The Breuer-Hering reflex in humans. Effects of pulmonary denervation and hypocapnia.

Iber, Conrad; Simon, Peggy M.; Skatrud, James B.; Mahowald, Mark W.; Dempsey, Jerome A.

doi:10.1164/ajrccm.152.1.7599827

Cited by 75 publications

(56 citation statements)

References 21 publications

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“…These are large diameter myelinated fibers with a fast conduction velocity and a low electrical threshold; they are present in all mammals so far tested; and have been recorded directly from the human vagus [17]. Moreover, experiments in conscious human volunteers have shown the presence of a Hering-Breuer reflex that is dependent on innervation of the lungs [18]. Although the reflex in humans has a higher threshold than that seen typically in experimental animals [19], we expect that 50 Hz stimulation of this whole afferent population should comfortably exceed that threshold.…”

Section: Discussionmentioning

confidence: 99%

Calibration of Thresholds for Functional Engagement of Vagal A, B and C Fiber Groups In Vivo

et al. 2017

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Vagal nerve stimulation is widely used therapeutically but the fiber groups activated are often unknown. Aim: To establish a simple protocol to define stimulus thresholds for vagal A, B and C fibers. Methods:The intact left or right cervical vagus was stimulated with 0.1 ms pulses in spontaneously breathing anesthetized rats. Heart and respiratory rate responses to vagal stimulation were recorded. The vagus was subsequently cut distally, and mass action potentials to the same stimuli were recorded. Results: Stimulating at either 50 Hz for 2 s or 2 Hz for 10 s at experimentally determined strengths revealed A, B and C fiber thresholds that were related to respiratory and heart rate changes. Conclusion: Our simple protocol discriminates vagal A, B and C fiber thresholds in vivo.

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Section: Discussionmentioning

confidence: 99%

Calibration of Thresholds for Functional Engagement of Vagal A, B and C Fiber Groups In Vivo

et al. 2017

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“…prior to 12 months post-transplantation (Higenbottam et al 1989;Hathaway et al 1993;Iber et al 1995;cf. Ramaekers et al 1996), pulmonary reinnervation has been reported after about 8 months in allograft transplanted rats (Kawaguchi et al 1998), 5 months in autotransplanted dogs (Mattila et al 1987) and 2 months in autotransplanted monkeys (Mihm et al 1989).…”

Section: Discussionmentioning

confidence: 99%

“…The majority (7 out of 8) of these subjects had been transplant recipients in the previous 13 months or less so the chance of reinnervation of the lungs was considered to be small (Higenbottam et al 1989;Hathaway et al 1993;Seals et al 1993;Iber et al 1995;Ramaekers et al 1996). All transplant subjects were clinically well at the time of the study but were on a regimen of immunosuppression and antimicrobial medications.…”

Section: Methodsmentioning

confidence: 99%

Changes in respiratory sensations induced by lobeline after human bilateral lung transplantation

Butler

Anand

Crawford

et al. 2001

The Journal of Physiology

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The sensations evoked by the injection of lobeline into the right antecubital vein were studied in 8 subjects after bilateral lung transplantation and 10 control subjects. In control subjects, two distinct sensations were experienced. There was an early noxious sensation (onset ≈10 s) followed by a late sensation of breathlessness (onset ≈26 s) associated with involuntary hyperventilation. The early sensation was accompanied by respiratory and cardiovascular changes. In contrast to control subjects, the early respiratory events and the noxious sensations evoked by injections of lobeline (18‐60 μg kg−1) did not occur in subjects with recent bilateral lung transplantation. This suggests that the early respiratory sensations are mediated by the discharge of receptors in the lungs. The late hyperventilation and the accompanying sensation of breathlessness occurred in both transplant and control subjects and are therefore likely to be mediated by receptors elsewhere in the body, presumably systemic arterial chemoreceptors stimulated by lobeline. In control subjects, but not transplant subjects, there was a consistent decrease in mean arterial pressure associated with the lobeline injection. This suggests that pulmonary afferents mediate the hypotension. For transplant subjects studied more than a year after transplantation, there was some evidence that the noxious respiratory sensations evoked by lobeline had returned. This suggests that some functional reinnervation of pulmonary afferents may occur.

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“…This prolongation of tI/ttot and fR was dose-dependent and instantaneous, suggesting that upper airway and pulmonary mechanoreceptors, rather than chemoreceptors, mediated these immediate responses to UAO [28][29][30][31][32][33]. The increase in tI/ttot should help to stabilise V9E at any given level of UAO, as described by the following equation [17,18,20], which was imposed experimentally.…”

Section: Timing Responses To Uaomentioning

confidence: 99%

Inspiratory duty cycle responses to flow limitation predict nocturnal hypoventilation

Schneider¹,

Krishnan

Pichard

et al. 2009

Eur Respir J

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Upper airway obstruction (UAO) can elicit neuromuscular responses that mitigate and/or compensate for the obstruction. It was hypothesised that flow-limited breathing elicits specific timing responses that can preserve ventilation due to increases in inspiratory duty cycle rather than respiratory rate.By altering nasal pressure during non-rapid eye movement (non-REM) sleep, similar degrees of UAO were induced in healthy males and females (n510 each). Inspiratory duty cycle, respiratory rate and minute ventilation were determined for each degree of UAO during non-REM sleep and compared with the baseline nonflow-limited condition.A dose-dependent increase in the inspiratory duty cycle and respiratory rate was observed in response to increasing severity of UAO. Increases in the inspiratory duty cycle, but not respiratory rate, helped to acutely maintain ventilation. Heterogeneity in these responses was associated with variable degrees of ventilatory compensation, allowing for the segregation of individuals at risk for hypoventilation during periods of inspiratory airflow limitation.Upper airway obstruction constitutes a unique load on the respiratory system. The inspiratory duty cycle, but not the respiratory rate, determine the individual's ability to compensate for inspiratory airflow limitation during sleep, and may represent a quantitative phenotype for obstructive sleep apnoea susceptibility.KEYWORDS: Nocturnal hypoventilation, obstructive sleep apnoea, sex, sleep-disordered breathing, susceptibility, ventilatory control O bstructive sleep apnoea comprises a spectrum of patients with varying degrees of upper airway obstruction (UAO) as manifested by snoring with intermittent arousals (upper airway resistance syndrome and respiratory effort-related arousals), obstructive hypopnoeas and apnoeas [1][2][3]. While male sex and obesity constitute strong risk factors for the varied manifestation of obstructive sleep apnoea [4-6], heritable factors can also play a significant role in the risk of this disorder [7][8][9][10][11][12][13], contributing to the heterogeneity in the expression of this disorder. Nevertheless, physiological mechanisms that explain the heterogeneity of sleep-disordered breathing severity are not known.UAO during sleep plays a pivotal role in the pathogenesis of obstructive sleep apnoea [14] and is caused by structural defects and disturbances in neuromuscular control [14,15]. UAO can elicit neuromuscular responses that mitigate and/or compensate for the obstruction. Under conditions of UAO (inspiratory airflow limitation), immediate responses in respiratory timing indices can help restore ventilation [16][17][18][19] and blunt disturbances in gas exchange [20]. Nevertheless the impact of respiratory pattern responses on ventilation during periods of UAO remains unclear.The purpose of the current study is to examine ventilatory responses to UAO during sleep in normal males and females. It was hypothesised that flow-limited breathing elicits specific timing responses that can preserve v...

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The Breuer-Hering reflex in humans. Effects of pulmonary denervation and hypocapnia.

Cited by 75 publications

References 21 publications

Calibration of Thresholds for Functional Engagement of Vagal A, B and C Fiber Groups In Vivo

Calibration of Thresholds for Functional Engagement of Vagal A, B and C Fiber Groups In Vivo

Changes in respiratory sensations induced by lobeline after human bilateral lung transplantation

Inspiratory duty cycle responses to flow limitation predict nocturnal hypoventilation

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