Nerves are the predominant stimuli of lacrimal gland secretion.
1 The lacrimal gland is innervated by efferent sympathetic and parasympathetic nerves that release the neurotransmitters norepinephrine (from sympathetic nerves) and acetylcholine (Ach) and VIP (from parasympathetic nerves). Norepinephrine, acetylcholine, and VIP are each potent and effective stimuli of lacrimal gland secretion, especially protein secretion, and each activates a separate, distinct signaling pathway.
2 –5 Norepinephrine activates α
1D-adrenergic receptors (α
1D-AR), which cause an increase in [Ca
2+]
i by a mechanism that is not yet determined but is not by production of inositol 1,3,5-trisphosphate (InsP
3).
4 In addition, these receptors activate endothelial nitric oxide synthase to produce NO.
6 The NO activates guanylyl cyclase to increase cellular levels of cGMP, which phosphorylates specific substrates to stimulate protein secretion.
6 Stimulation of α
1D-AR, also using an unknown effector enzyme, produce diacylglycerol, which activates protein kinase Cε (PKCε) to stimulate secretion and PKCα and PKCδ to inhibit secretion.
5 α
1D-AR also transactivate the epidermal (EGF) receptor to increase extracellular-regulated kinase (ERK)1/2 activity, which attenuates secretion.
7,8 Acetylcholine activates muscarinic type 3 acetylcholine receptors (M
3AchRs), which are coupled to phospholipase Cβ (PLCβ). PLCβ activation produces the PKC activator diacylglycerol and InsP
3.
3 InsP
3 increases the [Ca
2+]
i that, along with the activation of PKCα, -δ, and -ε, stimulates the secretion of protein stored in preformed secretory granules.
3,5 M
3AchR also activate ERK 1/2 and phospholipase D, which attenuate secretion.
9,10 VIP interacts with VIPAC1 to stimulate secretion by increasing cellular levels of cAMP and increasing [Ca
2+]
i.
11 Even though norepinephrine, Ach, and VIP activate distinct signaling pathways, the neurotransmitters can be released together and can interact, causing a different secretory response than that activated by each agonist alone. For example, phenylephrine and VIP added together potentiate secretion,
2 whereas phenylephrine and carbachol (an Ach analog) added at the same time cause additive secretion.
4