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Tiotropium is a muscarinic receptor antagonist, often referred to as an antimuscarinic or anticholinergic agent. Although it does not display selectivity for specific muscarinic receptors, when topically applied it acts mainly on M 3 muscarinic receptors [ 29 ] located on smooth muscle cells and submucosal glands.
Some examples of anticholinergics are tiotropium (Spiriva) and ipratropium bromide. [citation needed] Tiotropium is a long-acting, 24-hour, anticholinergic bronchodilator used in the management of chronic obstructive pulmonary disease (COPD). Only available as an inhalant, ipratropium bromide is used in the treatment of asthma and COPD.
ATC code R03 Drugs for obstructive airway diseases is a therapeutic subgroup of the Anatomical Therapeutic Chemical Classification System, a system of alphanumeric codes developed by the World Health Organization (WHO) for the classification of drugs and other medical products.
Both M 2 and M 3 muscarinic receptors are expressed in the smooth muscles of the airway, with the majority of the receptors being the M 2 type. Activation of the M 2 receptors, which are coupled to G i, inhibits the β-adrenergic mediated relaxation of the airway smooth muscle.
The muscarinic M 3 receptor regulates insulin secretion from the pancreas [7] and are an important target for understanding the mechanisms of type 2 diabetes mellitus.. Some antipsychotic drugs that are prescribed to treat schizophrenia and bipolar disorder (such as olanzapine and clozapine) have a high risk of diabetes side-effects.
Muscarinic acetylcholine receptors (mAChRs) are acetylcholine receptors that form G protein-coupled receptor complexes in the cell membranes of certain neurons [1] and other cells. They play several roles, including acting as the main end-receptor stimulated by acetylcholine released from postganglionic fibers .
Subsequently, the primed cells will differentiate either into effector cells or into memory cells that can mount stronger and faster response to second and upcoming immune challenges. [2] T and B cell priming occurs in the secondary lymphoid organs (lymph nodes and spleen). Priming of naïve T cells requires dendritic cell antigen presentation.
The carotid body is situated on the posterior aspect of the bifurcation of the common carotid artery. [3] The carotid body is made up of two types of cells, called glomus cells: glomus type I cells are peripheral chemoreceptors, and glomus type II cells are sustentacular supportive cells. Glomus type I cells are derived from the neural crest. [4]