Carotid Body Chemoreflex Research Articles

Exercise training improves peripheral chemoreflex function in heart failure rabbits

An enhancement of peripheral chemoreflex sensitivity contributes to sympathetic hyperactivity in chronic heart failure (CHF) rabbits. The enhanced chemoreflex function in CHF involves augmented carotid body (CB) chemoreceptor activity via upregulation of the angiotensin II (ANG II) type 1 (AT(1))-receptor pathway and downregulation of the neuronal nitric oxide synthase (nNOS)-nitric oxide (NO) pathway in the CB. Here we investigated whether exercise training (EXT) normalizes the enhanced peripheral chemoreflex function in CHF rabbits and possible mechanisms mediating this effect. EXT partially, but not fully, normalized the exaggerated baseline renal sympathetic nerve activity (RSNA) and the response of RSNA to hypoxia in CHF rabbits. EXT also decreased the baseline CB nerve single-fiber discharge (4.9 +/- 0.4 vs. 7.7 +/- 0.4 imp/s at Po(2) = 103 +/- 2.3 Torr) and the response to hypoxia (20.6 +/- 1.1 vs. 36.3 +/- 1.3 imp/s at Po(2) = 41 +/- 2.2 Torr) from CB chemoreceptors in CHF rabbits, which could be reversed by treatment of the CB with ANG II or a nNOS inhibitor. Our results also showed that NO concentration and protein expression of nNOS were increased in the CBs from EXT + CHF rabbits, compared with that in CHF rabbits. On the other hand, elevated ANG II concentration and AT(1)-receptor overexpression of the CBs in CHF state were blunted by EXT. These results indicate that EXT normalizes the CB chemoreflex in CHF by preventing an increase in afferent CB chemoreceptor activity. EXT reverses the alterations in the nNOS-NO and ANG II-AT(1)-receptor pathways in the CB responsible for chemoreceptor sensitization in CHF.

Dynamic time-varying analysis of heart rate and blood pressure variability in cats exposed to short-term chronic intermittent hypoxia

Chronic intermittent hypoxia (CIH) contributes to the development of hypertension in patients with obstructive sleep apnea and animal models. However, the early cardiovascular changes that precede CIH-induced hypertension are not completely understood. Nevertheless, it has been proposed that one of the possible contributing mechanisms to CIH-induced hypertension is a potentiation of carotid body (CB) hypoxic chemoreflexes. Therefore, we studied the dynamic responses of heart rate, blood pressure, and their variabilities during acute exposure to different levels of hypoxia after CIH short-term preconditioning (4 days) in cats. In addition, we measured baroreflex sensitivity (BRS) on the control of heart rate by noninvasive techniques. To assess the relationships among these indexes and CB chemoreflexes, we also recorded CB chemosensory discharges. Our data show that short-term CIH reduced BRS, potentiated the increase in heart rate induced by acute hypoxia, and was associated with a dynamic shift of heart rate variability (HRV) spectral indexes toward the low-frequency band. In addition, we found a striking linear correlation (r = 0.97) between the low-to-high frequency ratio of HRV and baseline. CB chemosensory discharges in the CIH-treated cats. Thus, our results suggest that cyclic hypoxic stimulation of the CB by short-term CIH induces subtle but clear selective alterations of HRV and BRS in normotensive cats.

NO and CO have got to GO for enhanced chemoreceptor sympathoexcitation in heart failure

arterial chemoreceptors located in the carotid body are an important defense mechanism against systemic hypoxemia. Activation of arterial chemoreceptors increases alveolar ventilation and sympathetic outflow to most vascular beds. During acute exposures to hypoxia, the sympathoexcitatory responses

Carotid body function in heart failure.

In this review, we summarize the present state of knowledge of the functional characteristics of the carotid body (CB) chemoreflex with respect to control of sympathetic nerve activity (SNA) in chronic heart failure (CHF). Evidence from both CHF patients and animal models of CHF has clearly established that the CB chemoreflex is enhanced in CHF and contributes to the tonic elevation in SNA. This adaptive change derives from altered function at the level of both the afferent and central nervous system (CNS) pathways of the reflex arc. At the level of the CB, an elevation in basal afferent discharge occurs under normoxic conditions in CHF rabbits, and the discharge responsiveness to hypoxia is enhanced. Outward voltage-gated K(+) currents (I(K)) are suppressed in CB glomus cells from CHF rabbits, and their sensitivity to hypoxic inhibition is enhanced. These changes in I(K) derive partly from downregulation of nitric oxide synthase (NOS)/NO signaling and upregulation of angiotensin II (Ang II)/Ang II receptor (AT(1)R) signaling in glomus cells. At the level of the CNS, interactions of the enhanced input from CB chemoreceptors with altered input from baroreceptor and cardiac afferent pathways and from central Ang II further enhance sympathetic drive. In addition, impaired function of NO in the paraventricular nucleus of the hypothalamus participates in the increased SNA response to CB chemoreceptor activation. These results underscore the principle that multiple mechanisms involving Ang II and NO at the level of both the CB and CNS represent complementary and perhaps redundant adaptive mechanisms to enhance CB chemoreflex function in CHF.

A “love triangle” elicited by electrochemistry: complex interactions among cardiac sympathetic afferent, chemo-, and baroreflexes

there are three major cardiovascular reflexes: the baroreflex, chemoreflex, and cardiac sympathetic afferent reflex (CSAR). This commentary provides a brief overview of these three reflexes and also discusses the interplay among them. In addition, it outlines the potential centrally integrative

Altered nitric oxide mechanism within the paraventricular nucleus contributes to the augmented carotid body chemoreflex in heart failure

Our previous study demonstrated a contribution of the paraventricular nucleus (PVN) of the hypothalamus in the processing of the carotid body (CB) chemoreflex. Nitric oxide (NO) (within the PVN), known to modulate autonomic function, is altered in rats with heart failure (HF). Therefore, the goal of the present study was to examine the influence of endogenous and exogenous NO within the PVN on the sympathoexcitatory component of the peripheral chemoreflex in normal and HF states. We measured mean arterial blood pressure, heart rate, renal sympathetic nerve activity (RSNA), and phrenic nerve activity (PNA) in sham-operated and HF rats (6-8 wk after coronary artery ligation) after incremental doses of potassium cyanide (25-100 mug/kg iv). There was potentiation of the reflex responses in HF compared with sham-operated rats. Bilateral microinjection of an inhibitor of NO synthase, N(G)-monomethyl-l-arginine (50 pmol), into the PVN augmented the RSNA and PNA response to peripheral chemoreceptor stimulation in sham-operated rats but had no effect in HF rats. Conversely, bilateral microinjection of a NO donor, sodium nitroprusside (50 nmol), into the PVN attenuated the RSNA response of the peripheral chemoreflex in sham-operated rats but to a smaller extent in HF rats. These data indicate that 1) NO within the PVN plays an important role in the processing of the CB chemoreflex and 2) there is an impairment of the NO function within the PVN of HF rats, which contributes to an augmented peripheral chemoreflex and subsequent elevation of sympathetic activity in HF.

Kv1.1 Deletion Augments the Afferent Hypoxic Chemosensory Pathway and Respiration

Mutations in the potassium channel gene Kv1.1 are associated with human episodic ataxia type 1 (EA-1) syndrome characterized by movement disorders and epilepsy. Ataxic episodes in EA-1 patients are often associated with exercise or emotional stress, which suggests a prominent role for the autonomic nervous system. Many of these alterations are reproduced in the Kv1.1-null mouse. Kv1.1 also regulates excitability of sensory neurons essential in cardiovascular and respiratory reflexes. We examined the neural control of the respiratory system of littermate wild-type (control) and Kv1.1-null mice during low O2 (hypoxia). Immunohistochemical studies demonstrated Kv1.1 in the afferent limb of the carotid body chemoreflex (the major regulator in the response to hypoxia), consisting of the carotid body, petrosal ganglion, and nucleus of the solitary tract (NTS). Respiration was examined by plethysmography. Null mice exhibited a greater increase in respiration during hypoxia compared with controls. In vitro carotid body sensory discharge during hypoxia was greater in null than control mice. In the caudal NTS, evoked EPSCs in brainstem slices were similar between control and null mice. However, the frequency of spontaneous and miniature EPSCs was greater in null mice. Null mice also exhibited more asynchronous release after a stimulus train. These results demonstrate the important role of Kv1.1 in afferent chemosensory activity and suggest that mutations in the human Kv1.1 gene have functional consequences during stress responses that involve respiratory reflexes.

Attenuation of the carotid body chemoreflex during the stimulation of the posterior vermis in the anaesthetised rabbit

The purpose of this study was to investigate the effects of electrical and chemical stimulation of the sub-lobule IX-b of the cerebellar uvula on the cardiorespiratory responses evoked on stimulation of the carotid chemoreceptors in the anaesthetised and paralysed rabbit. Recordings of arterial blood pressure, ECG, heart rate and phrenic nerve activity were evaluated. Sub-lobule IX-b was activated electrically (1 ms, 20 μA, 100 Hz, 4-s train) and stimulated chemically with sodium glutamate microinjections (2 mM, pH=7.4±0.1) using bipolar concentric or multibarrelled microelectrodes. Carotid body chemoreflexes were evoked by the retrograde injection of sodium cyanide (0.1%, 0.1 ml) into the blood supply of the carotid body through a cannula inserted in the external carotid artery. The interaction of uvula stimulation and the carotid chemoreceptor reflex was studied by following the chemoreceptor stimulus with a stimulus to the uvula. Electrical and chemical stimulation of the uvula evoked a characteristic bradycardia and a depressor response together with a decrease in phrenic nerve activity. Carotid body stimulation evoked a decrease in heart rate accompanied by an increase of both arterial blood pressure and phrenic nerve activity. However, simultaneous delivery of the two stimuli resulted in a depressor response together with a decrease of phrenic nerve activity and an increased bradycardia. These data suggest that stimulation of the cerebellar uvula exerts an inhibitory control of the chemoreflex efficacy as far as respiratory activity and blood pressure is concerned.

Prenatal hypoxia impairs the early postnatal development of the carotid chemoafferent pathway

Rat carotid bodies (CB) are considered as the main component that initiates the Hypoxic Ventilatory Response (HVR). Most of these chemoafferent fibres project into discrete areas of the medulla oblongata via the petrosal ganglion (PG), mainly in the caudal part of the nucleus Tractus Solitarius (NTS), and, to a lesser extent, in the ventrolateral medulla (VLM) [1]. Both medullary areas contain two major respiratory cell groups: the dorsal respiratory group, in the ventrolateral subset of the solitary tract, and the ventral respiratory group, in the VLM. These two medullary respiratory groups are closely associated with catecholaminergic neurones that belong to, the A2C2 cell group and the A1C1 cell group respectively. There is growing evidence that medullary cate-cholaminergic neurones participate in the chemoreflex response to systemic hypoxia. During the two first weeks of life, the sensitivity of the carotid bodies adapts to the comparatively hypoxic environment of the foetus and then reset to the higher PaO2 of the new-born. This environmental change in oxygen leads to an increase in the carotid body sensitivity, due in part to a decrease in the release of dopamine [2]. The postnatal maturation of the carotid body sensitivity depends on the level of environmental oxygen during the early postnatal period. The aim of the present study is to investigate the effects of prenatal hypoxia (last 15 days of gestation in 10% O2) on the neurochemical and functional development (postnatal day 0, 3, 7, 14, 21 and 68) of the chemoafferent pathway. We thus assessed the development of in vivo tyrosine hydroxylase (TH) activity, the rate-limiting enzyme in the catecholamine synthesis [3], in the CB, PG and the A1C1, A2C2 cell groups. In the same way, TH mRNA was evaluated in the CB, PG structures. Moreover, we evaluated the functional maturity of the chemoreflex pathway by measuring the HVR. We attempted to address four main questions. First, can prenatal hypoxia induce a neurochemical impairment of the CB resetting? Second, could the neurochemical impairment be related to the mRNA level? Third, are central and peripheral structures affected in the same manner? Fourth, are the neuronal impairments reflected at the functional level? Our results show that 1) prenatal hypoxia amplifies the neurochemical resetting of the peripheral chemoreceptors; 2) a part of the neurochemical impairment is explained at the mRNA level; 3) central and peripheral structures exhibit opposite impairment; 4) prenatal hypoxia modifies the HVR pattern. In conclusion, prenatal hypoxic exposure during the two last weeks of gestation impairs the carotid body chemoreflex pathway at the functional, the neurochemical and the molecular level, affecting the CB resetting process.

A chemoreflex model of relation between blood pressure and heart rate in sleep apnea syndrome.

In obstructive sleep apnea syndrome (OSAS), pronounced low-frequency (LF) oscillations of blood pressure and interbeat interval (I) occur during recurrent apneas. We investigated the time relations between LF oscillations of diastolic pressure (D) and I in 12 patients with OSAS by means of spectral analysis. A high coherency between I and D was found, allowing a description of the relation by gain and phase. Oscillations in I and D were almost in counterphase in the LF range. Simple physiological models were implemented to interpret the observed features of LF oscillations. Model 1 describes the vagal and sympathetic influence by the carotid body chemoreflex on the circulation. From derivation of the frequency response of this model, gain and phase relations were obtained as would be expected from the action of the chemoreflex. We found that a range of phase relations can be induced by this reflex, depending on the relative vagal and sympathetic efferent influence on the circulation. This range of phase relations was indeed observed in 10 patients. Extended models that also included the orienting reflex (model 1a) or the baroreflex and a mechanical influence of breathing on the circulation (model 2) could not fit the data without a major contribution of the chemoreflex. We conclude that the relation between LF oscillations in I and D in OSAS can be explained by assuming that stimulation of the carotid body chemoreflex is the main source of these oscillations.

Adrenal response to long-term hypoxia is still increased after carotid body denervation in rat.

This study investigated the effects of long-term normobaric hypoxia (10% O2 in N2 for 2, 7, 14, and 28 days) on the metabolism of catecholamines in rat adrenals and the role of the carotid body chemoreceptors in the adrenal response. The content and utilization of dopamine were significantly increased from the 7th day of hypoxia and remained enhanced thereafter. The content of norepinephrine and epinephrine decreased after 2 days of hypoxia and increased thereafter; after 28 days of hypoxia the norepinephrine amounts remained enhanced but the epinephrine levels were no longer significantly increased. In vivo tyrosine hydroxylation increased after 7 days of hypoxia. Bilateral transection of the carotid sinus nerve 1 wk before hypoxia failed to abolish the increase in the content and utilization of dopamine after 7, 14, or 21 days of hypoxic exposure. These results indicate that long-term normobaric hypoxia elicits a long-lasting increase in the metabolism of catecholamines in adrenals, especially as assessed by dopamine measurement, and that this response does not involve a carotid body chemoreflex pathway.

Cervical preganglionic sympathetic nerve activity and chemoreflexes in the cat

The role of chemoreflexes originating from carotid body and central chemoreceptors in the regulation of cervical preganglionic sympathetic nerve (PSN) activity was studied in anesthetized and spontaneously breathing cats. PSN efferents which responded to hypoxia were selected for the study. The PSN activity, breath-by-breath inspiratory tidal volume, tracheal PO2 and PCO2, and arterial systemic blood pressure were recorded simultaneously. The responses of PSN efferents to transient changes in and steady-state levels of arterial PO2 and PCO2 and to graded bolus injections of intravenous sodium cyanide (50-100 micrograms), nicotine (50-100 micrograms), and dopamine hydrochloride (30-60 micrograms) were compared before and after bilateral section of carotid sinus nerves (CSN). CSN section raised the base-line PSN activity and practically eliminated the responses to brief pharmacological stimuli, but it did not eliminate the responses to transient changes in and steady-state levels of arterial PO2 and PCO2. However, CSN section diminished PSN responses and abolished ventilatory responses to hypoxia. Thus the PSN response to hypoxia was partly independent of peripheral chemoreflex and of respiratory drive. We conclude that carotid body chemoreflex elicits fast PSN responses and that a moderate decline in arterial PO2 causes an additional slow, direct excitation of sympathetic nervous system. The latter indicates O2 chemosensitivity of the system in the physiological range of arterial PO2. This O2-sensing property may allow sympathetic nervous system to initiate chemoreflex responses independent of the peripheral chemoreceptors.

Hypoxemia reflexly increases secretion from tracheal submucosal glands in dogs.

We anesthetized dogs, ventilated their lungs via the lower trachea, and exposed the epithelial surface of the upper trachea and coated it with powdered tantalum. Secretions from submucosal gland ducts formed elevations (hillocks) in the tantalum layer; we counted the number of hillocks that appeared in a 1.2-cm2 field. In 12 dogs, during normoxemia, 12 +/- 2 hillocks/cm2 formed in 90 s; during severe hypoxemia [fractional inspired O2 concentration (FIO2) = 0.05], 40 +/- 4 hillocks/cm2 formed in 90 s. Injections of sodium cyanide (25-75 micrograms) into the arterial supply to the carotid body also stimulated tracheal submucosal gland secretion. Secretory response to hypoxemia was suppressed by 1) section of both carotid sinus body nerves in six dogs and 2) section of both superior laryngeal nerves and vagus nerves in six other dogs. During mild hypoxemia (FIO2 = 0.10 or 0.15) tracheal submucosal gland secretion still increased. We conclude that hypoxemia increases secretion from submucosal glands in canine trachea by a carotid body chemoreflex.

Role of carotid chemoreflex in respiratory acclimatization to hypoxemia in goat and sheep

The role of the carotid body chemoreflex in the ventilatory acclimatization to chronic hypoxia was studied in the unanesthetized goat and sheep. The time-course of changes in ventilation, P CO 2 , pH and P CO 2 of arterial blood and cisternal fluid (CF) were measured before and following exposure to a simulated altitude of 3660–5000 m, with and without intact carotid sinus nerves. At sea level, after section of carotid sinus nerves most animals hypoventilated chronically, and developed mild arterial hypoxemia and hypercapnia. Upon exposure to acute hypoxia, all of the intact animals hyperventilated and CF pH increased from 7.310 to 7.380 whereas after chemodenervation, the increase in ventilation was small and delayed, and CF pH decreased from 7.285 to 7.143. During exposure of the intact animals to chronic hypoxia, hyperventilation accompanied by decreases in arterial and CF P CO 2 reached its peak in two days; these changes partially subsided during the next few days. Partial compensation of respiratory alkalosis occurred during the first day. In contrast, several chemodenervated animals died during chronic hypoxia; the survivors showed either a small decrease or an increase in Pa CO 2 . Thus, an intact peripheral chemoreflex drive during hypoxia in necessary for ventilatory acclimatization which raises the arterial and presumably tissue P CO 2 in spite of alkalosis. The new proposal is that a central tissue metabolic acidosis resulting from a direct effect of acute hypoxia is partly compensated as hypoxia is prolonged. This central compensation decreases ventilatory drive and hence opposes the ventilatory acclimatization during chronic hypoxia initiated by the peripheral chemoreflexes.

The cardiovascular reflexes

The carotid sinus and aortic arch pressure reflexes are of supreme importance in the regulation of the circulation They are tonically activated by normal physiological stimuli The physiological role of the carotid and aortic body chemoreflexes m hemorrhagic shock has been described. Certain recently discovered reflexes, which may be important m normal physiology, have been briefly mentioned. The physiological purpose of the venous pressure receptors is not yet established Deeper planes of anaesthesia depress the sino-aortic pressure reflex mechanism, and on this account fall of blood pressure due to surgical trauma is liable to occur. Light planes of anaesthesia do not depress this protective compensatory mechanism. However, during light planes of anaesthesia certain detrimental reflexes may be evoked by nonohysiological stimuli associated with surgical procedure. The nature of a number of these untoward reflexes—carotid sinus, intrathoracic, and cehac plexus—has been reviewed Reflex disturbances occurring during neurosurgery and in individuals with spinal cord injuries have also been mentioned.