Abstract
We review the substantial recent progress made in understanding the underlying mechanisms controlling breathing and the applicability of these findings to selected human diseases. Emphasis is placed on the sites of central respiratory rhythm and pattern generation as well as newly described functions of the carotid chemoreceptors, the integrative nature of the central chemoreceptors, and the interaction between peripheral and central chemoreception. Recent findings that support critical contributions from cortical central command and muscle afferent feedback to exercise hyperpnoea are also reviewed. These basic principles, and the evidence supporting chemoreceptor and ventilatory control system plasticity during and following constant and intermittent hypoxaemia and stagnant hypoxia, are applied to: 1) the pathogenesis, consequences and treatment of obstructive sleep apnoea; and 2) exercise hyperpnoea and its control and limitations with ageing, chronic obstructive pulmonary disease and congestive heart failure.
Abstract
We review control of breathing in humans and how new findings lead to novel treatments in sleep apnoea, CHF and COPD http://ow.ly/weJ7A
Footnotes
Previous articles in this series: No 1: Naeije R, Vachiery J-L, Yerly P, et al. The transpulmonary pressure gradient for the diagnosis of pulmonary vascular diseases. Eur Respir J 2013; 41: 217–223; No. 2: Hughes JMB, van der Lee I. The TL,NO/TL,CO ratio in pulmonary function test interpretation. Eur Respir J 2013; 41: 453–461; No. 3: Vonk-Noordegraaf A, Westerhof N. Describing right ventricular function. Eur Respir J 2013; 41: 1419–1423; No. 4: Hamzaoui O, Monnet X, Teboul J-L. Pulsus paradoxus. Eur Respir J 2013; 42: 1696–1705; No. 5: Prisk GK. Microgravity and the respiratory system. Eur Respir J 2014; 43: 1459–1471.
Support statement: Original research findings of the authors reported in this review were supported by NHLBI (grant numbers HL-15469 (J.A. Dempsey) and HL-50531 (C.A. Smith)), the American Heart Association and the US Veterans Administration.
Conflict of interest: None declared.
- Received March 12, 2014.
- Accepted April 17, 2014.
- ©ERS 2014