Neuromuscular junction function

To achieve their different effects NTs are not only released from different neurons to act on different receptors but their biochemistry is different. While the mechanism of their release may be similar (Chapter 4) their turnover varies. Most NTs are synthesised from precursors in the axon terminals, stored in vesicles and released by arriving action potentials. Some are subsequently broken down extracellularly, e.g. acetylcholine by cholinesterase, but many, like the amino acids, are taken back into the nerve where they are incorporated into biochemical pathways that may modify their structure initially but ultimately ensure a maintained NT level. Such processes are ideally suited to the fast transmission effected by the amino acids and acetylcholine in some cases (nicotinic), and complements the anatomical features of their neurons and the recepter mechanisms they activate. Further, to ensure the maintenance of function in vital pathways, glutamate and GABA are stored in very high concentrations (10 pmol/mg) just as ACh is at the neuromuscular junction. 

Explain the functions of the following myosin crossbridges, troponin, tropomyosin, sarcomeres, Z lines, neuromuscular junction, transverse tubules, and sarcoplasmic reticulum... 

Bullens, R. W., O Hanlon, G. M., Wagner, E. etal. Complex gangliosides at the neuromuscular junction are membrane receptors for autoantibodies and botulinum neurotoxin but redundant for normal synaptic function. /. Neurosci. 22 6876-6884, 2002. 

You may be questioned on the structure and function of the neuromuscular junction and could be expected to illustrate your answer with a diagram. A well-drawn diagram will make your answer clearer. 

Acetylcholine Mescaline, in micromolar concentrations, decreases the release of acetylcholine at the neuromuscular junction, with subsequent effects on end-plate potentials and motor function (Ghansah et al. 1993). Whether or not any similar effect occurs on central cholinergic systems has not been investigated. 

Many receptors for neurotransmitters function as ligand-gated channels for Na and/or Ca " ions (see p. 354). The ones that have been studied in the greatest detail are the nicotinic receptors for acetylcholine (see p. 352). These consist of five separate but structurally closely related subunits. Each forms four transmembrane helices, the second of which is involved in the central pore in each case. The type of monomer and its arrangement in the complex is not identical in all receptors of this type. In the neuromuscular junction (see p. 334), the arrangement aPya8 is found (1). 

Ticks have a bad reputation for good reasons. Not only are they carriers of a number of diseases, the saliva of some can cause paralysis. North American natives were aware of tick paralysis, but the condition was officially noted as a disease of both animals and humans in 1912. The bites of at least 60 species of ticks can cause paralysis, which often does not appear until several days after the bite. The first indication is redness and swelling around the site of the bite. This is followed by neuromuscular weakness and difficulty in walking. If the tick is not removed, speech and breathing are affected, with eventual respiratory paralysis and death. Fortunately, removal of the tick results in a quick recovery of function. The exact mechanism of paralysis is not known but it appears to come from a substance that affects the neuromuscular junction. While not related to the venom of the tick saliva, the tick can also transmit diseases such as Lyme disease, Rocky Mountain spotted fever, Q fever, typhus, and others. Table 13.1 lists some venomous arachnids. 

Tetanus immunoglobulin is an example of an antibody preparation used to induee passive immunization against a mierobial toxin. Tetanus (lockjaw) is an infectious disease caused by the bacterium, Clostridium tetani. Bacterial spores can commonly contaminate surface wounds and the resulting bacterial cells produce a toxin as they multiply. The toxin interferes with normal neurological function, particularly at neuromuscular junctions. The result is spasmodic contraction of muscles and, if untreated, mortality rates are high. Treatment with antibiotics and anti-toxin, however, is highly effective if administered promptly. 

Selectivity of action is based on several factors. Some drugs stimulate either muscarinic receptors or nicotinic receptors selectively. Some agents stimulate nicotinic receptors at neuromuscular junctions preferentially and have less effect on nicotinic receptors in ganglia. Organ selectivity can also be achieved by using appropriate routes of administration ("pharmacokinetic selectivity"). For example, muscarinic stimulants can be administered topically to the surface of the eye to modify ocular function while minimizing systemic effects. 

One of the best-understood autoimmune diseases is myasthenia gravis, a condition associated with a decrease in the number of functional post-synaptic nicotinic acetylcholine receptors (Fig. 30-23) in neuromuscular junctions. e The resulting extreme muscular weakness can be fatal. Myasthenia gravis is not rare and affects about one in 10,000 peopled An interesting treatment consists of the administration of physostigmine, diisopropyl-phosphofluoridate (Chapter 12, Section C,l), or other acetylcholinesterase inhibitors (Box 12-E). These very toxic compounds, when administered in controlled amounts, permit accumulation of higher acetylcholine concentration with a resultant activation of muscular contraction. The same compounds... 

When the calcium ion concentration is lowered in the fluids bathing nerve axons ifluids which are in very rapid equilibrium with the blood plasma) the electrical resistance ol the axon membrane is lowered, there is increased movement of sodium ions to ihe inside, and the ability ol ihe nerve to return io iis normal siale fallowing a discharge is slowed. Thus, on the one hand, there is hyperexcitabilily. Bui. the ability lor synaptic transmission is inhihited because the rate of acetylcholine liberation is a function ot ihe calcium ion concentration. The neuromuscular junction is... 

It is believed that fine cytoplasmic arms connect the nuclei-containing portion of the myocytons with the contractile components such that many parenchymal cells are in fact myocytons (Lumsden and Hildreth, 1983). Also, some cytoplasmic arms are believed to form multiple neuromuscular junctions that provide for neuronal control/modulation of muscle activity. Limited information is available on the functional relationship of trematode nerve and muscle although the situation in ces-todes has been described as polyneuronal and polyterminal in that each neuron can form synapse-like contacts with multiple myocytons and each myocyton can synapse with several neurons (Webb, 1987). Morphologically atypical synapses and paracrine release sites have been described in the relationship between muscle and nerve in flatworms details on the role they play are not available, although they are believed to facilitate nerve-muscle communication. 

Drugs discussed in this chapter are used to decrease muscle excitability and contraction via an effect at the spinal cord level, at the neuromuscular junction, or within the muscle cell itself. Some texts also classify neuromuscular junction blockers such as curare and succinylcholine as skeletal muscle relaxants. However, these drugs are more appropriately classified as skeletal muscle paralytics because they eliminate muscle contraction by blocking transmission at the myoneural synapse. This type of skeletal muscle paralysis is used primarily during general anesthesia using neuromuscular blockers as an adjunct in surgery was discussed in Chapter 11. Skeletal muscle relaxants do not typically prevent muscle contraction they only attempt to normalize muscle excitability to decrease pain and improve motor function. 

Injection of botulinum toxin is a rather innovative way to control localized muscle hyperexcitability. Botulinum toxin is a purified version of the toxin that causes botulism. Systemic doses of this toxin can be extremely dangerous or fatal because botulinum toxin inhibits the release of acetylcholine from presynaptic terminals at the skeletal neuromuscular junction. Loss of presynaptic acetylcholine release results in paralysis of the muscle fiber supplied by that terminal. Systemic dissemination of botulinum toxin can therefore cause widespread paralysis, including loss of respiratory muscle function. Injection into specific muscles, however, can sequester the toxin within these muscles, thus producing localized effects that are beneficial in certain forms of muscle hyperexcitability. 

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