Nicotinic acetylcholine receptor stimulation: A new approach for stimulating tear secretion in dry eye disease

Stephen C Pflugfelder; Austin Cao; Anat Galor; Kelly K Nichols; Noam A Cohen; Michelle Dalton

doi:10.1016/j.jtos.2022.05.001

Nicotinic acetylcholine receptor stimulation: A new approach for stimulating tear secretion in dry eye disease

Ocul Surf. 2022 Jul:25:58-64. doi: 10.1016/j.jtos.2022.05.001. Epub 2022 May 10.

Authors

Stephen C Pflugfelder¹, Austin Cao², Anat Galor³, Kelly K Nichols⁴, Noam A Cohen⁵, Michelle Dalton⁶

Affiliations

¹ Baylor College of Medicine, Houston, TX, USA. Electronic address: stevenp@bcm.edu.
² Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
³ Bascom Palmer Eye Institute, Miami, FL, USA.
⁴ University of Alabama at Birmingham School of Optometry, Birmingham, AL, USA.
⁵ Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Monell Chemical Senses Center, Philadelphia, PA, USA.
⁶ Dalton & Associates, Inc., Reading, PA, USA.

PMID: 35550851
DOI: 10.1016/j.jtos.2022.05.001

Abstract

Tear secretion is regulated by the lacrimal functional unit consisting of afferent and efferent nerve innervation. The afferent arm consists of trigeminal nociceptors on the ocular surface and nasal mucosa. When stimulated by agonists, nicotinic acetylcholine receptors on nerve endings in the nose initiate a reflex arc resulting in instantaneous tear secretion. Pharmacologic nasal neural stimulation to increase endogenous tear production is a novel approach to treating dry eye disease.

Keywords: Dry eye disease; Nasal spray; Nicotinic acetylcholine receptors; Pharmacologic neuro-activator; Trigeminal nerve; Varenicline.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Dry Eye Syndromes*
Humans
Lacrimal Apparatus* / innervation
Nociceptors
Receptors, Nicotinic*
Tears

Substances

Receptors, Nicotinic