Independent Researcher, EonBio, 3780 Pelham Drive, Mobile, AL 36619, USA.
Cardiology Associates of Mobile, Mobile, AL 36604, USA.
Int J Mol Sci. 2024 Jun 26;25(13):6959. doi: 10.3390/ijms25136959.
Observed and recorded in various forms since ancient times, 'syncope' is often popularly called 'fainting', such that the two terms are used synonymously. Syncope/fainting can be caused by a variety of conditions, including but not limited to head injuries, vertigo, and oxygen deficiency. Here, we draw on a large body of literature on syncope, including the role of a recently discovered set of specialized mammalian neurons. Although the etiology of syncope still remains a mystery, we have attempted to provide a comprehensive account of what is known and what still needs to be performed. Much of our understanding of syncope is owing to studies in the laboratory mouse, whereas evidence from human patients remains scarce. Interestingly, the cardioinhibitory Bezold-Jarisch reflex, recognized in the early 1900s, has an intriguing similarity to-and forms the basis of-syncope. In this review, we have integrated this minimal model into the modern view of the brain-neuron-heart signaling loop of syncope, to which several signaling events contribute. Molecular signaling is our major focus here, presented in terms of a normal heart, and thus, syncope due to abnormal or weak heart activity is not discussed in detail. In addition, we have offered possible directions for clinical intervention based on this model. Overall, this article is expected to generate interest in chronic vertigo and syncope/fainting, an enigmatic condition that affects most humans at some point in life; it is also hoped that this may lead to a mechanism-based clinical intervention in the future.
自古以来，“晕厥”就以各种形式被观察和记录下来，通常俗称为“昏厥”，因此这两个术语可以互换使用。晕厥/昏厥可由多种情况引起，包括但不限于头部受伤、眩晕和缺氧。在这里，我们借鉴了大量关于晕厥的文献，包括最近发现的一组专门的哺乳动物神经元的作用。虽然晕厥的病因仍然是个谜，但我们试图提供一个全面的了解，什么是已知的，什么仍然需要进行。我们对晕厥的大部分理解都归功于实验室小鼠的研究，而来自人类患者的证据仍然很少。有趣的是，早在 20 世纪初就被认识到的心脏抑制性贝佐尔德-贾里希反射与晕厥之间存在有趣的相似之处，并构成了晕厥的基础。在这篇综述中，我们将这个最小模型整合到了晕厥的大脑-神经元-心脏信号环路的现代观点中，其中几个信号事件都有贡献。分子信号是我们在这里的主要关注点，以正常心脏的形式呈现，因此，不会详细讨论因异常或微弱的心脏活动而导致的晕厥。此外，我们还根据该模型提供了可能的临床干预方向。总的来说，本文有望引起对慢性眩晕和晕厥/昏厥的兴趣，这种神秘的状况在人生的某个阶段影响着大多数人；我们还希望这可能会导致未来基于机制的临床干预。
