Bibliography - Sympathetic Nervous System

Advances in the role of the Sympathetic Nervous System in cardiovascular medicine

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Functionally specific renal sympathetic nerve fibers: role in cardiovascular regulation

DiBona GF

Summary

The sympathetic nervous system provides differentiated regulation of the functions of various organs.This differentiated regulation occurs through mechanisms that operate at multiple sites within the classic reflex arc: peripherally at the level of afferent input stimuli to various reflex pathways, centrally at the level of interconnections between various central neuron pools, and peripherally at the level of efferent fibers targeted to various effectors within the organ. In the kidney, increased renal sympathetic nerve activity regulates the functions of the intrarenal effectors: the tubules, the blood vessels, and the juxtaglomerular granular cells. This enables a physiologically appropriate coordination between the circulatory, filtration, reabsorptive, excretory, and renin secretory contributions to overall renal function.

Am J Hypertens. 2001;14:163S-170S.

Commentary

This in-depth review deals with the sympathetic innervation of the kidney and its relevance for the regulation of the cardiovascular system.With respect to the renal sympathetic fibers, the following issues are dealt with: anatomic details, neurophysiologic aspects and the pattern of sympathetic nerve activation; nonlinear dynamic analysis of renal sympathetic nerve activity. The renal sympathetic fibers are clearly involved in the physiologically appropriate coordination between the circulatory, filtration, reabsorptive, excretory, and renin secretory contributions to overall renal function.
Renal disease and failure, usually associated with hypertension, is being recognized more and more with sympathetic hyperactivity (see also the review by Augustyniak et al, discussed in the present issue of the SNS Report). The question arises whether it would be useful to counteract sympathetic hyperactivity by means of drugs which cause sympathoinhibition.