“…As a neurotransmitter, PACAP is present in the splanchnic nerve terminal and released preferentially under elevated sym-pathetic firing to elicit adrenal medullary catecholamine release (16,22,23). The predominant PACAP target receptor in the adrenal medulla is the high affinity PAC 1 -R, a G s -linked receptor that activates adenylate cyclase to increase cyclic adenosine monophosphate (cAMP) (24,25). Recent studies have shown that PACAP stimulation activates the stimulatory exchange protein activated by cAMP (Epac) pathway through the elevation in cAMP (26,27), triggering phospholipase C and a protein kinase C (PKC)-dependent subthreshold depolarization that is necessary for catecholamine release from chromaffin cells (16).…”