在肺部气道中，乙酰胆碱是主要的副交感神经递质，它不仅能够帮助支气管压缩和粘液分泌，还能够调节气道炎症和气管重塑。近期有学者认为这样的效果主要是通过muscarinic M3受体介导的。该内容发表在2015年3月的《Trends in pharmacological sciences》(药理学趋势)杂志上的一篇文章。乙酰胆碱调节炎症和对气道重塑的作用，直接作用于气道细胞，通过机械压力对气道作用，然后产生支气管压缩。炎症和重塑的调节同时受神经和非神经的乙酰胆碱影响。综合这些因素，作者认为以M3介导的胆碱治疗，通过分泌的粘液，支气管压缩，炎症和气道重塑进行。，利用相关药物进行治疗能够改善慢性肺阻塞性疾病(COPD)和哮喘。

        Trends Pharmacol Sci. 2015 Mar;36(3):164-71. doi: 10.1016/j.tips.2014.11.005. Epub 2014 Dec 13.

        Acetylcholine beyond bronchoconstriction: roles in inflammation and remodeling.

        Kistemaker LE1, Gosens R2.

        Author information

        Abstract

        Acetylcholine is the primary parasympathetic neurotransmitter in the airways, where it not only induces bronchoconstriction and mucus secretion, but also regulates airway inflammation and remodeling. In this review, we propose that these effects are all primarily mediated via the muscarinic M3 receptor. Acetylcholine promotes inflammation and remodeling via direct effects on airway cells, and via mechanical stress applied to the airways sequential to bronchoconstriction. The effects on inflammation and remodeling are regulated by both neuronal and non-neuronal acetylcholine. Taken together, we believe that the combined effects of anticholinergic therapy on M3-mediated bronchoconstriction, mucus secretion, inflammation, and remodeling may account for the positive outcome of treatment with these drugs for patients with chronic pulmonary obstructive disease (COPD) or asthma.