Lecture 15 Cholinergic Transmission
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Transcript of Lecture 15 Cholinergic Transmission
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Lecture 15Cholinergic Transmission
Rang, Dale and Ritter, 5th Edition, Chapter 10
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Learning Objectives
• Describe the synthesis, storage and release of acetylcholine and how drugs can interact with these pathways in the ANS
• Describe the nicotinic receptors• Describe the muscarinic receptors and their
locations.• Describe the effects and major clinical uses
of drugs affecting the cholinergic system.
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Where Does Acetylcholine Act?
• Stimulation of all autonomic ganglia• Stimulation of all parasympathetic
pathways.• Stimulates secretion of adrenaline from the
adrenal medulla• From the last lecture: Do you remember
which receptors are involved?
.
NICOTINIC
NICOTINIC
MUSCARINIC
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Classification of ACh Receptors
• Actions that can be produced by MUSCARINE – the active ingredient of the poisonous mushroom Amanita muscarineand can be abolished by small doses of ATROPINE (generally correspond to parasympathetic stimulation.)
• Actions that can be produced by nicotine.
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CHOLINE +AcCoA ACh + HSCoAChAT
ACh
AChE
CHOLINE + ACETATE
M1 receptor nAChR
M2receptor
CHOLINE
glucose
pyruvate
glucose
The Cholinergic Synapse
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Acetylcholine Vesicular Transporter
• ACh transport is coupled to an electrochemical gradient for protons.
• Blocked with vesamicol.
H+
H+
ATP ADP
ACh
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Possible Sites of Drug Action:• Mimic (nicotinic or muscarinic agonists) or
prevent (antagonists) the action of Ach on the receptor
• prevent the synthesis of Ach (prevents cholineuptake), e.g. hemicholinium
• prevent the release of Ach, e.g. botulinium toxin (Botox), or Ca2+ channel blockers
• Enhance the release, e.g. 4-aminopyridine • prevent the vesicular storage, e.g. vesamicol• prevent the breakdown of Ach, e.g. neostigmine
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Nicotinic Receptors
• Divided into two classes – muscle (Nm) and neuronal (Ng)
• Muscle receptors occur at the skeletal neuromuscular junction (non ANS, but will discuss in next lecture)
• Neuronal occur in autonomic ganglia and in the brain
• All are ligand gated ion channels – MoA 3 lecture (Lecture 12).
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Nicotinic Receptors
• Activation causes increased cell permeability to sodium and potassium ions
• Increase in cations inside the cell leads to depolarisation of the postsynaptic membrane
• This results in a fast excitatory postsynaptic potential at the ganglionic synapse.
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Nicotinic Receptors Are Subject to Depolarising Blockade
• In addition to blockade by an antagonist –nicotinic receptors can also be inactivated by prolonged agonist exposure
• Application of nicotine to a sympathetic ganglion initially causes an action potential discharge, after a few seconds this discharge ceases and transmission is blocked, after time the cell will repolarise, but transmission remains blocked
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Depolarising Blockade
• This is caused by two mechanisms:– Voltage sensitive Na+ channels become
refractory and no long able to open in response to a brief depolarising stimulus
– Even after the cell has repolarised receptor desensitization occurs
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Drugs Acting At Nicotinic Receptors
• Ng – don’t make very useful drug targets due to widespread distribution throughout the ANS. Experimental tools such as DMPP (agonist).
• Nm – muscle relaxants (for anaesthesia) –pancuronium or suxamethonium(depolarising).
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Muscarinic Receptorss
• 5 receptors have been cloned M1-M5• All are G-protein coupled receptors• M1, M3 and M5 – Gq (what second
messengers would be activated?)• M2, M4 – Gi/o• Only M1, M2 and M3 have been well
characterised
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Muscarinic Actions
• Stimulation of exocrine glands such as sweat, salivary, mucous and lacrimalglands. Gastric, intestinal and pancreatic sections are also increased (partially due to parasympathetic input) (M3)
• Stimulation of smooth muscle contraction in bronchi, GI tract, gall bladder, bileduct, urinary bladder and ureters (M3)
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Muscarinic Actions (cont’d)
• Stimulation of the circular muscles of the iris and muscles of accommodation (pupil constricts, lens accommodated to near vision) – M3
• Relaxation of sphincters in the GI, biliaryand urinary tracts.
• Slowing of the heart. (M2)
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Most Agonists/Antagonists Are Non-selective
• Agonists: – Muscarine– Pilocarpine– Bethanechol– McNA343 and oxotremorine are selective for M1
receptors, while carbachol is relatively inactive on M1.
• Antagonists:– Atropine– Scopolamine– M1 antagonist: pirenzipine– M2 antagonist: gallamine
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Tab
le 7
.2 p
age
119,
Ran
g, D
ale
and
Ritt
er
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Nicotinic Cholinergic
Synapse
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Cholinergic Muscarinic Synapse
• Difference from previous slide:– Presynaptic receptors and post synaptic
receptors are muscarinic. Presynaptic MUSCARINIC receptors serve to INHIBIT further release of Ach.
– Therefore, muscarinic agonists & antagonists rather than nicotinic ones, e.g. Ach & atropine respectively should be used as examples.