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Muscarinic acetylcholine receptor M1 (CHRM1), Muscarinic acetylcholine receptor M2 (CHRM2), Muscarinic acetylcholine receptor M3 (CHRM3) (M1, M2, M3 (or CHRM1, CHRM2, CHRM3))

Target
M1, M2, M3 (or CHRM1, CHRM2, CHRM3)
Molecular classification
G protein-coupled receptor (GPCR)[9][1][3][5], Receptor, Metabotropic receptor[9]
01

Overview

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].

Other names
Muscarinic receptor M1, M2, M3mAChR M1, mAChR M2, mAChR M3Cholinergic receptor, muscarinic 1/2/3CHRM1, CHRM2, CHRM3Acetylcholine receptor, muscarinic type 1/2/3
02

Mechanism of action

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]

03

Biological functions

Signal transduction[7][9][3]Regulation of smooth muscle contraction (M3)[2][3][5]Modulation of cardiac function (M2)[2][3]Regulation of glandular and exocrine secretion (M1, M3)[2][3]Regulation of cognitive function (mainly M1)[2][3][4]Regulation of neurotransmitter release (M1, M2)[3][6]
04

Disease associations

Alzheimer disease (M1, M3)[2][4]Schizophrenia and other psychiatric disorders (mainly M1, M4, but M1-M3 involved)[6][4]Cardiovascular disease (M2)[2][3]Asthma and COPD (M3)[1][5][2]Overactive bladder (M3)[2][3]Gastrointestinal disorders (M3)[2][3]Pain (neuropathic, role under study)Other neurodegenerative and neuropsychiatric diseases[4][6]
05

Safety considerations

Lack of subtype selectivity leads to off-target effects (e.g. dry mouth, blurred vision, constipation, urinary retention, tachycardia, CNS effects)[4][2][1]Cardiac safety: M2 antagonism may cause tachycardia/arrhythmias[3]CNS side effects: confusion, cognitive impairment, particularly in elderly (antagonists)[2][4]Prolonged M3 antagonism: risk of glaucoma worsening, urinary retention[2][3]Peripheral vs. central effect balance is a challenge
06

Interacting drugs

Agonists: Bethanechol (nonselective, various uses), Pilocarpine (M3> others, glaucoma, dry mouth), Cevimeline (M3> others, Sjögren’s syndrome), Xanomeline (M1/M4, in trials for schizophrenia)[8][2]

2 more in the full profile.

07

Biomarkers

CHRM1, CHRM2, CHRM3 expression levels (potential research biomarkers for Alzheimer’s, schizophrenia, and some cancers)[4][6]No widely used clinical biomarker for patient selection in current therapeutic context

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