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Muscarinic acetylcholine receptor M1, M2, M4, M5 (mAChR M1, M2, M4, M5)

Target
mAChR M1, M2, M4, M5
Molecular classification
G protein-coupled receptor, Receptor
01

Overview

The muscarinic acetylcholine receptors M1, M2, M4, and M5 are a subset of the G protein-coupled receptor (GPCR) family that mediate the metabotropic actions of the neurotransmitter acetylcholine in the central and peripheral nervous systems (UniProt, NIH). These receptors are categorized into two groups based on their G-protein coupling: M1 and M5 are Gq-coupled (excitatory), while M2 and M4 are Gi-coupled (inhibitory) (Wikipedia, ResearchGate). In the brain, M1 and M4 receptors are highly expressed in regions like the cortex and striatum, where they play critical roles in cognitive processes, memory, and the regulation of dopaminergic signaling (BMS, NIH). M2 receptors are widely distributed and involved in heart rate regulation and presynaptic inhibition, while M5 receptors are primarily localized in the midbrain and linked to the reward and addiction pathways (StatPearls, MDPI). This specific subset is a major focus of drug development for neuropsychiatric disorders, particularly schizophrenia and Alzheimer's disease, where agonists like xanomeline aim to improve symptoms by targeting M1 and M4 while avoiding the M3-mediated peripheral side effects such as gastrointestinal distress (Wikipedia, PatSnap). Therapeutic strategies include orthosteric agonists, antagonists, and increasingly, subtype-selective positive allosteric modulators (PAMs) to achieve better precision and safety (Nature Reviews Drug Discovery, MDPI).

Other names
Muscarinic receptorsCHRM1CHRM2CHRM4CHRM5mAChRsCholinergic receptors muscarinic
02

Mechanism of action

Agonism, antagonism, and allosteric modulation of specific muscarinic receptor subtypes to regulate neurotransmission, cognitive function, and autonomic activity.

03

Biological functions

Signal transductionNeurotransmissionCognitive functionDopamine regulationHeart rate regulationReward processingSynaptic plasticity
04

Disease associations

SchizophreniaAlzheimer's diseaseParkinson's diseaseAddictionCognitive impairmentBipolar disorder
05

Safety considerations

Cholinergic side effects (nausea, vomiting, sweating, hypersalivation)Cardiovascular effects (bradycardia or tachycardia)Cognitive impairment or delirium (associated with antagonism)Therapeutic window limitations due to subtype cross-reactivityRisk of cholinergic crisis with excessive agonism
06

Interacting drugs

Xanomeline

7 more in the full profile.

07

Biomarkers

Positive and Negative Syndrome Scale (PANSS)Mini-Mental State Examination (MMSE)PET imaging of receptor occupancy (e.g., [11C]MK-6884)Cerebrospinal fluid acetylcholine levels

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