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types of ACh receptors nicotinic and muscarinic, so named by Dale because the choline-induced responses were similar either to those of nicotine or to those of the alkaloid muscarine The postganglionic parasympathetic receptors are located within the innervated organ and are muscarinic; ie, they are antagonized by atropinic drugs The receptors in ganglia, like those of skeletal muscle, are nicotinic; they are not blocked by atropine but by other agents (eg, tubocurarine) It is likely that more than ACh is involved in nerve transmission at a ganglionic level Many peptides substance P, enkephalins, somatostatin, vasoactive intestinal peptide, adenosine triphosphate (ATP), and most recently nitric oxide have been identi ed in the autonomic ganglia, localizing in some cases to the same cell as ACh (This negates Dale s law, which stipulates that one neuron elaborates only one neurotransmitter) Particular neuronal ring rates appear to cause the preferential release of one or another of these substances Most of the neuropeptides exert their postsynaptic effects through the G-protein transduction system which utilizes adenylcyclase or phospholipase C as intermediaries The neuropeptides act as modulators of neural transmission, although their exact function in many cases remains to be determined With two exceptions, postganglionic sympathetic bers release only NE at their terminals The sweat glands and some blood vessels in muscle are innervated by postganglionic sympathetic bers, but their terminals, as mentioned, release ACh The NE that is discharged into the synaptic space activates speci c adrenergic receptors on the postsynaptic membrane of target cells Adrenergic receptors are of two types, classi ed originally by Ahlquist as alpha and beta In general, the alpha receptors mediate vasoconstriction, relaxation of the gut, and dilatation of the pupil; beta receptors mediate vasodilatation, especially in muscles; relaxation of the bronchi; and an increased rate and contractility of the heart Each of these receptors is subdivided further into two types Alpha1 receptors are postsynaptic; alpha2 receptors are situated on the presynaptic membrane and, when stimulated, diminish the release of the transmitter Beta1 receptors are, for all practical purposes, limited to the heart; their activation increases the heart rate and contractility Beta2 receptors, when stimulated, relax the smooth muscle of the bronchi and of most other sites, including the blood vessels of skeletal muscle A comprehensive account of neurohumoral transmission and receptor function can be found in the review by Hoffman and colleagues and in the monograph by Cooper and colleagues Discussed in the following pages are the ways in which the two divisions of the autonomic nervous system, acting in conjunction with the endocrine glands, maintain the homeostasis of the organism As stated above, the integration of these two systems is achieved primarily in the hypothalamus In addition, the endocrine glands are in uenced by circulating catecholamines, and some of them are innervated by adrenergic bers, which terminate not only on blood vessels but also, in some cases, directly on secretory cells These autonomic-endocrine relations are elaborated in Chap 27.

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