Inhibition of cAMP‐Phosphodiesterase 4 (PDE4) Induces Salivation in Mice

Abstract

While exploring potential anti-inflammatory benefits of PDE4 inhibition in a mouse model of bacterial lung infection, we noticed that treatment with the PDE4 inhibitor Piclamilast visibly induced salivation in the animals. Given the predominant role of autonomic nervous system regulation in the control of salivation, and the potential impact of altered autonomics triggered by PDE4 inhibition on our infection model, we have further explored this observation. InKetamine/Xylazine-anesthetized mice, in which saliva production was tracked by the weight increase of thin filter paper strips placed into the mouths of the animals, treatment with PDE4 inhibitors did not induce saliva production per se, but synergized with low doses of the β-adrenoceptor agonist Isoprenaline to induce substantial salivation that was ablated by treatment with the β-blocker Propranolol, but not the mACh-blocker Atropine, and was absent in CFTRΔF508/ΔF508 mice that lack functional CFTR. Conversely, in awake mice, visual scoring (elevated/abnormal salivation=1; no elevated/abnormal salivation=0) indicated that treatment with PDE4 inhibitors was by itself sufficient to induce substantial salivation, which was ablated by treatment with either Propranolol or Atropine, and was also absent in ΔF508-CFTR-mutant mice. Our findings suggest that in anesthetized mice, in which autonomic nervous system regulations are suppressed, inhibition of cAMP degradation by PDE4 within salivary gland cells potentiates the effects of increased cAMP production resulting from β-adrenoceptor activation, and thereby promote the cAMP/PKA-dependent activation of CFTR that promotes saliva secretion. However, in awake mice, PDE4 inhibition acts via an additional mechanism on the autonomic, muscarinic regulation of salivation, likely by affecting neurotransmitter release. In both awake and anesthetized mice, salivation was induced by several structurally distinct PDE4 inhibitors, but not by a PDE3 inhibitor, suggesting that salivation is a class effect of PAN-PDE4 inhibitors. The PDE4 family comprises four PDE4 subtypes, PDE4A to D. Genetic ablation of any individual PDE4 subtype in the respective KO mouse strains did not induce salivation in either awake or anesthetized mice, indicating that salivation must result from the concurrent inactivation of multiple (at least two) PDE4 subtypes. Taken together, our data identify PDE4 as a critical regulator of CFTR function in an in vivo model and suggests a therapeutic potential of PDE4 inhibition to alleviate CFTR hypofunction in cystic fibrosis. In addition, our data reveal a therapeutic potential for PDE4 inhibition in the treatment of dry mouth, a condition frequently associated with drug-, radiation-, or ageing-induced salivary gland dysfunction.