EditorialPhysiology in PerspectiveNikki ForresterNikki ForresterAmerican Physiological Society, Rockville, MarylandPublished Online:20 Jan 2023https://doi.org/10.1152/physiol.00002.2023MoreSectionsPDF (79 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat This issue of Physiology features four outstanding review articles that summarize current knowledge and uncover areas for future research across a range of topics in physiology. First, we analyze how developmental hypoxia affects the vertebrate cardiovascular system. Next, we describe the role of coupling delay in synchronized oscillations, with a focus on the segmentation clock. Third, we evaluate mechanistic models for how the insular cortex regulates the physiological needs of organisms and their need-driven behaviors. Finally, we explore how breakthroughs in precision medicine can improve diagnoses and treatments for people with mental illness.The environment during early development can have profound effects on an organism’s morphology, physiology, function, and behavior. Adaptive responses to adverse temperature, oxygen, or pH conditions can persist throughout an organism’s lifetime and even across generations through epigenetic changes. Hypoxia, or an insufficient supply of oxygen, is a particularly common and disruptive environmental stressor. Whereas oxygen levels are tightly regulated in mammalian wombs, embryonic birds and ectothermic vertebrates can experience highly variable oxygen levels during development. Because the vertebrate cardiovascular system is heavily involved in mitigating oxygen deprivation, it is especially sensitive to developmental hypoxia. In this review, Galli et al. (1) conduct a comparative analysis of vertebrate cardiovascular responses to developmental hypoxia to identify common and novel responses as well as potential medical and ecological implications.In segmented animals, cells must be able to communicate with one another to ensure the proper segmentation of somites. Cells achieve this by sending and receiving information via signaling pathways, such as the Notch signaling pathway. The Notch signaling pathway plays a critical role in somitogenesis by coordinating the segmentation clock, which is a molecular oscillator that regulates the periodic formation of somites in embryos. If these oscillations are out of synchrony between cells, then somite segmentation does not occur properly, potentially causing respiratory complications or death. Mathematical models suggest that the time required to transmit signals between cells, or coupling delay, is important for oscillatory dynamics, but the biological implications of coupling delay remain less understood. In this review, Kageyama et al. (2) describe the biological importance of coupling delay in synchronized oscillations of the segmentation clock and reveal areas for future analysis.All cellular organisms must maintain the appropriate intracellular environment. When the necessary conditions for homeostasis are not met by the environment and cannot be regulated internally, organisms must take actions to fulfill their physiological needs. In multicellular animals, this process often involves powerful motivations, such as thirst or hunger, and the concerted action of different tissues and organs. However, the neural basis of the motivations that drive these behaviors is relatively unclear. Animal models suggest that the insular cortex receives internal sensory information and regulates physiological needs and need-driven behavior. In this review, Prilutski and Livneh (3) discuss mechanistic models for how the insular cortex regulates physiological needs, develop a framework for testing these models, and outline implications for various diseases and disorders.Diagnostic errors in mental disorders are common, with low inter-reliability and some studies reporting misdiagnosis rates of up to 66%. Even when patients are correctly diagnosed, the lack of clinical guidelines for drug selection can complicate a psychiatrist’s ability to select accurate treatments. Precision medicine holds the potential to improve care for patients with mental illness, in part through comprehensively exploring the physiological basis of such conditions. In addition, recent advancements in multi-omics technologies and data analytics can pave the way for better diagnostic tests and treatment decisions. In this review, Scala et al. (4) explore how breakthroughs in precision medicine and multi-omic physiological profiling can improve disease classification, psychiatric diagnoses, and treatments.No conflicts of interest, financial or otherwise, are declared by the author.
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