Purinoceptors in neuromuscular transmission

At the neuromuscular junction, P-2-purinoceptors mediate the actions of the co-transmitter ATP and P-1-purinoceptors, those of its degradation product adenosine. The classification of the subtypes of P-1- and P-2-purinoceptors and their signal transduction routes is presented. Purinoceptor mediated effects on the prejunctional release of acetylcholine and the postjunctional desensitization and expression of nicotinic receptors are discussed in depth. An additional section on the reversal action of the P-2-purinoceptor antagonist suramin on neuromuscular block underscores the importance of testing purinoceptor-targeted drugs once they will be marketed, to avoid adverse effects in patients. (C) 1997 Elsevier Science Inc.