The human lens possesses acetylcholine receptors that are functional throughout life

Muscarinic receptor agonists and antagonists: effects on ocular function

Muscarinic agonists act mainly via muscarinic M₃ cholinoceptors to cause contraction of the iris sphincter, ciliary muscle and trabecular meshwork as well as increase outflow facility of aqueous humour. In the iris dilator, the effect of muscarinic agonists is species dependent but is predominantly relaxation via muscarinic M₃ receptors. In the conjunctiva, muscarinic agonists stimulate goblet cell secretion which contributes to the protective tear film. Muscarinic M₂ and M₃ receptors appear mainly involved. In the lens muscarinic agonists act via muscarinic M₁ receptors to produce depolarization and increase [Ca(2+)](i). All five subtypes of muscarinic receptor are present in the retina. In the developing retina, acetylcholine appears to limit purinergic stimulation of retinal development and decrease cell proliferation. In the adult retina acetylcholine and other muscarinic agonists may have complex effects, for example, enhancing light-evoked neuronal firing in transient ON retinal ganglion cells and inhibiting firing in OFF retinal ganglion cells. In the lacrimal gland, muscarinic agonists activate M₃ receptors on secretory globular acinar cells to stimulate tear secretion and also cause contraction of myoepithelial cells. In Sjögren's syndrome, antibodies to the muscarinic M₃ receptor disrupt normal gland function leading to xerophthalmia although the mechanism of action of the antibody is still not clear. Atropine and pirenzepine are useful in limiting the development of myopia in children probably by an action on muscarinic receptors in the sclera, although many other muscarinic receptor antagonists are not effective.

Alzheimer's disease: visual system review

BACKGROUND

Ten million baby boomers in the United States will get Alzheimer's disease. Optometrists can benefit from understanding the impact the Alzheimer's disease process has on the visual system. This can result in more effective management of the condition and in more effective communication with members of the Alzheimer's disease multidisciplinary team.

METHODS

This is a review of the literature but by no means a completely exhaustive review. Alzheimer's disease is a complex disease. A rapidly expanding body of knowledge covers multiple disciplines.

RESULTS

The visual system shows deficits early in the degenerative process of Alzheimer's disease. Biomarkers through the visual system such as nerve fiber deficits, lens opacities, and functional losses in the magnocellular pathway, such as contrast sensitivity and temporal processing, may prove to not only help detect Alzheimer's disease early but also detect it before there are the classic cognitive and memory losses.

CONCLUSIONS

The effects of Alzheimer's disease are devastating. Optometrists, as primary care clinicians, can make critical contributions in the diagnosis, treatment, and management of this neurodegenerative disease.

Muscarinic acetylcholine receptors as effector sites for present and future therapeutic applications: focus on non-neural cholinergic systems

This review summarises the expression and function of muscarinic acetylcholine receptors (mAChR) in the organism, and the therapeutic implications of recent patents on cholinergic agents. Aside from the well known therapeutic applications of parasympathomimetic and -lytic drugs for diseases of the heart, eye, circulation and airways, new possible fields for mAChR agonists and antagonists in clinical therapy have begun to emerge. In particular, the role of non-neural cholinergic mechanisms in tissue regeneration, development and even carcinogenesis has become increasingly studied by a number of research teams within the last decade. This review exemplifies and contrasts experimental findings of mAChR drug action, and discusses these with regard to patents from the past 4 years.

Distribution of acetylcholine-sensitive currents around the rabbit crystalline lens

The relative distribution of acetylcholine (ACh) receptors on the surface of the isolated ocular lens of the rabbit was determined from induced changes in translens short-circuit current (I(SC)) and the translenticular resistance (R(t)) at seven delineated, parallel zones from the anterior to the posterior pole. For this, one O-ring (from among several having different diameters) was used to separate two zones in a vertically arranged Ussing-type chamber. Different O-rings separated different zone pairs. Earlier experiments from this laboratory used a conventional divided chamber, which occluded the equatorial surface, to demonstrate that anterior applications of ACh transiently decreased the I(SC) due to an intracellular Ca(2+) release and inhibition of anteriorly located K(+) channels. Measurements obtained with the newly designed zonal arrangement determined that the entire epithelial surface from its anterior-most aspect to the equatorial region responds electrically to ACh exposure, while the posterior-most region does not. Furthermore, lens-mounting positions that resulted in separation of the epithelium so that portions of its surface were present in each hemichamber resulted in inverse current changes upon bilateral ACh addition to the bathing solutions. Reductions in outward cationic current across the anterior surface into the anterior bath upon ACh treatment were accompanied by an increase in translens resistance consistent with a closure of basolateral K(+) channels. Overall, these results suggest that the posterior fiber cells may lack ACh receptors, which are clearly present in the lens epithelium that covers about two-thirds of the rabbit lens surface area, and indicate that an ACh-evoked Ca(2+) signal does not spread throughout the epithelial layer. A functional role for lens acetylcholine receptors remains to be determined.

Calcium cell signalling and cataract: role of the endoplasmic reticulum

The lens possesses an impressive array of G-protein receptors that are coupled to the release of intracellular calcium. They include members of the muscarinic, adrenergic and purinergic families and activation of the former has been implicated in cataract for some time. There are several possible mechanisms whereby activation of such receptors could give rise to cataract. A prolonged increase in intracellular calcium would be expected to activate proteases such as calpain and so could induce unscheduled and irreversible breakdown of important structural proteins. It has recently been shown that activation of G-protein receptors also modulates lens cell growth, and any interference with the highly controlled pattern of cell growth and development within the lens is also likely to have catastrophic consequences. If the calcium store is totally inactivated in lens cells, for example by exposure to thapsigargin, then growth ceases. This finding provides a means of inhibiting the lens cell growth which leads to posterior capsular opacification (PCO). For example, it has been shown that thapsigargin-coated intraocular lenses totally inhibit lens cell growth within cultured capsular bags, and if this technology could be transferred to the clinic then it could provide a simple and relatively inexpensive means of preventing PCO.

Thapsigargin inhibits a potassium conductance and stimulates calcium influx in the intact rat lens

1. An increase in lens cell calcium has long been associated with cortical cataract. Recently, it has been shown that thapsigargin induces a rise in lens cell calcium by release from endoplasmic reticulum stores. The effects of this rise on the optical and membrane characteristics of the lens were studied in the isolated rat lens. 2. The electrical characteristics of the isolated, perifused rat lens were measured using a two-internal microelectrode technique that permits measurement of plasma membrane conductance (Gm), membrane potential (Vm) and junctional conductance in the intact lens. 3. Thapsigargin (1 microM) induced a rapid overall depolarization of Vm that was accompanied by first a decrease and then an increase in Gm. 4. Replacing external Na+ with tetraethylammonium (TEA) abolished the decrease in Gm. However, a transient increase phase was still observed. 5. The changes in conductance were further characterized by measuring 22Na+ and 45Ca2+ influxes into the isolated lens. Thapsigargin (1 microM) induced a transient increase in 45Ca2+, but did not affect Na+ influx. 6. The Ca2+ channel blocker La3+ (10 microM) totally inhibited the thapsigargin-induced Ca2+ influx. It also blocked the increase in Gm observed in control and in Na+-free-TEA medium. In the absence of external calcium, thapsigargin induced a small depolarization in Vm. 7. These data indicate that thapsigargin induces both a decrease in K+ conductance and an increase in Ca2+ conductance. These probably result from release of stored Ca2+ and subsequent activation of store-operated Ca2+ channels (capacitative Ca2+ entry). 8. Thapsigargin application over the time course of these experiments (24 h) had no effect on junctional conductance or on the transparency of the lens.