Division of Cardiology, Department of Medicine, University of California-Los Angeles, Los Angeles, California.
Renal Division, Department of Medicine, Emory University School of Medicine, and the Veterans Affairs Medical Center, Atlanta, Georgia.
J Am Coll Cardiol. 2014 Oct 21;64(16):1740-50. doi: 10.1016/j.jacc.2014.06.1201.
This review summarizes the detrimental effects of cigarette and noncigarette emission exposure on autonomic function, with particular emphasis on the mechanisms of acute and chronic modulation of the sympathetic nervous system. We propose that the nicotine and fine particulate matter in tobacco smoke lead to increased sympathetic nerve activity, which becomes persistent via a positive feedback loop between sympathetic nerve activity and reactive oxidative species. Furthermore, we propose that baroreflex suppression of sympathetic activation is attenuated in habitual smokers; that is, the baroreflex plays a permissive role, allowing sympathoexcitation to occur without restraint in the setting of increased pressor response. This model is also applicable to other nontobacco cigarette emission exposures (e.g., marijuana, waterpipes [hookahs], electronic cigarettes, and even air pollution). Fortunately, emerging data suggest that baroreflex sensitivity and autonomic function may be restored after smoking cessation, providing further evidence in support of the health benefits of smoking cessation.
这篇综述总结了香烟和非香烟排放物暴露对自主功能的有害影响，特别强调了交感神经系统急性和慢性调节的机制。我们提出，烟草烟雾中的尼古丁和细颗粒物导致交感神经活动增加，通过交感神经活动和活性氧之间的正反馈循环，这种增加变得持续。此外，我们提出习惯性吸烟者的血压反射抑制交感神经激活作用减弱；也就是说，血压反射起着允许作用，在增加的升压反应情况下，允许交感兴奋不受限制地发生。该模型也适用于其他非烟草香烟排放物暴露（例如，大麻、水烟管[水烟袋]、电子烟，甚至空气污染）。幸运的是，新出现的数据表明，戒烟后血压反射敏感性和自主功能可能恢复，这进一步证明了戒烟的健康益处。
