The Role of Neuromuscular Blocking Drugs in Elderly Patients

The exchange of trophic factors by motor neurons and muscle fibers maintains the neuromuscular junction. Neurotrophic factors (muscle-derived trophic factors acting on motor neurons) and myotrophic factors (motor neuron-derived trophic factors acting on muscle fibers) may play a role in the generation of secondary myotubes and the maturation of neuromuscular junctions during development. It has been suggested that the expression of the trophic factors and their receptors (trk B) might be altered with age, resulting in synaptic dysfunction and cell death. Trk B is a family of transmembrane proteins composed of a tyrosine kinase that serve as receptors for brain-derived neurotrophic factor, neurotrophin-3 and neurotrophin-4/5.