Changes in expression of autonomic nerves in aging and disease

Mechanisms of autonomic neuroeffector transmission are summarised, including evidence for a multiplicity of transmitters, co-transmission, neuromodulation and 'chemical coding' of individual autonomic neurons, where the combination of transmitters they contain is known, as well as their projections and central connections. Changes in expression of autonomic nerves and co-transmitters that occur during development and aging, following trauma, surgery, after chronic exposure to drugs, and in a number of disease situations are described. It is suggested that in neuropathological analysis, compensatory increases in innervation should be considered as well as loss or damage to nerves. Studies of the molecular mechanisms involved in the control of co-transmitter and receptor expression are now needed.