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Abstract
Muscarinic acetylcholine receptors (mAChRs) are G proteincoupled receptors (GPCRs)
that mediate the metabotropic actions of acetylcholine (ACh). There are five subtypes
of mAChR, M1 - M5, which are expressed throughout the central nervous system (CNS)
on numerous cell types and represent promising treatment targets for a number of different
diseases, disorders, and conditions of the CNS. Although the present review will focus
on Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI), a number
of conditions such as Parkinson's disease (PD), schizophrenia, and others represent
significant unmet medical needs for which selective muscarinic agents could offer
therapeutic benefits. Numerous advances have been made regarding mAChR localization
through the use of subtype-selective antibodies and radioligand binding studies and
these efforts have helped propel a number of mAChR therapeutics into clinical trials.
However, much of what we know about mAChR localization in the healthy and diseased
brain has come from studies employing radioligand binding with relatively modest selectivity.
The development of subtype-selective small molecule radioligands suitable for in vitro
and in vivo use, as well as robust, commercially-available antibodies remains a critical
need for the field. Additionally, novel genetic tools should be developed and leveraged
to help move the field increasingly towards a systems-level understanding of mAChR
subtype action. Finally, functional, proteomic, and genetic data from ongoing human
studies hold great promise for optimizing the design and interpretation of studies
examining receptor levels by enabling patient stratification. This article is part
of the Special Issue entitled 'Neuropharmacology on Muscarinic Receptors'.