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Muscarine, L-(+)-muscarine, or muscarin is a
natural product A natural product is a natural compound or substance produced by a living organism—that is, found in nature. In the broadest sense, natural products include any substance produced by life. Natural products can also be prepared by chemical syn ...
found in certain
mushroom A mushroom or toadstool is the fleshy, spore-bearing fruiting body of a fungus, typically produced above ground, on soil, or on its food source. ''Toadstool'' generally denotes one poisonous to humans. The standard for the name "mushroom" is t ...
s, particularly in ''
Inocybe ''Inocybe'' is a large genus of mushroom-forming fungi with over 1400 species, including all forms and variations. Members of ''Inocybe'' are mycorrhizal, and some evidence shows that the high degree of speciation in the genus is due to adaptatio ...
'' and ''
Clitocybe ''Clitocybe'' is a genus of mushrooms characterized by white, off-white, buff, cream, pink, or light-yellow spores, gills running down the stem, and pale white to brown or lilac coloration. They are primarily saprotrophic, decomposing forest grou ...
'' species, such as the deadly '' C. dealbata''. Mushrooms in the genera ''
Entoloma ''Entoloma'' is a large genus of terrestrial pink-gilled mushrooms, with about 1,000 species. Most have a drab appearance, pink gills which are attached to the stem, a smooth thick cap, and angular spores. Many entolomas are saprobic but some ...
'' and ''
Mycena ''Mycena'' is a large genus of small saprotrophic mushrooms that are rarely more than a few centimeters in width. They are characterized by a white spore print, a small conical or bell-shaped cap, and a thin fragile stem. Most are gray or br ...
'' have also been found to contain levels of muscarine which can be dangerous if ingested. Muscarine has been found in harmless trace amounts in ''
Boletus ''Boletus'' is a genus of mushroom-producing fungi, comprising over 100 species. The genus ''Boletus'' was originally broadly defined and described by Carl Linnaeus in 1753, essentially containing all fungi with hymenial pores instead of ...
'', ''
Hygrocybe ''Hygrocybe'' is a genus of agarics (gilled fungi) in the family (biology), family Hygrophoraceae. Called waxcaps in English (sometimes waxy caps in North America), basidiocarps (fruit bodies) are often brightly coloured and have dry to waxy pile ...
'', ''
Lactarius ''Lactarius'' is a genus of mushroom-producing, ectomycorrhizal fungi, containing several edible species. The species of the genus, commonly known as milk-caps, are characterized by the milky fluid ("latex") they exude when cut or damaged. Like ...
'' and ''
Russula ''Russula'' is a very large genus composed of around 750 worldwide species of ectomycorrhizal mushrooms. They are typically common, fairly large, and brightly colored – making them one of the most recognizable genera among mycologists and mushr ...
''. Trace concentrations of muscarine are also found in ''
Amanita muscaria ''Amanita muscaria'', commonly known as the fly agaric or fly amanita, is a basidiomycete of the genus ''Amanita''. It is also a muscimol mushroom. Native throughout the temperate and boreal regions of the Northern Hemisphere, ''Amanita muscar ...
'', though the pharmacologically more relevant compound from this mushroom is the
Z-drug Nonbenzodiazepines (), sometimes referred to colloquially as Z-drugs (as many of their names begin with the letter "z"), are a class of psychoactive drugs that are very benzodiazepine-like in nature. They are used in the treatment of sleep problem ...
-like alkaloid
muscimol Muscimol (also known as agarin or pantherine) is one of the principal psychoactive constituents of '' Amanita muscaria'' and related species of mushroom. Muscimol is a potent and selective orthosteric agonist for the GABAA receptors and displa ...
. ''A. muscaria'' fruitbodies contain a variable dose of muscarine, usually around 0.0003% fresh weight. This is very low and toxicity symptoms occur very rarely. ''Inocybe'' and ''Clitocybe'' contain muscarine concentrations up to 1.6%. Muscarine is a nonselective
agonist An agonist is a chemical that activates a receptor to produce a biological response. Receptors are cellular proteins whose activation causes the cell to modify what it is currently doing. In contrast, an antagonist blocks the action of the ago ...
of the
muscarinic acetylcholine receptor Muscarinic acetylcholine receptors, or mAChRs, are acetylcholine receptors that form G protein-coupled receptor complexes in the cell membranes of certain neurons and other cells. They play several roles, including acting as the main end-rece ...
s.


History

The name ''muscarine'' derives from that of ''
Amanita muscaria ''Amanita muscaria'', commonly known as the fly agaric or fly amanita, is a basidiomycete of the genus ''Amanita''. It is also a muscimol mushroom. Native throughout the temperate and boreal regions of the Northern Hemisphere, ''Amanita muscar ...
'', from which it was first isolated, by German chemists
Oswald Schmiedeberg Johann Ernst Oswald Schmiedeberg (10 October 1838 – 12 July 1921) was a Baltic German pharmacologist. In 1866 he earned his medical doctorate from the University of Dorpat with a thesis concerning the measurement of chloroform in blood, before ...
and Richard Koppe at the
University of Dorpat The University of Tartu (UT; et, Tartu Ülikool; la, Universitas Tartuensis) is a university in the city of Tartu in Estonia. It is the national university of Estonia. It is the only classical university in the country, and also its biggest ...
, who reported their findings in 1869. The mushroom's specific name in turn comes from the
Latin Latin (, or , ) is a classical language belonging to the Italic branch of the Indo-European languages. Latin was originally a dialect spoken in the lower Tiber area (then known as Latium) around present-day Rome, but through the power of the ...
for fly because the mushroom was often used to attract and catch flies, hence its common name, "fly agaric". Muscarine was the first
parasympathomimetic A parasympathomimetic drug, sometimes called a cholinomimetic drug or cholinergic receptor stimulating agent, is a substance that stimulates the parasympathetic nervous system (PSNS). These chemicals are also called cholinergic drugs because ace ...
substance ever studied and causes profound activation of the
peripheral A peripheral or peripheral device is an auxiliary device used to put information into and get information out of a computer. The term ''peripheral device'' refers to all hardware components that are attached to a computer and are controlled by the ...
parasympathetic nervous system The parasympathetic nervous system (PSNS) is one of the three divisions of the autonomic nervous system, the others being the sympathetic nervous system and the enteric nervous system. The enteric nervous system is sometimes considered part of ...
that may end in circulatory collapse and death. Being a
quaternary ammonium salt In chemistry, quaternary ammonium cations, also known as quats, are positively charged polyatomic ions of the structure , R being an alkyl group or an aryl group. Unlike the ammonium ion () and the primary, secondary, or tertiary ammonium cations ...
, muscarine is less completely absorbed from the
gastrointestinal tract The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organ (biology), organs of the digestive syste ...
than tertiary amines, and it does not cross the
blood–brain barrier The blood–brain barrier (BBB) is a highly selective semipermeable membrane, semipermeable border of endothelium, endothelial cells that prevents solutes in the circulating blood from ''non-selectively'' crossing into the extracellular fluid of ...
. Muscarinic agonists activate muscarinic receptors while nicotinic agonists activate nicotine receptors. Both are direct-acting cholinomimetics; they produce their effects by binding to and activating cholinergic receptors. Final proof of the structure was given by Franz Jellinek and colleagues in 1957 with the help of X-ray diffraction analysis; Jellinek further described the three-dimensional structure of the molecule using muscarine chloride. These new findings set into motion research on the pharmacology of muscarine and muscarine-like substances that are structurally related to
acetylcholine Acetylcholine (ACh) is an organic chemical that functions in the brain and body of many types of animals (including humans) as a neurotransmitter. Its name is derived from its chemical structure: it is an ester of acetic acid and choline. Part ...
.


Structure and reactivity

Muscarine mimics the function of the natural neurotransmitter acetylcholine in the muscarinic part of the cholinergic nervous system, despite the less flexible structure due to the five-membered ring in the molecular skeleton. With the exception of the double bonded oxygen, all of the acetylcholine structure is present in the right bottom side of muscarine (see ''Figure 3'' below for comparison of both structures). There are two mirror forms of muscarine, named: 2S-muscarine and 2R-muscarine. Image:2S-muscarine.png, Figure 1. The structural formula of 2S-muscarine. Image:2R-Muscarin.png, Figure 2. The structural formula of 2R-muscarine. image:Acetylcholine.svg, Figure 3. Acetylcholine for comparison.


Efficient synthesis of (+)-muscarine

The scheme below represents a very efficient way of the synthesis of (+)-muscarine according to the scientists Chan and Li in the Canadian journal of Chemistry in 1992. S-(−)-Ethyl lactate (2)(Figure 4) is converted into the 2,6-dichlorobenzyl ether (3).
Diisobutylaluminium hydride Diisobutylaluminium hydride (DIBALH, DIBAL, DIBAL-H or DIBAH) is a reducing agent with the formula (''i''-Bu2AlH)2, where ''i''-Bu represents isobutyl (-CH2CH(CH3)2). This organoaluminium compound is a reagent in organic synthesis. Properties Lik ...
(DIBAL) reduction of the 2,6-dichlorobenzyl ether gives the
aldehyde In organic chemistry, an aldehyde () is an organic compound containing a functional group with the structure . The functional group itself (without the "R" side chain) can be referred to as an aldehyde but can also be classified as a formyl grou ...
(4). Treatment of the crude aldehyde with allyl bromide and zinc powder in water with NH4Cl as catalyst resulted in an anti:syn mixture of 5a and 5b. Treatment of 5a with iodine in CH3CN at 0 °C gives the cyclized product 6a. Finally treatment of 6a with excess trimethylamine in ethanol gave (+)-muscarine (2S,4R,5S). A similar reaction sequence with 5b gave (+)-epimuscarine (7).


Other Syntheses

It can be synthesized in various ways from completely different substances, particularly from 2,5-dimethyl-3-carboxymethyl flurane.


Pharmacology


Pharmacodynamics

Muscarine mimics the action of the
neurotransmitter A neurotransmitter is a signaling molecule secreted by a neuron to affect another cell across a synapse. The cell receiving the signal, any main body part or target cell, may be another neuron, but could also be a gland or muscle cell. Neuro ...
acetylcholine Acetylcholine (ACh) is an organic chemical that functions in the brain and body of many types of animals (including humans) as a neurotransmitter. Its name is derived from its chemical structure: it is an ester of acetic acid and choline. Part ...
by agonising
muscarinic acetylcholine receptor Muscarinic acetylcholine receptors, or mAChRs, are acetylcholine receptors that form G protein-coupled receptor complexes in the cell membranes of certain neurons and other cells. They play several roles, including acting as the main end-rece ...
s. These receptors were named after muscarine, to differentiate them from the other
acetylcholine Acetylcholine (ACh) is an organic chemical that functions in the brain and body of many types of animals (including humans) as a neurotransmitter. Its name is derived from its chemical structure: it is an ester of acetic acid and choline. Part ...
receptors ( nicotinic receptors), which are comparatively unresponsive to muscarine. There are five different types of muscarinic receptors: M1, M2, M3, M4 and M5. Most tissues express a mixture of subtypes. The M2 and M3 subtypes mediate muscarinic responses at peripheral autonomic tissues. M1 and M4 subtypes are more abundant in
brain A brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as vision. It is the most complex organ in a v ...
and
autonomic ganglia An autonomic ganglion is a cluster of nerve cell bodies (a ganglion) in the autonomic nervous system The autonomic nervous system (ANS), formerly referred to as the vegetative nervous system, is a division of the peripheral nervous system that s ...
. The odd numbered receptors, M1, M3 and M5, interact with Gq proteins to stimulate phosphoinositide hydrolysis and the release of intracellular calcium. Conversely, the even numbered receptors, M2 and M4, interact with Gi proteins to inhibit adenylyl cyclase, which results in a decrease of intracellular concentration of cyclic adenosine monophosphate (cAMP). Most agonists for muscarine receptors are not selective for subtypes. Muscarinic receptors also signal via other pathways, for instance via
G beta-gamma complex The G beta-gamma complex (Gβγ) is a tightly bound dimeric protein complex, composed of one Gβ and one Gγ subunit, and is a component of heterotrimeric G proteins. Heterotrimeric G proteins, also called guanosine nucleotide-binding proteins, c ...
modulation of
potassium channel Potassium channels are the most widely distributed type of ion channel found in virtually all organisms. They form potassium-selective pores that span cell membranes. Potassium channels are found in most cell types and control a wide variety of cel ...
s. This allows muscarine to modulate cellular excitability via the membrane potential.


Metabolism

A paucity of research exists on the metabolism of muscarine in the human body, suggesting this compound is not metabolized by humans. Though there has been extensive research in the field of acetylcholine metabolism by
acetylcholinesterase Acetylcholinesterase (HGNC symbol ACHE; EC 3.1.1.7; systematic name acetylcholine acetylhydrolase), also known as AChE, AChase or acetylhydrolase, is the primary cholinesterase in the body. It is an enzyme Enzymes () are proteins that a ...
, muscarine is not metabolized by this enzyme, partly explaining the compound's potential toxicity. Muscarine is readily soluble in water. The most likely way for muscarine to leave the blood is via renal clearance; it will eventually leave the body in urine.


Medical uses

Muscarinic agonists are used as drugs in treating
glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for fluid within the eye rem ...
, postoperative
ileus Ileus is a disruption of the normal propulsive ability of the intestine. It can be caused by lack of peristalsis or by mechanical obstruction. The word 'ileus' is from Ancient Greek ''eileós'' (, "intestinal obstruction"). The term 'subileus' ref ...
, congenital
megacolon Megacolon is an abnormal dilation of the colon (also called the large intestine). This leads to hypertrophy of the colon. The dilation is often accompanied by a paralysis of the peristaltic movements of the bowel. In more extreme cases, the feces ...
,
urinary retention Urinary retention is an inability to completely empty the bladder. Onset can be sudden or gradual. When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include loss of bladd ...
and
xerostomia Xerostomia, also known as dry mouth, is dryness in the mouth, which may be associated with a change in the composition of saliva, or reduced salivary flow, or have no identifiable cause. This symptom is very common and is often seen as a side ef ...
. Muscarine is
contraindicated In medicine, a contraindication is a condition that serves as a reason not to take a certain medical treatment due to the harm that it would cause the patient. Contraindication is the opposite of indication, which is a reason to use a certain tre ...
in people with diseases that make them susceptible to parasympathetic stimulation, people who have
asthma Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, cou ...
or
COPD Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce mu ...
, or people who have
peptic ulcer Peptic ulcer disease (PUD) is a break in the inner lining of the stomach, the first part of the small intestine, or sometimes the lower esophagus. An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines i ...
disease. Also people with an obstruction in the
gastrointestinal The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...
or
urinary tract The urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, con ...
are not prescribed muscarine because it will aggravate the obstruction, causing pressure to build up that may lead to perforation.


Efficacy

As muscarine works on the
muscarinic acetylcholine receptor Muscarinic acetylcholine receptors, or mAChRs, are acetylcholine receptors that form G protein-coupled receptor complexes in the cell membranes of certain neurons and other cells. They play several roles, including acting as the main end-rece ...
, the best comparison can be made with acetylcholine, which normally works on this receptor. Pure muscarine compared to pure acetylcholine is stated in most cases to be more potent, its action is always slower but longer lasting than acetylcholine. A possible explanation for this long-lasting behavior might be that muscarine does not get hydrolyzed by acetylcholinesterase in the synaptic cleft.


Toxicology

Muscarine poisoning is characterized by
miosis Miosis, or myosis (), is excessive constriction of the pupil.Farlex medical dictionary
citing: ...
, blurred vision, increased
salivation Saliva (commonly referred to as spit) is an extracellular fluid produced and secreted by salivary glands in the mouth. In humans, saliva is around 99% water, plus electrolytes, mucus, white blood cells, epithelial cells (from which DNA can be e ...
, excessive sweating,
lacrimation Tears are a clear liquid secreted by the lacrimal glands (tear gland) found in the eyes of all land mammals. Tears are made up of water, electrolytes, proteins, lipids, and mucins that form layers on the surface of eyes. The different types of ...
, bronchial secretions, bronchoconstriction,
bradycardia Bradycardia (also sinus bradycardia) is a slow resting heart rate, commonly under 60 beats per minute (BPM) as determined by an electrocardiogram. It is considered to be a normal heart rate during sleep, in young and healthy or elderly adults, a ...
, abdominal cramping, increased gastric acid secretion, diarrhea and
polyuria Polyuria () is excessive or an abnormally large production or passage of urine (greater than 2.5 L or 3 L over 24 hours in adults). Increased production and passage of urine may also be termed diuresis. Polyuria often appears in conjunction wit ...
. If muscarine reaches the brain it can cause
tremor A tremor is an involuntary, somewhat rhythmic, muscle contraction and relaxation involving oscillations or twitching movements of one or more body parts. It is the most common of all involuntary movements and can affect the hands, arms, eyes, fa ...
,
convulsions A convulsion is a medical condition where the body muscles contract and relax rapidly and repeatedly, resulting in uncontrolled shaking. Because epileptic seizures typically include convulsions, the term ''convulsion'' is sometimes used as a s ...
and
hypothermia Hypothermia is defined as a body core temperature below in humans. Symptoms depend on the temperature. In mild hypothermia, there is shivering and mental confusion. In moderate hypothermia, shivering stops and confusion increases. In severe h ...
. Cardiac ventricles contain
muscarinic receptors Muscarinic acetylcholine receptors, or mAChRs, are acetylcholine receptors that form G protein-coupled receptor complexes in the cell membranes of certain neurons and other cells. They play several roles, including acting as the main end-rec ...
that mediate a decrease in the force of contractions leading to a lower blood pressure. If muscarine is administered intravenously, muscarine can trigger acute
circulatory failure Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. Initial symptoms of shock may include weakness, fast heart rate, fast breathing, sweating, anxiety, and increased thir ...
with
cardiac arrest Cardiac arrest is when the heart suddenly and unexpectedly stops beating. It is a medical emergency that, without immediate medical intervention, will result in sudden cardiac death within minutes. Cardiopulmonary resuscitation (CPR) and possib ...
. The symptoms of intoxication with mushrooms rich in muscarine, especially ''
Inocybe ''Inocybe'' is a large genus of mushroom-forming fungi with over 1400 species, including all forms and variations. Members of ''Inocybe'' are mycorrhizal, and some evidence shows that the high degree of speciation in the genus is due to adaptatio ...
'', are very typical: The symptoms start early, after one-quarter to two hours, with headache, nausea, vomiting, and constriction of the
pharynx The pharynx (plural: pharynges) is the part of the throat behind the mouth and nasal cavity, and above the oesophagus and trachea (the tubes going down to the stomach and the lungs). It is found in vertebrates and invertebrates, though its struc ...
. Then salivation, lacrimation, and diffuse perspiration set in, combined with miosis, disturbed accommodation, and reduced vision. Gastric and small bowel
colic Colic or cholic () is a form of pain that starts and stops abruptly. It occurs due to muscular contractions of a hollow tube ( small and large intestine, gall bladder, ureter, etc.) in an attempt to relieve an obstruction by forcing content out ...
leads to diarrhea, and there is a painful urge for urination.
Bronchoconstriction Bronchoconstriction is the constriction of the airways in the lungs due to the tightening of surrounding smooth muscle, with consequent coughing, wheezing, and shortness of breath. Causes The condition has a number of causes, the most common be ...
leads to asthmatic attacks and severe
dyspnea Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathing, breathe well enough. The American Thoracic Society defines it as "a subjective experience of brea ...
, and bradycardia combined with marked
hypotension Hypotension is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Blood pressure is indicated by two numbers, the systolic blood pressure (the top number) and the dias ...
and
vasodilation Vasodilation is the widening of blood vessels. It results from relaxation of smooth muscle cells within the vessel walls, in particular in the large veins, large arteries, and smaller arterioles. The process is the opposite of vasoconstriction, ...
results in
circulatory shock Shock is the state of insufficient blood flow to the Tissue (biology), tissues of the body as a result of problems with the circulatory system. Initial symptoms of shock may include weakness, fast heart rate, fast breathing, sweating, anxiety, a ...
. Death after 8 to 9 hours has been reported in about 5% of the cases, but can be avoided completely by prompt administration of IV or IM
anticholinergic Anticholinergics (anticholinergic agents) are substances that block the action of the neurotransmitter called acetylcholine (ACh) at synapses in the central and peripheral nervous system. These agents inhibit the parasympathetic nervous system ...
drugs.Peter G. Waser; Chemistry and pharmacology of muscarine, muscarone and some related compounds; Pharmacology Department, University of Zurich, Switzerland 1961


Antidote

Antimuscarinic A muscarinic receptor antagonist (MRA) is a type of anticholinergic agent that blocks the activity of the muscarinic acetylcholine receptor. The muscarinic receptor is a protein involved in the transmission of signals through certain parts of the ...
s such as
atropine Atropine is a tropane alkaloid and anticholinergic medication used to treat certain types of nerve agent and pesticide poisonings as well as some types of slow heart rate, and to decrease saliva production during surgery. It is typically given i ...
can be used as an
antidote An antidote is a substance that can counteract a form of poisoning. The term ultimately derives from the Greek term φάρμακον ἀντίδοτον ''(pharmakon) antidoton'', "(medicine) given as a remedy". Antidotes for anticoagulants are s ...
to muscarine. Atropine is, like muscarine, an alkaloid but unlike muscarine is an antagonist of the muscarinic receptors. Hence, it inhibits the effects of acetylcholine. Muscarinic antagonists dilate the pupil and relax the ciliary muscle, are used in treatment of inflammatory uveitis and is associated with glaucoma. They are also used to treat urinary incontinence and diseases characterized by bowel hypermotility such as
irritable bowel syndrome Irritable bowel syndrome (IBS) is a "disorder of gut-brain interaction" characterized by a group of symptoms that commonly include abdominal pain and or abdominal bloating and changes in the consistency of bowel movements. These symptoms may ...
. Muscarinic antagonists are often called parasympatholytics because they have the same effect as agents that block postganglionic parasympathetic nerves.


References


External links


Treatment of muscarine poisoning

Psychoactive ''Amanitas'' on Erowid
{{Muscarinic acetylcholine receptor modulators Muscarinic agonists Mycotoxins Quaternary ammonium compounds Alkaloids