Respiratory and autonomic dysfunction in congenital central hypoventilation syndrome

J Neurophysiol. 2016 Aug 1;116(2):742-52. doi: 10.1152/jn.00026.2016. Epub 2016 May 25.

Abstract

The developmental lineage of the PHOX2B-expressing neurons in the retrotrapezoid nucleus (RTN) has been extensively studied. These cells are thought to function as central respiratory chemoreceptors, i.e., the mechanism by which brain Pco2 regulates breathing. The molecular and cellular basis of central respiratory chemoreception is based on the detection of CO2 via intrinsic proton receptors (TASK-2, GPR4) as well as synaptic input from peripheral chemoreceptors and other brain regions. Murine models of congenital central hypoventilation syndrome designed with PHOX2B mutations have suggested RTN neuron agenesis. In this review, we examine, through human and experimental animal models, how a restricted number of neurons that express the transcription factor PHOX2B play a crucial role in the control of breathing and autonomic regulation.

Keywords: CCHS; breathing; chemoreflex; ventrolateral medulla.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Autonomic Nervous System Diseases / etiology*
  • Autonomic Nervous System Diseases / genetics
  • Chemoreceptor Cells / physiology
  • Disease Models, Animal
  • Homeodomain Proteins / genetics
  • Humans
  • Hypoventilation / complications
  • Hypoventilation / congenital*
  • Hypoventilation / genetics
  • Hypoventilation / pathology
  • Medulla Oblongata / metabolism
  • Medulla Oblongata / pathology
  • Respiration Disorders / etiology*
  • Respiration Disorders / genetics
  • Sleep Apnea, Central / complications*
  • Sleep Apnea, Central / genetics
  • Sleep Apnea, Central / pathology
  • Transcription Factors / genetics

Substances

  • Homeodomain Proteins
  • NBPhox protein
  • Transcription Factors

Supplementary concepts

  • Congenital central hypoventilation syndrome