Abstract
Substantial advances have been made recently into the discovery of fundamental mechanisms
underlying the neural control of breathing and even some inroads into translating
these findings to treating breathing disorders. Here, we review several of these advances,
starting with an appreciation of the importance of V̇A:V̇CO2:PaCO2 relationships, then summarizing our current understanding of the mechanisms and neural
pathways for central rhythm generation, chemoreception, exercise hyperpnea, plasticity,
and sleep-state effects on ventilatory control. We apply these fundamental principles
to consider the pathophysiology of ventilatory control attending hypersensitized chemoreception
in select cardiorespiratory diseases, the pathogenesis of sleep-disordered breathing,
and the exertional hyperventilation and dyspnea associated with aging and chronic
diseases. These examples underscore the critical importance that many ventilatory
control issues play in disease pathogenesis, diagnosis, and treatment.
Keywords
chemoreception - exercise hyperpnea - plasticity - sleep-disordered breathing - respiratory
rhythm generation - exertional dyspnea - COPD - CHF - aging
