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Muscarinic acetylcholine receptors M1, M2, and M3 are members of the G protein-coupled receptor (GPCR) superfamily that mediate the actions of the neurotransmitter acetylcholine in the central and peripheral nervous systems[9][1][3][7]. M1 is primarily located in the central nervous system and is involved in cognition, memory, and other higher functions[2][4]; M2 is chiefly expressed in the heart where it regulates cardiac rate and contractility[2][3]; M3 is abundant in smooth muscle (airway, GI tract, bladder) and exocrine glands, and regulates smooth muscle contraction, glandular secretion, and vasodilation[2][3][5]. These receptors are vital therapeutic targets in a range of diseases such as Alzheimer’s disease, schizophrenia, overactive bladder, COPD, and gastrointestinal disorders, but their high sequence similarity and widespread physiological roles pose challenges for subtype-selective drug development[1][7]. Drugs acting on M1-M3 include nonselective and subtype-selective agonists and antagonists; lack of selectivity can cause wide-ranging adverse effects[1][2][4].
Agonists: stimulate the receptor, mimicking the action of acetylcholine at muscarinic receptors (signal through G-proteins, subtype dependent)[2][3][8] Antagonists: competitively inhibit acetylcholine binding, blocking normal receptor function[2][8] Some allosteric modulators can enhance or inhibit signaling via non-orthosteric sites[1][7]
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