Underner M, Millet C, Charrière V, Dore P, Meurice J C, Patte F
Service de Pneumologie, Hôpital de la Milètrie, C.H.R.U. de Poitiers.
Rev Pneumol Clin. 1989;45(4):144-51.
The autonomic nervous system includes, side by side with the sympathetic and parasymathetic systems, a third, non-adrenergic and non-cholinergic system called NANC. The mediators in this system are peptides acting as neurotransmitters, i.e. neuropeptides. The NANC system has two components: bronchodilator and bronchoconstrictor. The bronchial relaxant system, called non-adrenergic inhibitory system, has several neurotransmitters, viz.: vasoactive intestinal peptide (VIP), isoleucine histidine peptide (IHP) and methionine histidine peptide (MPH), all derived from a common precursor: pre-pro VIP. MHP has been described in man and IHP in some animal species. VIP relaxes the bronchial smooth muscle, is vasodilator and exerts cellular effects in phagocytes, lymphocytes and mast cells. VIP receptors are present on cells. The other component, called non-cholinergic excitatory system, has tachykinins as neuromediators, including substance P, neurokinins A and B, neuropeptide K and calcitonin gene related peptide (CGRP). Substance P contracts the bronchi, increases mucus secretion, dilates vessels and also exerts cellular effects in lymphocytes and phagocytes. Tachykinins act through receptors 3 types of which are now known: NK 1, NK 2 and NK 3. Other neuropeptides have been isolated, including galanin, neuropeptide Y, bombesin, gastrin releasing peptide, enkephalins and katacalcin. The coexistence, in pre- and post-synaptic positions, of the conventional mediators (noradrenaline, acetylcholine) and neuropeptides leads to the concept of co-transmission and makes the notion of nerve impulse transmission more complex. The development of neuropeptide agonists and antagonists opens new therapeutic prospects in the management of asthma.
自主神经系统除了交感和副交感神经系统外，还包括第三个系统，即非肾上腺素能和非胆碱能系统（NANC）。该系统中的介质是作为神经递质起作用的肽，即神经肽。NANC系统有两个组成部分：支气管扩张和支气管收缩。支气管舒张系统，即非肾上腺素能抑制系统，有几种神经递质，即：血管活性肠肽（VIP）、异亮氨酸组氨酸肽（IHP）和蛋氨酸组氨酸肽（MPH），它们都来源于一个共同的前体：前-前体VIP。MHP已在人类中被描述，IHP在一些动物物种中被描述。VIP可舒张支气管平滑肌，是血管舒张剂，并对吞噬细胞、淋巴细胞和肥大细胞产生细胞效应。VIP受体存在于细胞上。另一个组成部分，即非胆碱能兴奋系统，以速激肽作为神经介质，包括P物质、神经激肽A和B、神经肽K和降钙素基因相关肽（CGRP）。P物质可使支气管收缩，增加黏液分泌，扩张血管，并对淋巴细胞和吞噬细胞产生细胞效应。速激肽通过三种已知的受体起作用：NK1、NK2和NK3。还分离出了其他神经肽，包括甘丙肽、神经肽Y、蛙皮素、胃泌素释放肽、脑啡肽和降钙素。传统介质（去甲肾上腺素、乙酰胆碱）和神经肽在突触前和突触后位置的共存导致了共同传递的概念，并使神经冲动传递的概念更加复杂。神经肽激动剂和拮抗剂的开发为哮喘的治疗开辟了新的前景。
