Synaptic neurotransmission at the splanchnic nerve‐chromaffin cell synapse is a chief element of the stimulus‐secretion coupling in the adrenal medullary tissue, managing and regulating the secretion of catecholamines. Making the state of play more intricate than initially envisioned, the synaptic vesicles of nerve terminals innervating the medulla contain various compounds, including various neurotransmitters and neuropeptides. Under basal conditions associated with a low splanchnic nerve discharge rate, neurotransmission is ensured by the synaptic release of the primary neurotransmitter acetylcholine (ACh). Under sustained and repetitive stimulations of the splanchnic nerve, as triggered in response to stressors, the synaptic release of neuropeptides, such as the pituitary adenylate cyclase‐activating polypeptide PACAP, supplants ACh release. The anatomical and functional changes that occur presynaptically at the preganglionic splanchnic nerve, combined with changes occurring postsynaptically at nicotinic acetylcholine receptors (nAChRs), confer the adrenomedullary synapses a solid and persistent aptitude to functional remodeling, from birth to aging. The present review focuses on the composite cholinergic and noncholinergic nature of neurotransmission occurring at the splanchnic nerve‐chromaffin cell synapse and its remodeling in response to physiological or pathological stimuli.

中文翻译：

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肾上腺髓质中的胆碱能和肽能神经传递：刺激-分泌耦合的动态控制

内脏神经-嗜铬细胞突触的突触神经传递是肾上腺髓质组织中刺激-分泌耦合的主要元素，管理和调节儿茶酚胺的分泌。使游戏状态比最初设想的更加复杂，支配髓质的神经末梢的突触囊泡含有各种化合物，包括各种神经递质和神经肽。在与低内脏神经放电率相关的基础条件下，主要神经递质乙酰胆碱 (ACh) 的突触释放确保了神经传递。在对内脏神经的持续和重复刺激下，由于响应压力源而触发，神经肽的突触释放，如垂体腺苷酸环化酶激活多肽 PACAP，取代了乙酰胆碱的释放。节前内脏神经突触前发生的解剖和功能变化，结合烟碱乙酰胆碱受体 (nAChR) 突触后发生的变化，赋予肾上腺髓质突触从出生到衰老的坚实而持久的功能重塑能力。本综述重点关注内脏神经-嗜铬细胞突触中发生的神经传递的复合胆碱能和非胆碱能性质及其响应生理或病理刺激的重塑。