New concepts in abnormalities of respiratory control in children.
OBJECTIVE
Respiratory control disorders such as apnea of prematurity, apparent life-threatening events, sudden infant death syndrome, and central hypoventilation are relatively frequent conditions in the pediatric age range and are associated with substantial morbidity and mortality. The explosion of technological breakthroughs in biology and medicine has facilitated our understanding of the fundamental mechanisms that govern the development of brain regions underlying respiratory control functions.


RESULTS
Recent critically important discoveries encompass the identification of neurons that constitute the central respiratory rhythm generator in the brainstem, the conceptual framework allowing for many neurons located in multiple strategic regions within the brain to coordinate central chemosensitivity, the discovery of long-term and short-term plasticity in hypoxic ventilatory regulation, and the recent uncovering of specific gene mutations in children affected with congenital central hypoventilation syndrome.


CONCLUSIONS
While the developmental aspects of control breathing are only now being actively explored in the context of our current understanding, it is likely that such efforts will yield important novel approaches to the clinical and pharmacologic management of these disorders in the near future.
Gozal
David
D
Kosair Children's Hospital Research Institute, and Department of Pediatrics, University of Louisville, Kentucky 40202, USA. david.gozal@louisville.edu
D006801:Humans; D000860:Hypoxia / Q000151:congenital / Q000503:physiopathology; D007223:Infant; D007231:Infant, Newborn; D009415:Nerve Net / Q000503:physiopathology; D012119:Respiration; D012120:Respiration Disorders / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology; D012125:Respiratory Center / Q000503:physiopathology*