Romanovsky Andrej A
Thermoregulation and Systemic Inflammation Laboratory (FeverLab), Trauma Research, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States.
Handb Clin Neurol. 2018;156:3-43. doi: 10.1016/B978-0-444-63912-7.00001-1.
Heat exchange processes between the body and the environment are introduced. The definition of the thermoneutral zone as the ambient temperature range within which body temperature (T) regulation is achieved only by nonevaporative processes is explained. Thermoreceptors, thermoregulatory effectors (both physiologic and behavioral), and neural pathways and T signals that connect receptors and effectors into a thermoregulation system are reviewed. A classification of thermoeffectors is proposed. A consensus concept is presented, according to which the thermoregulation system is organized as a dynamic federation of independent thermoeffector loops. While the activity of each effector is driven by a unique combination of deep (core) and superficial (shell) Ts, the regulated variable of the system can be viewed as a spatially distributed T with a heavily represented core and a lightly represented shell. Core T is the main feedback; it is always negative. Shell Ts (mostly of the hairy skin) represent the auxiliary feedback, which can be negative or positive, and which decreases the system's response time and load error. Signals from the glabrous (nonhairy) skin about the temperature of objects in the environment serve as feedforward signals for various behaviors. Physiologic effectors do not use feedforward signals. The system interacts with other homeostatic systems by "meshing" with their loops. Coordination between different thermoeffectors is achieved through the common controlled variable, T. The term balance point (not set point) is used for a regulated level of T. The term interthreshold zone is used for a T range in which no effectors are activated. Thermoregulatory states are classified, based on whether: T is increased (hyperthermia) or decreased (hypothermia); the interthreshold zone is narrow (homeothermic type of regulation) or wide (poikilothermic type); and the balance point is increased (fever) or decreased (anapyrexia). During fever, thermoregulation can be either homeothermic or poikilothermic; anapyrexia is always a poikilothermic state. The biologic significance of poikilothermic states is discussed. As an example of practical applications of the concept presented, thermopharmacology is reviewed. Thermopharmacology uses drugs to modulate specific temperature signals at the level of a thermoreceptor (transient receptor potential channel).
介绍了人体与环境之间的热交换过程。解释了热中性区的定义，即在此环境温度范围内，体温（T）调节仅通过非蒸发过程实现。回顾了温度感受器、体温调节效应器（生理和行为方面的）以及将感受器和效应器连接成体温调节系统的神经通路和T信号。提出了热效应器的分类。提出了一个共识概念，即体温调节系统是由独立的热效应器回路动态联合组成的。虽然每个效应器的活动由深部（核心）和浅表（外壳）体温的独特组合驱动，但系统的调节变量可视为空间分布的体温，核心体温占主导，浅表体温占比小。核心体温是主要反馈；它始终是负反馈。浅表体温（主要是有毛皮肤的体温）代表辅助反馈，其可以是负反馈或正反馈，并且它会减少系统的响应时间和负载误差。来自无毛（光滑）皮肤的关于环境中物体温度的信号用作各种行为的前馈信号。生理效应器不使用前馈信号。该系统通过与其他稳态系统的回路“啮合”来与它们相互作用。不同热效应器之间的协调通过共同的受控变量体温来实现。术语平衡点（而非设定点）用于指调节后的体温水平。术语阈间区用于指未激活任何效应器的体温范围。根据以下情况对体温调节状态进行分类：体温是升高（高热）还是降低（低温）；阈间区是窄（恒温调节类型）还是宽（变温调节类型）；以及平衡点是升高（发热）还是降低（无热）。在发热期间，体温调节可以是恒温的或变温的；无热始终是变温状态。讨论了变温状态的生物学意义。作为所提出概念实际应用的一个例子，对热药理学进行了回顾。热药理学使用药物在温度感受器（瞬时受体电位通道）水平调节特定的温度信号。
