The concept of purinergic neurotransmission was proposed in 1972, after it was shown that adenosine 5 -triphosphate (ATP) was a transmitter in non-adrenergic, non-cholinergic inhibitory nerves in the guinea pig taenia coli. Subsequently, ATP was identified as a cotransmitter in sympathetic and parasympathetic nerves, and it is now recognized that ATP acts as a cotransmitter in most nerves in both the peripheral nervous system and central nervous system (CNS). ATP acts as a fast excitatory neurotransmitter or neuromodulator and has potent long-term (trophic) roles in cell proliferation, differentiation, and death in development and regeneration, as well as in disease. Three subclasses of receptors to purines and pyrimidines have been identified, P1 adenosine receptors (with four subtypes), P2X ionotropic nucleotide receptors (seven subtypes), and P2Y metabotropic nucleotide receptors (eight subtypes). ATP is released physiologically by many different cell types by mechanical deformation, and after release ATP undergoes rapid enzymatic degradation by ectonucleotidases. Purinergic receptors appeared early in evolution and have a widespread distribution on many different non-neuronal cell types as well as neurons. There is evidence for the involvement of purinergic signaling in embryonic development and in the activities of stem cells. There is a rapidly growing literature about the pathophysiology of purinergic signaling, and there are therapeutic developments for a variety of diseases, including stroke and thrombosis, osteoporosis, kidney failure, bladder incontinence, cystic fibrosis, dry eye, cancer, and disorders of the CNS, such as Alzheimer's, Parkinson's, and Huntington's disease, multiple sclerosis, epilepsy, migraine, and neuropsychiatric disorders.sacral parasympathetic nerves, and NANC transmission was later shown in the urinary bladder and vascular system.
ATP AS A TRANSMITTER IN NANC NERVESThe next step was to try to identify the transmitter released during NANC inhibitory transmission in the gut and by NANC excitatory transmission in the urinary bladder. Several criteria needed to be satisfied to establish a neurotransmitter: synthesis and storage in nerve terminals; release by a Ca 2+ -dependent mechanism; mimicry of the nerve-mediated responses by the exogenously applied transmitter; inactivation by ectoenzymes and/or neuronal uptake; and parallel block or potentiation of responses to stimulation by nerves and exogenously applied transmitter.
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