{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T21:21:33Z","timestamp":1782854493635,"version":"3.54.5"},"reference-count":56,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2016,5,5]],"date-time":"2016-05-05T00:00:00Z","timestamp":1462406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Physiology"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec><jats:title>Key points<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Hypoglycaemia is counteracted by release of hormones and an increase in ventilation and CO<jats:sub>2<\/jats:sub> sensitivity to restore blood glucose levels and prevent a fall in blood pH.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>The full counter\u2010regulatory response and an appropriate increase in ventilation is dependent on carotid body stimulation.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>We show that the hypoglycaemia\u2010induced increase in ventilation and CO<jats:sub>2<\/jats:sub> sensitivity is abolished by preventing adrenaline release or blocking its receptors.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Physiological levels of adrenaline mimicked the effect of hypoglycaemia on ventilation and CO<jats:sub>2<\/jats:sub> sensitivity.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>These results suggest that adrenaline, rather than low glucose, is an adequate stimulus for the carotid body\u2010mediated changes in ventilation and CO<jats:sub>2<\/jats:sub> sensitivity during hypoglycaemia to prevent a serious acidosis in poorly controlled diabetes.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Hypoglycaemia <jats:italic>in vivo<\/jats:italic> induces a counter\u2010regulatory response that involves the release of hormones to restore blood glucose levels. Concomitantly, hypoglycaemia evokes a carotid body\u2010mediated hyperpnoea that maintains arterial CO<jats:sub>2<\/jats:sub> levels and prevents respiratory acidosis in the face of increased metabolism. It is unclear whether the carotid body is directly stimulated by low glucose or by a counter\u2010regulatory hormone such as adrenaline. Minute ventilation was recorded during infusion of insulin\u2010induced hypoglycaemia (8\u201317\u00a0mIU\u00a0kg<jats:sup>\u22121<\/jats:sup>\u00a0min<jats:sup>\u22121<\/jats:sup>) in Alfaxan\u2010anaesthetised male Wistar rats. Hypoglycaemia significantly augmented minute ventilation (123\u00a0\u00b1\u00a04 to 143\u00a0\u00b1\u00a07\u00a0ml\u00a0min<jats:sup>\u22121<\/jats:sup>) and CO<jats:sub>2<\/jats:sub> sensitivity (3.3\u00a0\u00b1\u00a00.3 to 4.4\u00a0\u00b1\u00a00.4\u00a0ml\u00a0min<jats:sup>\u22121<\/jats:sup>\u00a0mmHg<jats:sup>\u22121<\/jats:sup>). These effects were abolished by either \u03b2\u2010adrenoreceptor blockade with propranolol or adrenalectomy. In this hypermetabolic, hypoglycaemic state, propranolol stimulated a rise in <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/tjp7231-math-0001.png\" xlink:title=\"urn:x-wiley:00223751:media:tjp7231:tjp7231-math-0001\"\/>, suggestive of a ventilation\u2013metabolism mismatch. Infusion of adrenaline (1\u00a0\u03bcg\u00a0kg<jats:sup>\u22121<\/jats:sup>\u00a0min<jats:sup>\u22121<\/jats:sup>) increased minute ventilation (145\u00a0\u00b1\u00a04 to 173\u00a0\u00b1\u00a05\u00a0ml\u00a0min<jats:sup>\u22121<\/jats:sup>) without altering <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/tjp7231-math-0002.png\" xlink:title=\"urn:x-wiley:00223751:media:tjp7231:tjp7231-math-0002\"\/> or pH and enhanced ventilatory CO<jats:sub>2<\/jats:sub> sensitivity (3.4\u00a0\u00b1\u00a00.4 to 5.1\u00a0\u00b1\u00a00.8\u00a0ml\u00a0min<jats:sup>\u22121<\/jats:sup>\u00a0mmHg<jats:sup>\u22121<\/jats:sup>). These effects were attenuated by either resection of the carotid sinus nerve or propranolol. Physiological concentrations of adrenaline increased the CO<jats:sub>2<\/jats:sub> sensitivity of freshly dissociated carotid body type I cells <jats:italic>in vitro<\/jats:italic>. These findings suggest that adrenaline release can account for the ventilatory hyperpnoea observed during hypoglycaemia by an augmented carotid body and whole body ventilatory CO<jats:sub>2<\/jats:sub> sensitivity.<\/jats:p><\/jats:sec>","DOI":"10.1113\/jp272191","type":"journal-article","created":{"date-parts":[[2016,3,30]],"date-time":"2016-03-30T23:22:01Z","timestamp":1459380121000},"page":"4439-4452","source":"Crossref","is-referenced-by-count":37,"title":["Adrenaline release evokes hyperpnoea and an increase in ventilatory CO<sub>2<\/sub> sensitivity during hypoglycaemia: a role for the carotid body"],"prefix":"10.1113","volume":"594","author":[{"given":"Emma L.","family":"Thompson","sequence":"first","affiliation":[{"name":"Institute of Cardiovascular Sciences, College of Medical and Dental Sciences University of Birmingham  Birmingham B15 2TT UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare 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