Oxygen sensing and stem cell activation in the hypoxic carotid body

The carotid body (CB) is the major arterial chemoreceptor responsible for the detection of acute decreases in O₂ tension (hypoxia) in arterial blood that trigger hyperventilation and sympathetic activation. The CB contains O₂-sensitive glomus (chief) cells, which respond to hypoxia with the release of transmitters to activate sensory nerve fibers impinging upon the brain respiratory and autonomic centers. During exposure to sustained hypoxia (for weeks or months), the CB grows several-fold in size, a response associated with acclimatization to high altitude or to medical conditions presenting hypoxemia. Here, I briefly present recent advances on the mechanisms underlying glomus cell sensitivity to hypoxia, in particular the role of mitochondrial complex I in acute oxygen sensing. I also summarize the properties of adult CB stem cells and of glomus cell-stem cell synapses, which contribute to CB hypertrophy in chronic hypoxia. A note on the relationship between hypoxic CB growth and tumorigenesis is included. Finally, the medical implications of CB pathophysiology are discussed.