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As a result of cholinergic crisis, the muscles stop responding to the high synaptic levels of acetylcholine, leading to flaccid paralysis, respiratory failure, and other signs and symptoms reminiscent of organophosphate poisoning. Other symptoms include increased sweating, salivation, bronchial secretions along with miosis (constricted pupils).
Individuals symptoms vary in severity and type. Severe, subacute gastrointestinal dysmotility and orthostatic hypotension are the most common symptoms in two-thirds of patients. Symptoms can be severe in some cases and gradually worsen in others. [1] Sympathetic failure manifests itself as orthostatic hypotension and anhidrosis.
Apart from skeletal muscle, the autonomic nervous system also requires acetylcholine neurotransmission; this explains the occurrence of autonomic symptoms in LEMS. [ 4 ] [ 3 ] P/Q voltage-gated calcium channels are also found in the cerebellum , explaining why some experience problems with coordination.
Chemical structure of acetylcholine. Cholinergic blocking drugs are a group of drugs that block the action of acetylcholine (ACh), a neurotransmitter, in synapses of the cholinergic nervous system. [1] They block acetylcholine from binding to cholinergic receptors, namely the nicotinic and muscarinic receptors.
Anatoxin-a is a very powerful nicotinic acetylcholine receptor agonist and as such has been extensively studied for medicinal purposes. It is mainly used as a pharmacological probe in order to investigate diseases characterized by low acetylcholine levels, such as muscular dystrophy , myasthenia gravis , Alzheimer disease , and Parkinson disease .
The resulting decrease in acetylcholine in the brain is thought to contribute to the decline in mental function of affected patients. [ 3 ] [ 2 ] For this reason, most currently available pharmacological treatments for dementia focus on compensating for faltering function of the nucleus basalis through artificially increasing acetylcholine levels.
Image credits: SapereAudeAdAbsurdum "I also suspect that even people who don't classify themselves as having megalophobia still get that little touch of vertigo when seeing some of the sub's content."
Acetylcholinesterase (HGNC symbol ACHE; EC 3.1.1.7; systematic name acetylcholine acetylhydrolase), also known as AChE, AChase or acetylhydrolase, is the primary cholinesterase in the body. It is an enzyme that catalyzes the breakdown of acetylcholine and some other choline esters that function as neurotransmitters :