The Role of Pharmacological Treatment in the Chemoreflex Modulation

Langner-Hetmańczuk, Anna; Tubek, Stanisław; Niewiński, Piotr; Ponikowski, Piotr

doi:10.3389/fphys.2022.912616

Cited by 6 publications

(9 citation statements)

References 99 publications

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“…In this context, pharmacological approaches have been described ( 93 , 98 ) as promising options for reducing CB overactivity. However, to the best of our knowledge, there are no reports considering the targeting of inflammatory signaling within the CB in diseases such as hypertension and heart failure.…”

Section: Targeting the Cb As A Therapeutic Approach For Inflammatory ...mentioning

confidence: 99%

The carotid body: A novel key player in neuroimmune interactions

et al. 2022

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United States; The idea that the nervous system communicates with the immune system to regulate physiological and pathological processes is not new. However, there is still much to learn about how these interactions occur under different conditions. The carotid body (CB) is a sensory organ located in the neck, classically known as the primary sensor of the oxygen (O2) levels in the organism of mammals. When the partial pressure of O2 in the arterial blood falls, the CB alerts the brain which coordinates cardiorespiratory responses to ensure adequate O2 supply to all tissues and organs in the body. A growing body of evidence, however, has demonstrated that the CB is much more than an O2 sensor. Actually, the CB is a multimodal sensor with the extraordinary ability to detect a wide diversity of circulating molecules in the arterial blood, including inflammatory mediators. In this review, we introduce the literature supporting the role of the CB as a critical component of neuroimmune interactions. Based on ours and other studies, we propose a novel neuroimmune pathway in which the CB acts as a sensor of circulating inflammatory mediators and, in conditions of systemic inflammation, recruits a sympathetic-mediated counteracting mechanism that appears to be a protective response.

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Section: Targeting the Cb As A Therapeutic Approach For Inflammatory ...mentioning

confidence: 99%

The carotid body: A novel key player in neuroimmune interactions

et al. 2022

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“…In 1997, it amounted to 40% (mean PChS: 0.673 ± 0.41 L·min −1 ·%SpO 2 −1 ) [ 23 ] and 42% (0.72 ± 0.36 L·min −1 ·%SpO 2 −1 ) [ 30 ] versus 44% (0.58 [0.32–0.95] L·min −1 ·%SpO 2 −1 ) [ 31 ] and 40% (0.6 ± 0.4 L·min −1 ·%SpO2 −1 ) [ 72 ] in 2013 and 2021, respectively (all studies used the same method). That fact appears surprising in view of the knowledge of the possible pharmacological impact on PChR [ 40 ].…”

Section: Comparison Of Studied Populationsmentioning

confidence: 99%

“…The impact of usually prescribed groups of diuretics: loop, thiazide, and thiazide-like, on PChR has not been studied. The only diuretic drug with a proven impact on PChS is carbonic anhydrase inhibitor—acetazolamide [ 40 ]. Unfortunately, not every study specifies the type of diuretic that patients received, and those which provide that information do not mention acetazolamide.…”

Section: The Impact Of Hf Etiology and Management On Pchr Functionmentioning

confidence: 99%

“…The role of PChR in the progression and prognosis of HF, the causes of their distorted function, and possible modulation methods is the subject of intense research. In recent times, many valuable reviews in these matters have been published [ 4 , 11 , 37 , 38 , 39 , 40 , 41 ], however, none of them focuses on data from all clinical trials evaluating both PChS and tonic PChR activity in HF human patients, their methodology, results, and the potential impact of HF treatment.…”

Section: Introductionmentioning

confidence: 99%

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A Methodological Perspective on the Function and Assessment of Peripheral Chemoreceptors in Heart Failure: A Review of Data from Clinical Trials

et al. 2022

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Augmented peripheral chemoreceptor sensitivity (PChS) is a common feature of many sympathetically mediated diseases, among others, and it is an important mechanism of the pathophysiology of heart failure (HF). It is related not only to the greater severity of symptoms, especially to dyspnea and lower exercise tolerance but also to a greater prevalence of complications and poor prognosis. The causes, mechanisms, and impact of the enhanced activity of peripheral chemoreceptors (PChR) in the HF population are subject to intense research. Several methodologies have been established and utilized to assess the PChR function. Each of them presents certain advantages and limitations. Furthermore, numerous factors could influence and modulate the response from PChR in studied subjects. Nevertheless, even with the impressive number of studies conducted in this field, there are still some gaps in knowledge that require further research. We performed a review of all clinical trials in HF human patients, in which the function of PChR was evaluated. This review provides an extensive synthesis of studies evaluating PChR function in the HF human population, including methods used, factors potentially influencing the results, and predictors of increased PChS.

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“…Indeed, women have been extremely under‐represented in the main clinical trials conducted in HF patients with PB/CA/CSR which tested the prognostic effects of non‐invasive ventilation, yielding disappointing results (Bradley et al., 2005; Cowie et al., 2015). Furthermore, chemoreflex activation is emerging as an important therapeutic target to improve respiratory stability and, eventually, reduce the risk of hospitalization and mortality in HF patients (Langner‐Hetmańczuk et al., 2022).…”

Section: Figure Hypothetical Clinical Implications Of the Sex Differe...mentioning

confidence: 99%