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2. Clinical aspects of NMJ physiology (and related pharmacology) Logo


This is not an exhaustive list, it serves only to illustrate how dysfunction of those elements of the NMJ considered here, impact upon function.


Lambert-Eaton syndrome Top


In Lambert-Eaton syndrome patients develop antibodies against the type of voltage-gated calcium channels found in the pre-junctional membranes of the NMJ. This impares transmitter release from the
pre-junction membranes and so transmission (excitation of the muscle) is very much less secure at junctions affected by this syndrome.

Patients have muscle weakness and impared stretch reflexes.


Myasthenia gravis Top


Patients with myasthenia gravis suffer from an autoimmune disease., They develop antibodies against the nAChR. The NMJs of these patients have reduced numbers of nAChRs and experience muscle weakness and an inability to maintained prolonged contraction of skeletal muscle. This can demonstrated by observing a patient’s handwriting quickly deteriorate. The muscles that move the eyes are also particularly badly affected giving patients a characteristic stare.
The symptoms of muscle weakness can be reduced by treatment with drugs that inhibit the enzyme, acetylcholine esterase.




Curare Top


  • Curare is a compound substance, containing two alkaloids: curine, C18H19NO3, which affects the muscle fibers of the heart, and curarine, C19H26N2O2, which affects the motor nerve endings in voluntary muscles.
  • Curarine is able to bind to and prevent the opening of a the acetylcholine receptor channel so that acetylcholine, released from the presynaptic nerve terminal (end-plate), cannot stimulate the muscle and so causes paralysis.
  • Curare is obtained from a South American woody vine, Strychnos toxifera and is used as an arrow poison by some Native American tribes of South America. If introduced to a wound (taken orally it is relatively inactive) curare rapidly causes loss of voluntary muscular action through paralysis and, usually, death through arrest of the muscles of respiration.
  • The first useful synthetic form of curare was developed after World War II by the Italian pharmacologist Daniel Bovet. Subsequently several other curare-like drugs were synthesized for medical use. Such compounds are used widely as muscle relaxants during surgical procedures and in therapy for such diseases as rabies and tetanus.

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Copyright © 1998 University of Bristol. All rights reserved.
Author: Phil Langton
Last modified: 9 Jun 1999 20:12
Authored in CALnet