Piloarpine is a cholinergic receptor agonist. It is a slowly hydrolyzed muscarinic agonist with no nicotinic effects. [1]. Pilocarpine is used in many different conditions. It is used to treat dry mouth and glaucoma (to lower high eye pressure). [2,3]. It is somehow related to N-glycanase-1 deficiency because in this condition, one of its symptoms is the production of abnormal tears/dry eyes.[4]. There is a sweat test known as pilocarpine iontophoresis which is used to stimulate sweat production and this is also related to NGLY-1 deficiency because on the contrary, this disease produces little amount of sweat.[4,5]. Pilocarpine treats both dry eyes and dry mouth. [6]. Another symptom of NGLY-1 deficiency is seizures and according to a rat study, pilocarpine-induced temporal lobe epilepsy has an association with increase dopamine activity.[4,7]. In a study, pilocarpine treated rats resulted in cognitive and behavioral problems that are linked to epilepsy in humans. [8].
Pilocarpine as mentioned earlier, is a cholinergic agonist, and it attaches to M3 receptors and causes stimulation of exocrine glands. [9]. Due to this stimulation, pilocarpine increases salivary and lachrymal responses, which improves both, dry eyes and dry mouth. [9]. SMR1 (submandibular rat-1) is a protein that is secreted into the saliva after administering beta adrenergic and cholinergic agonists. [10]. In a rat’s study, it has been concluded about the expression of SMR1 protein in salivary glands, lungs, and urogenital tissues in male rats. [10]. And it also showed that SMR1 is extensively N-glycosylated in glandular tissues. [10].

10. https://www.researchgate.net/publication/23699610-Autonomic-nervous-system-regulates-secretion-of-anti-inflammatory-prohormone-SMR1-from-rat-salivary-glands

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