, non-cholinergic nerve-mediated relaxation of the pig bladder neck an examination of possible neurotransmitter candidates. Eur J Pharmacol 99 287-293... 

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