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Intercellular communication and signaling are essential for the coordination of physiological processes in response to extracellular agonists at the tissue and whole-organ level 1,2 . The most direct way of intercellular communication is created by the occurrence of gap junctions. Gap junctions are plaques of gap junction channels, which are proteinaceous channels formed by the head-to-head docking of two connexin (Cx) hemichannels of adjacent cells 3,4 (Figure 1). Gap junctions allow the passage of small signaling molecules with a molecular weight of less than 1.5 kDa, including Ca2+ or IP3 5, causing and modulating Ca2+-release from the intracellular stores of the neighboring cells 6 (Figure 2). Gap junction channels are tightly regulated by intra- and intermolecular protein interactions and by cellular signaling processes, like redox modification and phosphorylation7. GJs facilitate the coordinated response of connected cells, thereby acting as a chemical and electrical syncytium. For example, the spreading of cardiac action potential across the atrial and ventricular myocytes is mediated by Cx-based GJ channels 85. Cxs not only have a role as gap junction channels, but also form unpaired hemichannels, thereby functioning as channels in membranes similarly to regular ion channels 8-10 (Figure 1). Hemichannels participate in paracrine signaling between neighboring cells by controlling the exchange of ions and signaling molecules between the intra- and extracellular environment.
In many cell types (like epithelial cells, osteoblastic cells, astrocytes, endothelial cells, etc.) and organs (like brain, liver, retina, cochlea and the vasculature), intercellular Ca2+-waves are fundamental for the coordination of multicellular responses 11. Increases in intracellular Ca2+ levels in a certain cell are not limited to this cell, but propagate to the surrounding neighboring cells, thereby establishing an intercellular Ca2+-wave 12,13 . These intercellular Ca2+-waves are important for normal physiological regulation of cell layers as a syncytium and their dysregulation has been associated with pathophysiological processes 11. In the corneal endothelium and epithelium, different groups 14-24, including our own 25-33, studied the mechanisms and roles of intercellular communication. In non-excitable cells, like corneal endothelial cells, two distinct modes of intercellular communication occur 28,29 , namely gap junctional intercellular communication and paracrine intercellular communication. Gap junctional intercellular communication involves a direct exchange of signaling molecules via gap junctions 7. Gap junctional intercellular communication is critical for maintaining tissue homeostasis, controlling cell proliferation, and establishing a synchronized response to extracellular stress 10,34,35 . In a number of pathologies, gap junction coupling is reduced due to defective Cxs, and hereby affecting gap junctional intercellular communication 36. This emphasizes the importance and influence of gap junctional intercellular communication in multicellular organisms. In contrast to gap junctional intercellular communication, paracrine intercellular communication is not dependent on cell-cell apposition, since it involves the release of diffusible extracellular messengers (Figure 2). Different types of signaling molecules are released in the extracellular space by signaling cells. The molecule is then transported to the target cell where it is detected by a specific receptor protein. Subsequently the receptor-signal complex induces a cellular response, which is terminated by removal of the signal, inactivation or desensitization. Released lipophilic extracellular signaling messengers penetrate the membrane and act on intracellular receptors. In contrast, hydrophilic messengers do not cross the plasma membrane of the responding cell, but act as a ligand that binds to surface-expressed receptor proteins, which then relay the signal to the intracellular environment. Three major families of cell surface receptor proteins participate in this process: ion-channel-linked, enzyme-linked, and G protein-linked. The released messenger molecule can act on receptors of the same cell (autocrine), on target cells in close proximity (paracrine), or on distant target cells that require the circulatory system (endocrine).
In many cell types, including corneal endothelium 28,29, ATP is one of the major hydrophilic, paracrine factors that drive the propagation of intercellular Ca2+-waves 37-40. During mechanical deformation, hypoxia, inflammation or stimulation by various agents, ATP can be released from healthy cells 41-44 in response to shear stress, stretch, or osmotic swelling 44,45. Different ATP-release mechanisms have been postulated, including vesicular exocytosis 44 and a plethora of transport mechanisms, such as ATP-binding cassette (ABC) transporters, plasmalemmal voltage-dependent anion channels 46, P2X7 receptor channels 47,48, as well as connexin hemichannels 49-52 and pannexin hemichannels 43,49,53. Extracellular ATP can be rapidly hydrolyzed to ADP, AMP and adenosine 54,55 by ectonucleotidases that are present in the extracellular environment. The extracellularly released ATP and its metabolite ADP 56 will spread through diffusion. The subsequent interaction of these nucleotides with purinergic receptors in the neighboring cells has been implicated in the propagation of intercellular Ca2+-waves 28,37,51. Two different classes of purinergic receptors are present: adenosine is the principal natural ligand for P1-purinoceptors, while both purine (ATP, ADP) and pyrimidine (UTP, UDP) nucleotides act on most P2-purinoceptors 57.
Intercellular communication can be investigated by different methods such as scrape loading, dye transfer, local uncaging of agonists like IP3 and Ca2+, mechanical stimulation, etc.. Here we describe the study of Ca2+-wave propagation elicited by mechanical stimulation of a single cell. The advantage of studying Ca2+-wave propagation by mechanical stimulation is that it provides an easy tool to quantify the spread of the Ca2+-wave over time and it allows quantitatively comparing different pretreatments of the cells. In the corneal endothelium, these intercellular Ca2+-waves allow a coordinated response from the monolayer, hereby acting as a possible defense mechanism of the non-regenerative corneal endothelium helping the endothelium to withstand extracellular stresses during intraocular surgery, or upon exposure to inflammatory mediators during immune rejection or uveitis 58,59 .