Purinoceptors in neuromuscular transmission.

At the neuromuscular junction, P2-purinoceptors mediate the actions of the co-transmitter ATP and P1-purinoceptors, those of its degradation product adenosine. The classification of the subtypes of P1- and P2-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 P2-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.