In search of autonomic balance: the good, the bad, and the ugly

Abboud FM. In search of autonomic balance: the good, the bad, and the ugly. Am J Physiol Regul Integr Comp Physiol 298: R1449-R1467, 2010. First published March 10, 2010; doi:10.1152/ajpregu.00130.2010.-Walter B. Cannon's research on the sympathetic nervous system and neurochemical transmission was pioneering. Wisdom has endowed our body with a powerful autonomic neural regulation of the circulation that provides optimal perfusion of every organ in accordance to its metabolic needs. Exquisite sensors tuned to an optimal internal environment trigger central and peripheral sympathetic and parasympathetic motor neurons and allow desirable and beneficial adjustments to physiologic needs as well as to acute cardiovascular stresses. This short review, presented as The Walter B. Cannon Memorial Award Lecture for 2009, addresses the mechanisms that disrupt sensory signaling and result in a chronic maladjustment of the autonomic neural output that in many cardiovascular diseases results in excessive increases in the risks of dying. The hopes for any reduction of those risks resides in an understanding of the molecular determinants of neuronal signaling.