Central Respiratory Drive: Molecular Basis and Genetics


Professor of Medicine, Harvard medical school, Chief-Emeritus, pulmonary and critical care unit, Massachusetts general Hospital, Boston, U.S.A


Central respiratory drive is of paramount importance in control of ventilation. The central drive is exquisitely sensitive to
changes in CO2/H+ concentration. New data show that the fast- acting neurotransmitter acetylcholine is essential in the
CO2/H+ ventilatory response as well as in generating the central drive. Ret gene and MASH-1 are essential in
development of the parasympathetic system and thus in the central respiratory drive. Clinical states of hypoventilation
most likely have a genetic defect affecting the cholinergic system.This article will review briefly the site and mechanisms
of action of CO2 centrally, the neurotransmitters involved in the process, the gene(s) involved in the process and clinical
states where there are abnormalities in the system and inevitably hypoventilation results.
(Tanaffos 2002;1(1):9-13 )