Mechanisms Regulating Neuromuscular Junction Development and Function and Causes of Muscle Wasting

Physiol Rev. 2015 Jul;95(3):809-52. doi: 10.1152/physrev.00033.2014.


The neuromuscular junction is the chemical synapse between motor neurons and skeletal muscle fibers. It is designed to reliably convert the action potential from the presynaptic motor neuron into the contraction of the postsynaptic muscle fiber. Diseases that affect the neuromuscular junction may cause failure of this conversion and result in loss of ambulation and respiration. The loss of motor input also causes muscle wasting as muscle mass is constantly adapted to contractile needs by the balancing of protein synthesis and protein degradation. Finally, neuromuscular activity and muscle mass have a major impact on metabolic properties of the organisms. This review discusses the mechanisms involved in the development and maintenance of the neuromuscular junction, the consequences of and the mechanisms involved in its dysfunction, and its role in maintaining muscle mass during aging. As life expectancy is increasing, loss of muscle mass during aging, called sarcopenia, has emerged as a field of high medical need. Interestingly, aging is also accompanied by structural changes at the neuromuscular junction, suggesting that the mechanisms involved in neuromuscular junction maintenance might be disturbed during aging. In addition, there is now evidence that behavioral paradigms and signaling pathways that are involved in longevity also affect neuromuscular junction stability and sarcopenia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acetylcholine / metabolism
  • Age Factors
  • Animals
  • Humans
  • Models, Animal
  • Muscle Contraction
  • Muscle Strength
  • Muscle, Skeletal / innervation*
  • Muscle, Skeletal / pathology
  • Neuromuscular Junction / growth & development*
  • Neuromuscular Junction / metabolism
  • Receptors, Cholinergic / metabolism
  • Sarcopenia / metabolism
  • Sarcopenia / pathology
  • Sarcopenia / physiopathology*
  • Synaptic Transmission*


  • Receptors, Cholinergic
  • Acetylcholine