A growing body of evidence has shown that the Rho/Rho-kinase pathway is involved in TM cell contraction and outflow facility regulation.
9 43 60 61 62 Agonists such as ET-1, thromboxane A2 mimetics, and angiotensin II induce myosin light chain (MLC) phosphorylation in TM cells through the activation of Rho GTPase.
9 It appears clear that many external factors, after interacting with G-protein-coupled receptors, regulate the activity of Rho/Rho-kinase pathway and other intracellular mechanisms, such as Ca
2+, to influence the phosphorylation status of MLC and, therefore, the contractile state of the outflow pathway, as has been demonstrated for ET-1.
9 By comparing the time-course of cell contraction in the presence or absence of Ca
2+ (Figs. 5A 5C) , it appears that extracellular Ca
2+ entry is not necessary for cell contraction but modulates this process probably by promoting the release of relaxing substances such as NO, as described in other cells.
63 Relaxing mechanisms would, therefore, counterbalance the contraction process triggered by the agonist. As previously mentioned, Ca
2+ entry through SOCs has been shown to activate adenylate cyclases, NO synthase, or PLA
2, which contributes to the relaxing effects.
56 Among the possible mechanisms possibly activated, cAMP or cGMP production has been shown to relax TM cells and to increase outflow facility.
64 65 66 67 In fact, in addition to increasing TM cell intracellular Ca
2+, BK induces the production of PGE
2 68 69 and enhances the effect of PGE
2 on cAMP production.
70 It seems plausible that cAMP production is enhanced by extracellular Ca
2+ entry stimulation of adenylate cyclase, as reported in other cell types.
56 Interestingly, BK effects on outflow facility appear to be biphasic, with an initial acute decrease
6 followed by a slowly developing and prolonged increase of outflow facility.
71 Again, extracellular Ca
2+ entry induced by BK may be involved in PGE
2 production, which mediates the increase in outflow facility. Other relaxing effects may be also activated by extracellular Ca
2+ entry through SOCs. In particular, Ca
2+-activated potassium channels are activated by several second messengers in TM cells as a mechanism to prevent excessive cell contraction.
7 27 65 72 Therefore, sustained Ca
2+ entry activates these channels together with other mechanisms to reduce tissue contractility, as shown in human vascular endothelial cells in which Ca
2+ store depletion and extracellular Ca
2+ entry are required to trigger NO production by histamine or ATP.
73 This process is tightly regulated by Ca
2+-activated potassium channels, which are essential for NO-mediated vasorelaxation.
73 Therefore, receptor- and store-operated Ca
2+ entry may not be necessary for cell contraction in TM cells but may contribute to modulate cell contractility or to release different substances that regulate outflow facility as a local homeostatic mechanism. Future experiments will test this hypothesis and whether these mechanisms may be pathologically altered by chronic exposure to ET-1, TGF-β, or substances elevated in glaucoma.