14 - Purinergic Neurotransmission

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An increase in the role of adenosine triphosphate (ATP) as a cotransmitter has been demonstrated in pathologic conditions, including interstitial cystitis and hypertension. In addition to rapid signaling during neurotransmission, ATP appears to act as a long-term (trophic) signaling molecule during development and regeneration, sometimes synergistically with growth factors. Purinergic mechanosensory transduction has been proposed where ATP released from epithelial cells closely associated with sensory nerve terminals labeled with P2X3 receptors leads to the activation of sensory nerve activity related to physiologic events—such as bladder voiding—or to nociception or both. Following the proposal by Burnstock in 1976 that nerves might store and release more than one transmitter, there is now considerable experimental support for ATP as a cotransmitter with classical transmitters and neuropeptides in most major nerve types. ATP released from nerves may also act as a prejunctional modulator of cotransmitter release (often through adenosine) or as a postjunctional modulator of cotransmitter actions.

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