Editorial: Carotid body: a new target for rescuing neural control of cardiorespiratory balance in disease

(2015) Editorial: Carotid body: a new target for rescuing neural control of cardiorespiratory balance in disease. The carotid body (CB) is considered the main arterial chemoreceptor. Interestingly, the CB respond to a large repertoire of stimuli that can elicit a reflex cardiorespiratory response. For this reason, the pathophysiological role played by alterations in CB function during disease conditions is under intense research. Since its discovery, the CB has been related almost exclusively to its pivotal role in adjusting ventilatory and cardiovascular function during acute or chronic alterations on blood gases (i.e., hypoxia and hypercapnia, sustained chronic hypoxia). However, recent advances has contribute to deciphere the role played by the CB in the progression of highly prevalent diseases such as hypertension, heart failure and insulin resistance. Indeed, elegant studies showing the effect of CB neurotomy in pathophysiology have unveiled a key role of these arterial chemoreceptors in the development of autonomic imbalance, respiratory disturbances, systemic inflammation, and impairment of glucose metabolism (Fitzgerald, 2014). Therefore, targeting the CB rises as a novel therapeutic strategy to improve disease outcome. However, the mechanisms involved in the alterations of CB function in pathophysiology are not completely understood. Indeed, classical pharmacotherapy intended to normalize CB function may be hard to establish since several cellular pathways are involved in the CB dysfunction. Augmented levels of CB neuromodulators such as angiotensin II, endothelin-1, pro-inflammatory cytokines, cyclic nucleotides, hydrogen sulfide, carbon monoxide and free radicals had all been related to CB chemosensory facilitation (Iturriaga et al., 2014; Prabhakhar and Joyner, 2015). Indeed, it has been proposed that the enhanced CB chemoreflex drive induces central nervous system (CNS) plasticity. In experimental chronic heart failure (CHF), the CB chemosensory activity is tonically elevated leading to sympatho-excitation and destabilization of breathing. Marcus et al. (2014) reviewed the contribution of the CB on the respiratory-sympathetic coupling in CHF and its role in the development of oscillatory breathing patterns and enhanced renal sympathetic nerve activity. The elimination of the CB afferents totally normalized breathing patterns and reduced sympathetic outflow suggesting that the CB plays a pivotal role in the progression of cardio-respiratory dysfunction during CHF. It has been shown that exposure to chronic intermittent hypoxia (CIH), one of the main features of obstructive sleep apnea syndrome (OSA), induces a potentiation of CB chemosensory activity (Iturriaga et al., 2014). It has been proposed that episodic hypoxia during CIH induces CB sensory plasticity increasing neural afferent …