Research Opportunities in Autonomic Neural Mechanisms of Cardiopulmonary Regulation: A Report From the National Heart, Lung, and Blood Institute and the National Institutes of Health Office of the Director Workshop

Reena Mehra, Olga A. Tjurmina, Olujimi A. Ajijola, Rishi Arora, Donald C. Bolser, Mark W. Chapleau, Peng Sheng Chen, Colleen E. Clancy, Brian P. Delisle, Michael R. Gold, Jeffrey J. Goldberger, David S. Goldstein, Beth A. Habecker, M. Louis Handoko, Robert Harvey, James P. Hummel, Thomas Hund, Christian Meyer, Susan Redline, Crystal M. RipplingerMarc A. Simon, Virend K. Somers, Stavros Stavrakis, Thomas Taylor-Clark, Bradley Joel Undem, Richard L. Verrier, Irving H. Zucker, George Sopko, Kalyanam Shivkumar

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

This virtual workshop was convened by the National Heart, Lung, and Blood Institute, in partnership with the Office of Strategic Coordination of the Office of the National Institutes of Health Director, and held September 2 to 3, 2020. The intent was to assemble a multidisciplinary group of experts in basic, translational, and clinical research in neuroscience and cardiopulmonary disorders to identify knowledge gaps, guide future research efforts, and foster multidisciplinary collaborations pertaining to autonomic neural mechanisms of cardiopulmonary regulation. The group critically evaluated the current state of knowledge of the roles that the autonomic nervous system plays in regulation of cardiopulmonary function in health and in pathophysiology of arrhythmias, heart failure, sleep and circadian dysfunction, and breathing disorders. Opportunities to leverage the Common Fund's SPARC (Stimulating Peripheral Activity to Relieve Conditions) program were characterized as related to nonpharmacologic neuromodulation and device-based therapies. Common themes discussed include knowledge gaps, research priorities, and approaches to develop novel predictive markers of autonomic dysfunction. Approaches to precisely target neural pathophysiological mechanisms to herald new therapies for arrhythmias, heart failure, sleep and circadian rhythm physiology, and breathing disorders were also detailed.

Original languageEnglish
Pages (from-to)265-293
Number of pages29
JournalJACC: Basic to Translational Science
Volume7
Issue number3
DOIs
StatePublished - Mar 2022

Bibliographical note

Funding Information:
This workshop was supported by the National Heart, Lung, and Blood Institute (NHLBI) and the National Institutes of Health (NIH) Office of the Director. Dr Ajijola is supported by NIH grants DP2 OD024323, OT2 OD028201, and OT2 OD023848, Dr Chen was supported by NIH grants OT2 OD028190, R01 HL139829, and the Burns & Allen Chair in Cardiology Research, Cedars-Sinai Medical Center. Dr Clancy has received research funding from NIH grants OT2 OD026580, OT2 OD026580, R01 HL152681, R01 HL128170, and U01 HL126273, InCarda Therapeutics, and the Department of Physiology and Membrane Biology Research Partnership Fund, Oracle cloud for research allocation. Dr Delisle is supported by NIH grants R01 HL153042, R01 HL141343, and the American Heart Association grant 20IPA35320141. Dr Habecker was supported by NIH grants R01 HL093056 and R01 HL146822. Dr Handoko has received an educational grant from Novartis and Boehringer Ingelheim. Dr Redline has received research funding from NIH grants R35 HL135818, R01 HL133684, U10 HD036801, R01 HL137234, R01 DK118736, R01 AG056331, and U24 HL140412, and Jazz Pharmaceuticals. Dr Ripplinger is supported in part by research funding from NIH grants OT2 OD026580, R01 HL093056, and R01 HL111600. Dr Somers is supported by NIH grants R01 HL065176 and R01 HL134885. Dr Stavrakis was supported by NIH grant R21 AG057879. Dr Taylor-Clark is supported by NIH grants R01 HL152219, U01 NS113868, OT2 OD023854, R21 DK124894, R01 DK110366, and U01 DK110366. Dr Undem is supported by NIH grant R35 HL155671. Dr Zucker has received support from Sorrento Therapeutics, Inc. and from NIH grant R01 HL126796. Dr Shivkumar is supported by NIH grants OT2 OD028201 and OT2 OD023848. Dr Ajijola is a cofounder and equity holder of NeuCures; has served as a consultant for Merck and Biosense-Webster Inc. Dr Gold has received clinical trial research funding from Boston Scientific and Medtronic; and has been a consultant for Boston Scientific, CVRx. and Medtronic. Dr Habecker is a co-inventor of a technology (intracellular sigma peptide) that Oregon Health and Science University has licensed to NervGen Pharma Corp. Dr Handoko has received research funding from Vifor Pharma; and has been a consultant for Novartis, Boehringer Ingelheim, Vifor Pharma, AstraZeneca, Bayer, MSD, Daiichi Sankyo, and Quin. Dr Hummel has been a scientific advisory board member; and holds equity in Nuvaira, Inc. Dr Redline has received consulting fees from Jazz Pharmaceuticals and Apnimed Inc. Dr Redline has received research funding from Jazz Pharmaceuticals. Dr Somers has served as a consultant for Bayer, Respicardia, Baker Tilly, and Jazz Pharmaceuticals; and has served on the scientific advisory board of the Sleep Number Corporation. Dr Shivkumar is a cofounder and equity holder of NeuCures Inc. Dr Simon is supported in part by NIH grant R01 AG058659, serves on a clinical trial steering committee for Janssen, and has consulted for Acceleron and Bial. Dr Mehra is supported by NIH grants U01HL125177, UH3HL140144 and the American Heart Association AHA 18SFRN34170013. Dr Arora is supported by NIH grants R01 HL140061, R01 HL125881, Technology Development Program, NIH Center for Accelerated Innovations at Cleveland Clinic, the American Heart Association Strategically Focused Research Networks Atrial Fibrillation Center, and has ownership interest in Rhythm Therapeutics, Inc. Dr Handoko is supported by the Dutch Heart Foundation (Senior Clinical Scientist grant 2020T058); has received research funding from Vifor Pharma; and has been a consultant for Novartis, Boehringer Ingelheim, Vifor Pharma, AstraZeneca, Bayer, MSD, Daiichi Sankyo, and Quin. The views expressed in this article are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the U.S. Department of Health and Human Services. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Funding Information:
The authors thank their colleagues Dr. Gene Civillico, Dr. Felicia Qashu, Ms. Kristina Faulk (National Institutes of Health Office of the Director), Dr. Aaron Laposky, Dr. Josh Fessel, and Dr. Michael Twery (National Heart, Lung, and Blood Institute, National Institutes of Health) for assisting with workshop agenda development and planning.

Publisher Copyright:
© 2022 The Authors

Keywords

  • asthma
  • atrial fibrillation
  • autonomic nervous system
  • cardiopulmonary
  • chronic obstructive pulmonary disease
  • circadian
  • heart failure
  • pulmonary arterial hypertension
  • sleep apnea
  • ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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