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Updated: Oct 16 2017

Autonomic Pathways

  • Noradrenergic nerve terminal
    • Norepinephrine production
      • adrenergic neurons transport tyrosine by a transport protein to synthesize norepinephrine
        • adrenergic and dopaminergic neurons use the same pathway
          • adrenergic neurons modify NE to Epi
          • dopaminergic neurons terminates at dopamine
      • tyrosine → dopa → dopamine → norepinephrine → epinephrine
      • the rate limiting step is the conversion of tyrosine to dopa by tyrosine hydroxylase
        • can be inhibited by metyrosine
    • NE pathway feedback
      • NE: negative feedback by acting on presynaptic α2 autoreceptors to inhibit further NE release
      • ACh: acts on M2 receptors also to inhibit further NE release
      • angiotensin II: activates NE release
    • Pathway Inhibitors
      • reserpine: inhibits the vesicular monoamine transporter (VMAT) preventing the storage of neurotransmitters
      • guanethidine: replaces the NE inside the neurotransmitter vesicles and depletes the vesicle of NE
      • cocaine and tricyclic antidepressants: inhibits the NET (reuptake)
  • Cholinergic Nerve Terminal
    • Acetylcholine (ACh) production
      • synthesized from choline and acetyl-CoA by choline acetyltransferase
        • acetyl-CoA is made in the mitochondria
        • choline is transported into the nerve by choline transporter (CHT)
    • Pathway Inhibitors
      • hemicholinium: blocks the uptake of choline by inhibiting CHT
      • vesamicol: inhibits vesicular acetylcholine transporter (VAT) preventing the storage of acetylcholine
      • botulinum toxin: cleaves the SNAP proteins thereby preventing the presynaptic vesicles from docking at the terminal and releasing acetylcholine
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