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Interaktion von Vagus und Sympathikus im Tracheo-Bronchialsystem

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Das cholinerge System der Atemwege

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Zusammenfassung

Die Regulation der glatten Atemwegsmuskulatur ist speziesverschieden. Die gemeinsame embyologische Entstehung von Lunge und Darm erklärt die Tatsache, daß Morphologie und Funktion der Nerven, Ganglien, glatten Muskelzellen und Rezeptoren ähnlich bzw. gleich der des Sastrointestinaltraktes ist. Die glatte Muskulatur und die Innervation des Tracheobronchialsystems hat folgende anatomische, morphologische und funktionelle Charakteristika: Cholinerge exzitatorische Nerven und non-adrenerge, non-cholinerge (NANC) inhibitorische Nerven sowie non-cholinerge, non-adrenerge exzitatorische Nerven, dafür aber keine adrenergen Nerven. Ferner eine dem Gastrointestinaltrakt ähnliche Ultrastruktur der Ganglien, Zellverbindungen der glatten Muskelzellen vom Nexustyp sowie eine mögliche spontane, myogene Aktivität, β2-Rezeptoren mit inhibitorischer Wirkung α1-Rezeptoren mit exzitatorischer Wirkung. Im Hinblick auf die Pathogenese chronisch-obstruktiver Atemwegserkrankungen dürften die sensorischen, non-adrenergen und non-cholinergen exzitatorischen Nerven eine Rolle spielen, die jedoch nicht ganz geklärt ist. Neuropeptide, im speziellen Tachykinine, wie Substance P dürften eine wichtige Mediatorfunktion haben und für eine neurogene Entzündungsreaktion verantwortlich sein.

Daraus könnten sich neue therapeutische Ansätze ergeben, deren Ziel es sein sollte, die Neurotransmitter der non-adrenergen, non-cholinergen exzitatorischen Nerven zu inaktivieren und deren Reaktion — im besonderen die neurogene Entzündung — zu unterdrücken und VIP und verwandte Neuropeptide zu aktivieren und vermehrt verfügbar zu machen, um das notwendige Gleichgewicht zwischen exzitatorischen Mechanismen und inhibitorischen Mechanismen wieder herzustellen.

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Authors and Affiliations

  1. Universitätsklinik Innere Medizin IV, Kardiologische Universitätsklinik Wien und Klinische Abteilung für Pulmologie, Österreich

    Univ.-Doz. Dr. M. Kneußl

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  1. Univ.-Doz. Dr. M. Kneußl
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  1. 2. Medizinische Abteilung mit Lungenkrankheiten und Tuberkulose Wilhelminenspital, Wien, Österreich

    Friedrich Kummer

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© 1992 Springer-Verlag/Wien

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Kneußl, M. (1992). Interaktion von Vagus und Sympathikus im Tracheo-Bronchialsystem. In: Kummer, F. (eds) Das cholinerge System der Atemwege. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9208-5_3

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  • DOI: https://doi.org/10.1007/978-3-7091-9208-5_3

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-82341-5

  • Online ISBN: 978-3-7091-9208-5

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