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• W1987406536 abstract "Most nerves have autoreceptors—that is, receptors for the neurotransmitter located on the nerve ending itself.1Starke K Gothert M Kilbinger H Modulation of neurotransmitter release by presynaptic autoreceptors.Physiol Rev. 1989; 69: 865-989Crossref Scopus (841) Google Scholar These receptors usually (but not always) inhibit the further release of neurotransmitter and therefore act as feedback inhibitory receptors that reduce neurotransmission. Such a mechanism presumably evolved to prevent excessive neural stimulation. Muscarinic autoreceptors on cholingergic nerves of the gut have long been recognized,2Kilbinger H Wessler I Inhibition of acetylcholine of the stimulation-evoked release of [3H] acetylcholine from the guinea-pig myenteric plexus.Neurosci Lett. 1980; 5: 1331-1340Crossref Scopus (101) Google Scholar and there is now evidence that such receptors also exist on cholinergic nerves of the airways and serve to inhibit the release of acetylcholine from postganglionic cholinergic nerve endings. Muscarinic autoreceptors were first demonstrated in guinea pig airways3Fryer AD Maclagan J Muscarinic inhibitory receptors in pulmonary parasymathetic nerves in the guinea-pig.Br J Pharmacol. 1984; 83: 973-978Crossref PubMed Scopus (286) Google Scholar and have now been identified in cat and dog airways,4Blaber LC Fryer AD Maclagan J Neuronal muscarinic receptors attenuate vagally-induced contraction of feline bronchial smooth muscle.Br J Pharmacol. 1985; 86: 723-728Crossref PubMed Scopus (103) Google Scholar,5Ito Y Yoshitomi T Autoregulation of acetylcholine release from vagus nerve terminals through activation of muscarinic receptors in the dog trachea.Br J Pharmacol. 1988; 93: 636-646Crossref PubMed Scopus (63) Google Scholar but not in rat or rabbit airways.3Fryer AD Maclagan J Muscarinic inhibitory receptors in pulmonary parasymathetic nerves in the guinea-pig.Br J Pharmacol. 1984; 83: 973-978Crossref PubMed Scopus (286) Google Scholar,6Maclagan J Faulkner D Effect of pirenzepine and gallamine on cardiac and pulmonary muscarinic receptors in the rabbit.Br J Pharmacol. 1989; 97: 506-512Crossref Scopus (31) Google Scholar Muscarinic autoreceptors have also been identified in human bronchi in vitro and exert a powerful inhibitory influence on cholinergic neurotransmission.7Minette PA Barnes PJ Prejunctional inhibitory muscarinic receptors on cholinergic nerves in human and guinea-pig airways.J Appl Physiol. 1988; 64: 2532-2537Crossref PubMed Scopus (173) Google Scholar Since these receptors are activated by the transmitter at physiologic rates of neural firing, they function as autoreceptors. Blockade of these receptors with muscarinic antagonists may therefore lead to enhanced release of acetylcholine which, in the case of airways, leads to exaggerated vagal bronchoconstriction. The pharmacology of muscarinic autoreceptors has recently been defined. At least five different subtypes of muscarinic receptor have now been cloned,8Buckley NJ Bonner TI Buckley CM Brann MR Antagonist binding properties of five cloned muscarinic receptors expressed in CHO-KI cells.Mol Pharmacol. 1989; 35: 469-476PubMed Google Scholar although drugs are available only to discriminate three of these subtypes. Three subtypes of muscarinic receptor have now been identified in animal and human lung.9Barnes PJ Minette PA Maclagan J Muscarinic receptor subtypes in lung.Trends Pharmacol Sci. 1988; 9: 412-416Abstract Full Text PDF PubMed Scopus (72) Google Scholar,10Maclagan J Barnes PJ Muscarinic pharmacology of the airways.Trends Pharmacol Sci. 1989; (in press)Google Scholar M1 (pirenzepine-sensitive) receptors are localized to parasympathetic ganglia and appear to facilitate neurotransmission,11Lammers J-W Minette P McCusker M Barnes PJ The role of pirenzepine-sensitive (M1) muscarinic receptors in vagally mediated bronchoconstriction in humans.Am Rev Respir Dis. 1989; 139: 446-449Crossref PubMed Scopus (91) Google Scholar whereas the classic muscarinic receptors that mediate contraction of airway smooth muscle are of the M3 subtype. Autoreceptors belong to the M2-subtype, which are characteristically found in the atria, and are selectively stimulated by pilocarpine and blocked by gallamine, AF-DX 116 and the highly selective drug methoctramine.3Fryer AD Maclagan J Muscarinic inhibitory receptors in pulmonary parasymathetic nerves in the guinea-pig.Br J Pharmacol. 1984; 83: 973-978Crossref PubMed Scopus (286) Google Scholar,4Blaber LC Fryer AD Maclagan J Neuronal muscarinic receptors attenuate vagally-induced contraction of feline bronchial smooth muscle.Br J Pharmacol. 1985; 86: 723-728Crossref PubMed Scopus (103) Google Scholar,12Watson N Barnes PJ Maclagan J Comparison of the in vivo potency of methoctramine for pro- and post-junctional muscarinic receptors in the guinea-pig lung.Br J Pharmacol. 1989; (in press)Google Scholar Anticholinergic drugs, such as atropine and ipratropium bromide, are nonselective blockers and so inhibit both prejunctional M2 receptors (on nerves) and post-junctional M3 receptors (on smooth muscle) with equal effect. Theoretically, this means that they will increase acetylcholine release when the nerve is activated and this may overcome the desired post-junctional blockade. This could lead to paradoxic bronchoconstriction, which has now been clearly demonstrated in animals after low doses of anticholinergic drugs.13Fryer AD Maclagan J Ipratropium bromide potentiates bronchoconstriction induced by vagal nerve stimulation in the guinea-pig.Eur J Pharmacol. 1987; 139: 187-191Crossref PubMed Scopus (34) Google Scholar Whether it may explain some of the cases of paradoxic bronchoconstriction reported in some patients with ipratropium bromide inhalers14Connolly CK Adverse reaction to ipratropium bromide.Br Med J. 1982; 5: 934-935Crossref Scopus (36) Google Scholar is not certain. However, it is likely that selective M3-receptor antagonists might be more useful than nonselective antagonists and such drugs are now under development. Are muscarinic autoreceptors relevant in airways disease? In a recent study of nonasthmatic subjects, the M2 selective cholinergic agonist pilocarpine, in a dose that had a small bronchoconstrictor effect in its own right, had an inhibitory effect on cholinergic reflex bronchoconstriction induced by inhalation of sulfur dioxide, whereas a similar degree of bronchoconstriction induced by histamine did not affect the reflex bronchoconstriction.15Minette PAH Lammers J Dixon CMS McCusker MT Barnes PJ A muscarinic agonist inhibits reflex bronchoconstriction in normal but not in asthmatic subjects.J Appl Physiol. 1989; (in press)Google Scholar This suggests that autoreceptors are present in normal human airways in vivo and are able to modulate cholinergic reflex bronchoconstriction. A similar conclusion has been reached by Ayala and Ahmed in a study published in this issue (see page 1285) in which histamine-induced bronchoconstriction (partly mediated through a cholinergic reflex in normal individuals) was reduced after prior inhalation of the nonselective cholinergic agonist methacholine. In both studies, the surprising observation was made that this inhibitory effect of cholinergic agonists was apparently absent in asthmatic patients. This suggests that there may be a dysfunction of muscarinic autoreceptors in asthma. Such a defect would lead to an exaggeration of cholinergic reflexes in the airways, and may also help to explain why beta-blockers may produce such a marked degree of bronchoconstriction in asthma,16Barnes PJ Muscarinic receptor subtypes: implications for lung disease.Thorax. 1989; 44: 161-167Crossref PubMed Scopus (77) Google Scholar which is mediated via cholinergic mechanisms.17Ind PW Dixon CMS Fuller RW Barnes PJ Anticholinergic blockade of beta-blocker induced bronchoconstriction.Am Rev Respir Dis. 1989; 139: 1390-1394Crossref PubMed Scopus (78) Google Scholar Beta-blockers may inhibit the modulatory action of endogenous catecholamines on beta2 adrenoceptors on cholinergic nerves,18Rhoden KJ Meldrum LA Barnes PJ Inhibition of cholinergic neurotransmission in human airways by beta2-adrenoceptors.J Appl Physiol. 1988; 65: 700-705PubMed Google Scholar leading to an increase in cholinergic tone. In normal individuals, this is switched off via autoreceptors, but if these receptors are dysfunctional in asthma, there will be an increased release of acetylcholine which may cause marked bronchoconstriction since airways are hyperresponsive to any constrictor. Whether there is a dysfunction of muscarinic autoreceptors in asthma needs to be confirmed by other studies. Animal models of airway inflammation may shed light on possible mechanisms. The application of molecular probes for M2-receptors may also reveal how inflammation might lead to a reduction in autoreceptor transcription. The role of muscarinic autoreceptors in airway disease is a new topic that merits further investigation." @default.
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• W1987406536 title "Muscarinic Autoreceptors in Airways" @default.
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