Mechanisms underpinning peripheral chemoreceptor modulation of hypertension

On its activation, the carotid body (CB) provides one of the greatest stimulants to raise cardiovascular sympathetic activity. Through proof of principle studies the CB has been shown to be a major driver of the heightened sympathetic activity associated with several cardiometabolic diseases. Understanding the mechanisms of hypoxia and cellular transduction as well as inter-cellular signalling within the CB becomes crucial for identification of novel interventions to quench CB hyperactivity in disease. In this review, we summarise the mechanisms of hypoxia but also emphasise that the CB is more than an oxygen sensor which is acutely tuned to the regulation of both oxygen and glucose with feedback from blood-borne hormones regulating metabolism. This feature opens new druggable targets to restrain CB activity as well as the possibility to consider this organ as a nodal point for regulating autonomic dysfunction underpinning the metabolic syndrome.