Nicotine increases chemoreflex sensitivity to hypoxia in non-smokers

Argacha, Jean-François; Xhaët, Olivier; Gujic, Marko; Adamopoulos, Dionysios; Beloka, Sofia; Dreyfuss, Céline; Degaute, Jean-Paul; Borne, Philippe van de

doi:10.1097/hjh.0b013e3282f2b93c

Cited by 22 publications

(17 citation statements)

References 59 publications

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“…The oscillations result from high ventilatory sensitivity to carbon dioxide (CO 2 ) and hypoxia in the presence of narrowed CO 2 reserve and induce frequent arousals from sleep. Nicotine, NO and carbon monoxide (CO) influence the regulation of breathing 17 18. We speculate that smokers slept better because of less breathing instability through higher nicotine and CO, and lower NO levels.…”

Section: Discussionmentioning

confidence: 99%

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Smoking, acute mountain sickness and altitude acclimatisation: a cohort study

Ding²,

Liu³

et al. 2012

Thorax

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RationaleThe relationship between cigarette smoking and acute mountain sickness (AMS) is not clear. Objective To assess AMS risk and altitude acclimatisation in relation to smoking. Methods 200 healthy non-smokers and 182 cigarette smokers were recruited from Han lowland workers. These were men without prior altitude exposure, matched for age, health status and occupation, who were transported to an altitude of 4525 masl. Measurements AMS, smoking habits, arterial saturation (SpO 2 ), haemoglobin (Hb), lung function and mean pulmonary artery pressure (PAPm) were assessed upon arrival and after 3 and 6 months. Main results Compared with non-smokers, smokers had a lower incidence of AMS and lower AMS scores than non-smokers upon arrival; higher Hb and PAPm associated with lower SpO 2 at 3 and 6 months at altitude; and lower forced expiratory volume in 1 s and maximal voluntary ventilation at 3 and 6 months. Conclusions Smoking slightly decreases the risk of AMS but impairs long-term altitude acclimatisation and lung function during a prolonged stay at high altitude.

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Section: Discussionmentioning

confidence: 99%

“…Chemoreceptor function is modulated by NO and CO 17. Nicotine increases peripheral chemoreflex sensitivity to reductions in arterial oxygen content in non-smokers but not in smokers 18. In people who live at altitude all their lives, a decrease in ventilation may eventually develop 23.…”

Section: Discussionmentioning

confidence: 99%

Smoking, acute mountain sickness and altitude acclimatisation: a cohort study

Ding²,

Liu³

et al. 2012

Thorax

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“…This could also be due to more localized effects of baroreflexmediated sympathetic vasoconstriction of arterioles supplying the carotid and aortic bodies. Reduced local blood flow might result in a neural discharge similar to that evoked by asphyxia, anoxemia (2), or nicotine and cyanide (1,7,19). Indeed, McCloskey (20) showed that increased impulse traffic of the carotid sinus nerve is easily elicited by hypotension-induced reductions in carotid body blood flow.…”

Section: Increased Pcs and Set Point In Potsmentioning

confidence: 95%

Baroreceptor unloading in postural tachycardia syndrome augments peripheral chemoreceptor sensitivity and decreases central chemoreceptor sensitivity

Taneja¹,

Medow

Clarke³

et al. 2011

American Journal of Physiology-Heart and Circulatory Physiology

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While orthostatic tachycardia is the hallmark of postural tachycardia syndrome (POTS), orthostasis also initiates increased minute ventilation (Ve) and decreased end-tidal CO(2) in many patients. We hypothesized that chemoreflex sensitivity would be increased in patients with POTS. We therefore measured chemoreceptor sensitivity in 20 POTS (16 women and 4 men) and 14 healthy controls (10 women and 4 men), 16-35 yr old by exposing them to eucapneic hyperoxia (30% O(2)), eucapneic hypoxia (10% O(2)), and hypercapnic hyperoxia (30% O(2) + 5% CO(2)) while supine and during 70° head-upright tilt. Heart rate, mean arterial pressure, O(2) saturation, end-tidal CO(2), and Ve were measured. Peripheral chemoreflex sensitivity was calculated as the difference in Ve during hypoxia compared with room air divided by the change in O(2) saturation. Central chemoreflex sensitivity was determined by the difference in Ve during hypercapnia divided by the change in CO(2). POTS subjects had an increased peripheral chemoreflex sensitivity (in l·min(-1)·%oxygen(-1)) in response to hypoxia (0.42 ± 0.38 vs. 0.19 ± 0.17) but a decreased central chemoreflex sensitivity (l·min(-1)·Torr(-1)) CO(2) response (0.49 ± 0.38 vs. 1.04 ± 0.18) compared with controls. CO(2) sensitivity was also reduced in POTS subjects when supine. POTS patients are markedly sensitized to hypoxia when upright but desensitized to CO(2) while upright or supine. The interactions between orthostatic baroreflex unloading and altered chemoreflex sensitivities may explain the hyperventilation in POTS patients.

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“…One earlier study by Kawakami et al [26] in smokers (SM) and their non-smoking (NSM) homozygote twins failed to demonstrate a smoking-related HVR attenuation after a 3-h-abstinence which is insufficient to eliminate nicotine with an in-vivo half-life of 2 h, as already speculated by these authors themselves. In fact, subsequent studies, including one from the same group, have shown an acute HVR-increase through smoking in both, SM and NSM probably mediated through carotid chemoreceptors [27–30] which might have masked a possible HVR attenuation in the elegant study by Kawakami et al [26] in twins.…”

Section: Introductionmentioning

confidence: 99%

Lower hypoxic ventilatory response in smokers compared to non-smokers during abstinence from cigarettes

Hildebrandt

Sauer

Koehler³

et al. 2016

BMC Pulm Med

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BackgroundCarotid body O2-chemosensitivity determines the hypoxic ventilatory response (HVR) as part of crucial regulatory reflex within oxygen homeostasis. Nicotine has been suggested to attenuate HVR in neonates of smoking mothers. However, whether smoking affects HVR in adulthood has remained unclear and probably blurred by acute ventilatory stimulation through cigarette smoke. We hypothesized that HVR is substantially reduced in smokers when studied after an overnight abstinence from cigarettes i.e. after nicotine elimination.MethodsWe therefore determined the isocapnic HVR of 23 healthy male smokers (age 33.9 ± 2.0 years, BMI 24.2 ± 0.5 kg m−2, mean ± SEM) with a smoking history of >8 years after 12 h of abstinence and compared it to that of 23 healthy male non-smokers matched for age and BMI.ResultsSmokers and non-smokers were comparable with regard to factors known to affect isocapnic HVR such as plasma levels of glucose and thiols as well as intracellular levels of glutathione in blood mononuclear cells. As a new finding, abstinent smokers had a significantly lower isocapnic HVR (0.024 ± 0.002 vs. 0.037 ± 0.003 l min−1 %−1BMI−1, P = 0.002) compared to non-smokers. However, upon re-exposure to cigarettes the smokers’ HVR increased immediately to the non-smokers’ level.ConclusionsThis is the first report of a substantial HVR reduction in abstinent adult smokers which appears to be masked by daily smoking routine and may therefore have been previously overlooked. A low HVR may be suggested as a novel link between smoking and aggravated hypoxemia during sleep especially in relevant clinical conditions such as COPD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-016-0323-0) contains supplementary material, which is available to authorized users.

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Nicotine increases chemoreflex sensitivity to hypoxia in non-smokers

Abstract: This is the first study to demonstrate that nicotine increases peripheral chemoreflex sensitivity to large reductions in arterial oxygen content in healthy non-smokers.

Cited by 22 publications

References 59 publications

Smoking, acute mountain sickness and altitude acclimatisation: a cohort study

Smoking, acute mountain sickness and altitude acclimatisation: a cohort study

Baroreceptor unloading in postural tachycardia syndrome augments peripheral chemoreceptor sensitivity and decreases central chemoreceptor sensitivity

Lower hypoxic ventilatory response in smokers compared to non-smokers during abstinence from cigarettes

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