The proper role of nerves in salivary secretion: a review.

Consideration of the history of this subject has created a perspective which helps one to appreciate how errors in thinking have occurred and why some have persisted, despite subsequent improvements in information. The most enduring misconception has been that the drying of the mouth under stress is due to sympathetic inhibitory fibers, a view that must be eradicated, for such fibers do not exist. The inhibition is due to central influences from higher centers acting on the salivary centers and thereby suppressing reflex activity. Wide variations exist in the neuro-effector arrangements and in the cellular responses in different glands from different species. Myoepithelial cells are usually contracted by both parasympathetic and sympathetic nerves. The blood vessels also receive a dual innervation, but parasympathetic impulses cause vasodilatation as part of secretion, whereas the sympathetic vasoconstrictor fibers are part of a more generalized vascular control system and not a direct part of the reflex secretory sympathetic pathway. Parasympathetic drive usually provides the main stimulus for fluid formation by parenchymal cells, whereas sympathetic nerves tend to increase the output of pre-formed components from certain cells. Absence of nerve impulses causes variable atrophic and other metabolic effects on the parenchymal cells. Evidence is beginning to accrue that certain nerve impulses may influence resynthetic activities. Vacuolation, often found experimentally after strong stimulation, also occurs to a variable extent in certain cells as a normal part of reflex secretion and may therefore have an effect on the components entering the saliva. If rupture of vacuoles occurs, then this may contribute to the salivary amylase that is present in the blood. Recent evidence points to the possibility that, even in a monomorphic gland, not all of the components necessarily enter nerve-induced saliva in "parallel" proportions. Consideration of current information has enabled some provisional generalizations about the roles of the secretory nerves to be suggested in the summary, but they must not be considered immutable.