Novel tear secretion system — the effect and the mechanism of PACAP on tear secretion

Dry eye syndrome is defined as a disorder of the tear film caused by either a decreased production in tears or a disruption to the stability of the complex tear film, which causes damage to the ocular surface. It has been developed the medicine for dry eye syndrome focusing anti-inflammation or mucin secretion, however, no treatment has been developed focusing on the effect of elevation of the lacrimal secretion. We recently identified that pituitary adenylate cyclase-activating polypeptide (PACAP)-null mice develop dry eye-like symptoms such as corneal keratinization and tear reduction. PACAP receptor (PAC1-R) immunoreactivity was observed in the acinar cells of the mouse lacrimal gland. PACAP eye drop significantly stimulated tear secretion level, and the effect was suppressed by pretreatment with PAC1-R antagonist or adenylate cyclase inhibitor. PACAP eye drop on the PACAP KO mouse significantly increased the tear secretion, and continuous eye drop suppressed progression of the corneal keratinization. PACAP eye drops increase aquaporin 5 (AQP5) levels in the membrane of acinar cells in lacrimal glands. AQP5 siRNA treatment significantly attenuates PACAP-induced tear secretion. Based on these results, PACAP might be clinically useful to treat dry eye disorder.