The airway cholinergic system: physiology and pharmacology

Pulm Pharmacol Ther. 2004;17(4):181-98. doi: 10.1016/j.pupt.2004.03.001.


The present review summarizes the current knowledge of the cholinergic systems in the airways with special emphasis on the role of acetylcholine both as neurotransmitter in ganglia and postganglionic parasympathetic nerves and as non-neuronal paracrine mediator. The different cholinoceptors, various nicotinic and muscarinic receptors, as well as their signalling mechanisms are presented. The complex ganglionic and prejunctional mechanisms controlling the release of acetylcholine are explained, and it is discussed whether changes in transmitter release could be involved in airway dysfunctions. The effects of acetylcholine on different target cells, smooth muscles, nerves, surface epithelial and secretory cells as well as mast cells are described in detail, including the receptor subtypes involved in signal transmission.

Publication types

  • Review

MeSH terms

  • Acetylcholine / metabolism*
  • Animals
  • Ganglia, Parasympathetic / physiology
  • Humans
  • Mast Cells / metabolism
  • Muscle, Smooth / innervation
  • Muscle, Smooth / physiology
  • Paracrine Communication / physiology
  • Receptors, Cholinergic / physiology*
  • Respiratory Mucosa / cytology
  • Respiratory Mucosa / metabolism
  • Respiratory Physiological Phenomena / drug effects*
  • Respiratory System / innervation
  • Respiratory System / metabolism*
  • Signal Transduction / physiology


  • Receptors, Cholinergic
  • Acetylcholine