Is “Cholinergic” Stimulus Useful for Ulcerative Colitis Treatment?

Excerpt

Pyridostigmine, an acetylcholinesterase inhibitor that increases acetylcholine levels in neuromuscular junctions and postganglionic parasympathetic nerve-targeted organ junctions, is a drug previously used for protection of the military from nerve agents and is routinely used clinically for the treatment of myasthenia gravis. Inhibition of the enzyme acetylcholinesterase impairs the hydrolysis and removal of acetylcholine in order to facilitate repolarization in the synapse. Enteric nerves in the submucosal and myenteric plexus of the gut wall are categorized in the postganglionic parasympathetic division and also release acetylcholine in order to regulate intestinal functions. Based on the long-term observation that smokers (with stimulation of nicotinic acetylcholine receptors) seldom develop T helper (Th) 2-type ulcerative colitis (UC), whereas the habit of smoking seems to worsen the symptoms of Th1-type Crohn’s disease (CD), the effect of pyridostigmine as a potential therapy for UC was investigated in a preclinical study by Singh et al. published in this issue of Digestive Diseases and Sciences [1]. …