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. Author manuscript; available in PMC: 2024 Jun 1.
Published in final edited form as: Hypertension. 2023 Apr 24;80(6):1297–1310. doi: 10.1161/HYPERTENSIONAHA.122.20782

Figure 6. Hypothetical scheme showing remodeling of thoracic spinal cord characterized by neuroinflammation and apoptosis leading to sympathoexcitation in PH.

Figure 6.

Afferent signaling from cardiopulmonary neurons through DRG to the dorsal horn of thoracic spinal cord mediated via TRPV1 and SP results in transcriptomic remodeling characterized by neuroinflammation (microglial activation+astrogliosis) and apoptosis. We postulate that neuroinflammation and apoptosis lead to increased sympathoexcitation via efferent pathways resulting in worsening PH, RVF, arrhythmias and death. Inhibition of microglial activation by minocycline attenuates neuroinflammation and associated sympathoexcitation resulting in rescue of PH and RVF.