Release of catecholamines, a Ca2(+)-dependent process, is the most useful biochemical marker in the diagnosis of neuroblastoma. Unfortunately, its stimulus is still unknown. We found that vasoactive intestinal polypeptide (VIP), in addition to acetylcholine and muscarine (but not nicotine), causes elevation of the cytoplasmic Ca2(+)-concentration in the highly differentiated human neuroblastoma cell line SK-N-SH, with or without the presence of extracellular Ca2+. Additionally, VIP was detected in SK-N-SH cells (0.65 ng/10(6) cells). Based on these observations and the fact that neuroblastoma is not innervated in vivo, we hypothesize that in this tumor VIP is responsible for Ca2(+)-dependent release of catecholamines in an autocrine or paracrine fashion.