How does acetylcholine (Ach) work?

Acetylcholine is derived in nerve terminals from acetyl CoA and choline via choline acetyltransferase (CAT). CAT facilitates the formation of ACh by catalyzing a reaction between choline and the acetyl group, primarily occurring at nerve cell terminals. ACh is stored in nerve cell endings until its release is triggered. Once released into the synaptic cleft (the space between nerve cells), ACh can bind to two types of receptors: nicotinic and muscarinic receptors. This furthers the chemical message along the nerve cells. Subsequently, acetylcholinesterase breaks down ACh in the synapse into choline and acetate, which are then recycled for future chemical signaling.