Adrenergic and muscarinergic receptors: classification, pathophysiological relevance and drug target

The rapid development of receptor pharmacology has not only proved to be of great fundamental value, but has also acquired clinical relevance. Major advances have been made in fundamental issues such as the analysis of receptor structures by means of cloning techniques; the elucidation of signal transduction processes, which mediate the signal triggered by receptor activation to intracellular effector structures; and the investigation of receptor changes associated with disease. After a more general discussion of these issues, special attention is paid in the present survey to alpha- and beta-adrenoceptors and to muscarinic receptors. The agonists and antagonists for the various receptor subtypes are discussed, as well as the most important changes in receptor characteristics associated with cardiovascular disease. Potential new therapeutic options based on improved knowledge of receptor pharmacology are discussed for the various alpha- and beta-adrenoceptor subtypes. Special attention is paid to the new and rapidly developing field of muscarinic receptors as a hypothetical basis for drug therapy in cardiovascular and other diseases.