Department of Anatomy and Histology, Faculty of Medicine, Medical University of Sofia, Sofia, Bulgaria.
Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria.
Adv Anat Embryol Cell Biol. 2023;237:123-138. doi: 10.1007/978-3-031-44757-0_8.
Emerging evidence shows that the carotid body (CB) dysfunction is implicated in various physiological and pathophysiological conditions. It has been revealed that the CB structure and neurochemical profile alter in certain human sympathetic-related and cardiometabolic diseases. Specifically, a tiny CB with a decrease of glomus cells and their dense-cored vesicles has been seen in subjects with sleep disordered breathing such as sudden infant death syndrome and obstructive sleep apnea patients and people with congenital central hypoventilation syndrome. Moreover, the CB degranulation is accompanied by significantly elevated levels of catecholamines and proinflammatory cytokines in such patients. The intermittent hypoxia stimulates the CB, eliciting augmented chemoreflex drive and enhanced cardiorespiratory and sympathetic responses. High CB excitability due to blood flow restrictions, oxidative stress, alterations in neurotransmitter gases and disruptions of local mediators is also observed in congestive heart failure conditions. On the other hand, the morpho-chemical changes in hypertension include an increase in the CB volume due to vasodilation, altered transmitter phenotype of chemoreceptor cells and elevated production of neurotrophic factors. Accordingly, in both humans and animal models CB denervation prevents the breathing instability and lowers blood pressure. Knowledge of the morphofunctional aspects of the CB, a better understanding of its role in disease and recent advances in human CB translational research would contribute to the development of new therapeutic strategies.
新出现的证据表明,颈动脉体(CB)功能障碍与各种生理和病理生理状况有关。已经发现,在某些与交感神经相关的人类和心脏代谢疾病中,CB 的结构和神经化学特征会发生改变。具体来说,在患有睡眠呼吸障碍(如婴儿猝死综合征和阻塞性睡眠呼吸暂停患者)和先天性中枢性通气不足综合征的患者中,可以看到 CB 结构微小、颗粒细胞减少以及它们的致密核心囊泡减少。此外,在这些患者中,CB 脱颗粒伴随着儿茶酚胺和促炎细胞因子水平的显著升高。间歇性缺氧刺激 CB,引起化学感受器反射驱动增强,心肺和交感神经反应增强。在充血性心力衰竭情况下,由于血流受限、神经递质气体改变和局部介质破坏,也会观察到 CB 兴奋性增高。另一方面,高血压中的形态化学变化包括由于血管扩张导致 CB 体积增加、化学感受器细胞的递质表型改变以及神经营养因子的产生增加。因此,在人类和动物模型中,CB 去神经支配可防止呼吸不稳定和降低血压。对 CB 的形态功能方面的了解,对其在疾病中的作用的更好理解以及人类 CB 转化研究的最新进展,将有助于开发新的治疗策略。