Timolol may inhibit aqueous humor secretion by cAMP-independent action on ciliary epithelial cells

The -adrenergic antagonisttimolol reduces ciliary epithelial secretion in glaucomatous patients.Whether inhibition is mediated by reducing cAMP is unknown. Elementalcomposition of rabbit ciliary epithelium was studied by electron probeX-ray microanalysis. Volume of cultured bovine pigmented ciliaryepithelial (PE) cells was measured by electronic cell sizing;Ca²⁺ activity and pH were monitored with fura 2 and2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein, respectively. Timolol (10 µM) produced similar K and Cl losses fromciliary epithelia in HCO/CO₂ solutionbut had no effect in HCO/CO₂-free solution or in HCO/CO₂ solutioncontaining the carbonic anhydrase inhibitor acetazolamide. Inhibitionof Na⁺/H⁺ exchange by dimethylamiloride inHCO/CO₂ solution reduced Cl and Kcomparably to timolol. cAMP did not reverse timolol's effects. Timolol(100 nM, 10 µM) and levobunolol (10 µM) produced cAMP-independentinhibition of the regulatory volume increase (RVI) in PE cells andincreased intracellular Ca²⁺ and pH. IncreasingCa²⁺ with ionomycin also blocked the RVI. The resultsdocument a previously unrecognized cAMP-independent transport effect oftimolol. Inhibition of Cl/HCO exchangemay mediate timolol's inhibition of aqueous humor formation.