Carbon dioxide chemoreception and hypoventilation syndromes with autonomic dysregulation.
Respiratory and autonomic disorders of infancy, childhood, and adulthood are a group of disorders that have varying presentation, combined with a range of severity of respiratory control and autonomic nervous system dysfunction. Within this group, congenital central hypoventilation syndrome and rapid onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation, exhibit the greatest respiratory control deficits, requiring supported ventilation as a mainstay of care. The discovery of the key role of the paired-like homeobox 2B gene in autonomic nervous system development, along with the identification of paired-like homeobox 2B gene mutations causing congenital central hypoventilation syndrome, has led to a fruitful dialog between basic scientists and physician-scientists, producing an explosion of knowledge regarding genotype-phenotype correlations in this disorder, as well as important animal models of chemosensory regulation deficit. Though the etiology of rapid onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation is still to be determined, recent studies have begun to carefully delineate the phenotype, suggesting that it too may provide fertile ground for research that both advances our knowledge and improves patient care.
Carroll
Michael S
MS
Center for Autonomic Medicine in Pediatrics, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60614, USA.
Patwari
Pallavi P
PP
Weese-Mayer
Debra E
DE
D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000235:genetics / Q000503:physiopathology*; D002245:Carbon Dioxide / Q000502:physiology*; D002628:Chemoreceptor Cells / Q000502:physiology*; D015870:Gene Expression; D018398:Homeodomain Proteins / Q000235:genetics; D006801:Humans; D010845:Obesity Hypoventilation Syndrome / Q000150:complications / Q000235:genetics / Q000503:physiopathology*; D011956:Receptors, Cell Surface / Q000502:physiology*; D014157:Transcription Factors / Q000235:genetics
D018398:Homeodomain Proteins; C109220:NBPhox protein; D011956:Receptors, Cell Surface; D014157:Transcription Factors; C054079:carbon dioxide receptor; D002245:Carbon Dioxide