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Neurotransmitters

Mediatores

For medical students2 min readUpdated 2026-10-10

Neurotransmitters are biologically active chemical substances released from the presynaptic terminal that transmit signals to the postsynaptic membrane. They determine the final outcome of synaptic transmission (excitation or inhibition) and regulate all bodily processes, ranging from muscle contraction to the level of arousal.

Dale's PrincipleEach nerve cell synthesizes only one primary neurotransmitter.
Main ExcitatoryGlutamate mediates 80% of all information transfer in the CNS.
InhibitionGABA and glycine selectively and temporarily block excitation.
Pain ModulatorsEnkephalins and endorphins inhibit the release of pain mediators.

Neurotransmitters of the Peripheral Nervous System

In the synapses of the peripheral nervous system (PNS), two main neurotransmitters play a key role: acetylcholine and norepinephrine.

The effects of these substances strictly depend on where they are released and which receptors they bind to. For example, in the somatic nervous system, acetylcholine is exclusively an excitatory neurotransmitter. However, in neuroeffector synapses of the autonomic nervous system (ANS), both acetylcholine and norepinephrine can cause either excitation or inhibition—the final outcome depends entirely on the physiological properties of the postsynaptic receptors.

Localization of Acetylcholine Release:

Localization of Norepinephrine Release:

Neurotransmitters of the Central Nervous System

In the CNS, neurotransmitters perform more complex tasks and are divided into three functional groups:

  1. Excitatory Neurotransmitters. The primary representative is glutamate. It is the main excitatory agent, responsible for transmitting the vast majority (up to 80%) of signals in the central nervous system.
  2. Regulatory Neurotransmitters. Their task is to adjust neuronal excitability, determine the level of arousal, and shape the motivational-emotional background.
  3. Acetylcholine maintains the baseline tone of nerve centers regardless of whether the body is asleep or awake.
  4. Norepinephrine additionally activates centers during stress and severe tension.
  5. Dopamine is critically important for regulating movement and maintaining normal muscle tone.
  6. Serotonin acts as a safety valve, keeping excessive excitation within necessary limits.
  7. Inhibitory Neurotransmitters. These include GABA (gamma-aminobutyric acid) and glycine. They can selectively and temporarily block the passage of nerve impulses, adapting to the current functional state of the body.

Cotransmitters and Neuromodulators

In addition to the primary transmitter, presynaptic terminals often release additional substances—cotransmitters. Their main function is the fine-tuning (modulation) of postsynaptic membrane sensitivity.

Neuromodulators are also distinguished as biologically active compounds that modulate the potency of primary neurotransmitters:

Receptor Classification

Postsynaptic membrane receptors are classified based on their sensitivity to specific chemical substances. The CNS contains virtually all types of receptors, whereas the periphery exhibits strict specialization.

Receptor TypeActivated ByMain Localization (PNS)
N-cholinergic receptors (nicotinic)Tobacco alkaloid — nicotine (in low doses)Neuromuscular junctions, autonomic ganglia, sympathetic cholinergic synapses
M-cholinergic receptors (muscarinic)Crustacean and fungal toxin — muscarineNeuroeffector synapses of the parasympathetic nervous system
Adrenoceptors ($\alpha$, $\beta_1$, $\beta_2$)NorepinephrineNeuroeffector synapses of the sympathetic nervous system

Mnemonic

To remember the localization of cholinergic receptors: N receptors respond to Nicotine and are located in Neuromuscular junctions. M receptors respond to Muscarine and provide Mild (parasympathetic) organ regulation.

Frequently asked questions

Which enzymes are involved in the synthesis and degradation of acetylcholine?

Acetylcholine metabolism involves two main enzymes that ensure its formation and breakdown.

  • Choline acetyltransferase (choline acetylase) is the enzyme catalyzing the biosynthesis of acetylcholine from choline and acetyl-CoA in the cytoplasm of cholinergic nerve terminals.
  • Acetylcholinesterase is an enzyme of the postsynaptic terminals that rapidly hydrolyzes the neurotransmitter in the synaptic cleft into choline and acetic acid.
What are the subtypes of adrenoceptors and what physiological effects do they produce?

Adrenoceptors are divided into alpha and beta subtypes, producing various metabotropic effects.

  • $\alpha_1$ and $\beta_1$ cause excitation of the postsynaptic cell.
  • $\alpha_2$ and $\beta_2$ cause inhibition.

The effector organ's response to norepinephrine directly depends on the predominant receptor type on the postsynaptic membrane (e.g., bronchial relaxation or vasoconstriction).

What types of glutamate receptors exist in the CNS?

Excitatory amino acid receptors for glutamate are subdivided into three main ligand-gated types.

  • Kainate receptors — one of the types of glutamate receptors.
  • AMPA ($\alpha$-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptors — upon activation, open sodium ion channels, triggering membrane depolarization.
  • NMDA (N-methyl-D-aspartate) receptors — receptors whose ion channel is blocked by magnesium ions at rest and opens only after prior depolarization by AMPA receptors.
By what mechanisms is a neurotransmitter removed from the synaptic cleft?

Removal and inactivation of a neurotransmitter occur via several mechanisms:

  • Reuptake — presynaptic membrane transport proteins return the neurotransmitter to the presynaptic terminal; for norepinephrine, 80% undergoes reuptake.
  • Enzymatic degradation — for example, acetylcholine is cleaved by acetylcholinesterase, and norepinephrine by MAO and COMT.
  • Diffusion — a portion of the neurotransmitter is lost due to diffusion away from the synaptic cleft.
  • Endocytosis — receptor-ligand complex internalization is also possible.
Can a single neuron synthesize several different neurotransmitters?

No, according to the classical Dale's principle, each nerve cell synthesizes only one primary neurotransmitter. However, additional substances—cotransmitters—may be released along with it.

What determines whether a neurotransmitter effect is excitatory or inhibitory?

In neuroeffector synapses of the autonomic nervous system, the final effect of a neurotransmitter (acetylcholine or norepinephrine) depends entirely on the properties of the receptors on the postsynaptic membrane. However, in the somatic system, acetylcholine always causes excitation.

What is the purpose of enkephalins and endorphins?

These substances are part of the body's antinociceptive (pain-relieving) system. They inhibit the release of primary transmitters in synapses during pain excitation, reducing pain intensity.

Where are M-cholinergic receptors located?

They are localized on target organs in neuroeffector synapses of the parasympathetic nervous system and are specifically excited by muscarine.

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