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Jonathan H. Widdicombe
Published in Volume 120, Issue 9
J Clin Invest. 2010; 120(9):3093–3096 doi:10.1172/JCI44235
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Figure 1
Means by which VIP (or other cAMP-elevating agents) stimulates Cl secretion by airway gland serous cells.

(A) Low levels of VIP are insufficient to stimulate Cl secretion but do elevate cAMP sufficiently to open CFTR. Low levels of acetylcholine (ACh) (also subthreshold for secretion) raise [Ca2+]i sufficiently to open basolateral K+ channels (GK). Together, the two agents induce Cl secretion, as previously suggested by Choi et al. (10). (B) High levels of VIP elevate cAMP sufficiently to activate both Cl and K+ channels, as previously suggested by Choi et al. (10). (C) cAMP elevates [Ca2+]i, which then activates basolateral K+ channels, as described by Lee and Foskett (9). (D) If the effects of cAMP on [Ca2+]i are somehow enhanced then VIP can induce Cl secretion in CF cells by activating CaCC, as suggested by Lee and Foskett (9).