Physiological reviewsPub Date : 2026-07-01Epub Date: 2026-01-07DOI: 10.1152/physrev.00015.2025
Steven A Shea, Frank A J L Scheer, Michelle L Gumz, Sophia A Eikenberry, Jingyi Qian, Saurabh S Thosar, Michael J Sole, Tami A Martino
{"title":"Unlocking the potential of circadian biology for cardiovascular health.","authors":"Steven A Shea, Frank A J L Scheer, Michelle L Gumz, Sophia A Eikenberry, Jingyi Qian, Saurabh S Thosar, Michael J Sole, Tami A Martino","doi":"10.1152/physrev.00015.2025","DOIUrl":"10.1152/physrev.00015.2025","url":null,"abstract":"<p><p>Circadian rhythms, governed by the body's endogenous clock mechanism, regulate daily fluctuations in cardiovascular function, optimizing physiological processes like blood pressure regulation, cardiac metabolism, and myocardial repair. Rhythms also align cardiovascular reactivity with predictable environmental and behavioral cycles, enabling normal function and affecting disease susceptibility. Major adverse cardiovascular events, including myocardial infarction, ventricular arrhythmias, and stroke, exhibit a distinct morning peak, with evidence for circadian regulation in cardiovascular health. Indeed, controlled human laboratory studies demonstrate that beyond the influences of sleep and other behaviors, endogenous circadian rhythms independently regulate blood pressure, autonomic nervous system activity, blood clotting, vascular tone, and metabolic function. Additionally, the kidney plays a critical role in circadian sodium handling, fluid balance, and blood pressure control, with disruptions in renal circadian rhythms contributing to hypertension and progression to heart failure. Chronic circadian misalignment resulting from shift work, irregular sleep-wake cycles, or misaligned lifestyle habits is strongly associated with increased cardiovascular risk and disease progression. The emerging field of Circadian Medicine applies circadian principles to clinical care, leveraging interventions such as optimizing light exposure, meal timing, and physical activity to restore biological alignment. Chronotherapy, the strategic timing of medications or procedures to align with a patient's diurnal or circadian rhythms, offers further potential for enhancing treatments and reducing adverse effects. By integrating circadian biology into cardiovascular medicine, novel strategies are emerging to help prevent disease, improve patient outcomes, and enhance therapeutic precision. Understanding the interplay between circadian regulation and cardiovascular physiology provides a foundation for advancing cardiovascular prevention and treatment strategies.</p>","PeriodicalId":20193,"journal":{"name":"Physiological reviews","volume":" ","pages":"1195-1262"},"PeriodicalIF":28.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12882775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Physiological reviewsPub Date : 2026-07-01Epub Date: 2026-02-03DOI: 10.1152/physrev.00001.2025
Ole Jensen, Mathilde Bonnefond
{"title":"The alpha rhythm: from physiology to behavior.","authors":"Ole Jensen, Mathilde Bonnefond","doi":"10.1152/physrev.00001.2025","DOIUrl":"10.1152/physrev.00001.2025","url":null,"abstract":"<p><p>The alpha rhythm, first identified by Hans Berger 100 years ago, is the dominant noninvasive electrophysiological signature of the healthy human brain in the awake state. For decades, it was believed that the alpha rhythm reflected rest or idling; however, this perspective changed in the 2000s when researchers found that alpha oscillations increase with cognitive demands. This discovery led to a paradigm shift, demonstrating that alpha oscillations reflect the functional inhibition of brain regions that are not needed for a specific task, thereby directing information to task-specific areas. We have reviewed the physiological mechanisms involved in generating alpha oscillations, which have informed computational models explaining how these oscillations emerge within physiologically realistic networks. At the behavioral level, alpha oscillations are strongly modulated across nearly all cognitive paradigms tested in humans, reflecting the allocation of computational resources within the active brain network. Research in individuals with attention-related issues has highlighted their impaired ability to modulate alpha oscillations, which is associated with performance deficits. Therefore, further exploration of alpha oscillations has the potential to uncover causal mechanisms underlying attention problems, such as those related to attention deficit hyperactivity disorder (ADHD) and aging. Finally, advancements in technology are opening new avenues for characterizing alpha oscillations in ecologically valid settings and across the lifespan. This progress sets the stage for exploring the role of alpha oscillations in cognitive development and their functioning in natural environments.</p>","PeriodicalId":20193,"journal":{"name":"Physiological reviews","volume":" ","pages":"1123-1159"},"PeriodicalIF":28.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7618721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Physiological reviewsPub Date : 2026-07-01Epub Date: 2026-03-06DOI: 10.1152/physrev.00023.2025
Arthur M Butt, Jianqin Niu, Chenju Yi, Alexei Verkhratsky
{"title":"Physiology of oligodendroglia.","authors":"Arthur M Butt, Jianqin Niu, Chenju Yi, Alexei Verkhratsky","doi":"10.1152/physrev.00023.2025","DOIUrl":"10.1152/physrev.00023.2025","url":null,"abstract":"<p><p>Oligodendrocytes are highly specialized neural cells that produce myelin, essential for rapid electrical conduction of neural signals in the central nervous system (CNS). The emergence of oligodendrocytes and myelin was a critical step in the evolution of vertebrates, fundamental for the development of the mammalian connectome, and indispensable for miniaturization and enhanced computing power of the brain. The advance in cognitive capacity is paralleled by increasing eminence of white matter, composed of interconnected bundles of myelinated axons; white matter volume increases from 6% of the brain in shrews, considered related to the most primitive mammals, up to 50% in <i>Homo sapiens</i>. Myelinating oligodendrocytes together with smaller populations of oligodendrocyte precursor cells (OPCs) and satellite or perineuronal oligodendrocytes account for more than half of the glial cells in the human brain. Together, these three cell types make up the oligodendroglial cell lineage that express common lineage-specific proteins and transcription factors and display a degree of molecular and functional diversity. OPCs are the most numerous oligodendroglial cells during developmental axonal myelination, which extends postnatally for many years in humans. The generation of myelinating oligodendrocytes from OPCs throughout life continues to be important for adaptive plasticity of neural circuits and myelination of new axons required for learning. Myelination decreases in the aging brain and correlates with natural or physiological age-related cognitive decline. Like all neural cells, oligodendroglia express a wide assortment of ion channels, transporters, and neurotransmitter receptors that are essential for maintaining neuronal signaling, principally myelination, axonal metabolic support, and homeostatic regulation of the periaxonal microenvironment. Notably, OPCs are unique among neuroglia in that, like neurons, they are electrically excitable and form synapses with neurons. Oligodendroglial cells also contribute to neuroplasticity through multiple mechanisms including axon guidance, synapse formation, and adaptive myelination. In short, oligodendroglia are essential for normal CNS integrity, cognitive function, and behavior.</p>","PeriodicalId":20193,"journal":{"name":"Physiological reviews","volume":" ","pages":"1837-1911"},"PeriodicalIF":28.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Physiological reviewsPub Date : 2026-07-01Epub Date: 2026-03-12DOI: 10.1152/physrev.00019.2025
Emma Nolan, Leanne Li, Evangelos Giampazolias, Luigi Ombrato, Ilaria Malanchi
{"title":"The lethal symbiont: exploring the pathophysiology of cancer.","authors":"Emma Nolan, Leanne Li, Evangelos Giampazolias, Luigi Ombrato, Ilaria Malanchi","doi":"10.1152/physrev.00019.2025","DOIUrl":"10.1152/physrev.00019.2025","url":null,"abstract":"<p><p>From its early genesis, cancer is integrated with the surrounding tissue. Its very existence depends on surrounding normal tissue cells engaging with cancer cells to create an alternative tissue environment. This emerging abnormal structure becomes connected with the host organism via blood, lymphatic vessels, and neural connections. Through those connections, the cancer mass communicates and perturbs the entire organism altering various aspects of the steady-state body physiology. At early, asymptomatic stages, the induced changes within distant organs that harbor the potential to facilitate the spread of cancer are termed \"premetastatic niche.\" Many processes involved with premetastatic changes hijack processes typical in other contexts such as development, injury, or infections, but their co-occurrence creates a new alternative physiology. The cancer to body connections not only have important consequences for the efficacy of cancer therapy but also enable cancer to evolve and adapt under the very pressure of those treatments. Furthermore, as cancer-induced changes are closely related to other physiological challenges, extrinsic perturbations such as diet, injury, and other inflammatory events have a strong impact on the tumor disease. As the disease progresses, the complex intersection of inflammatory, metabolic, and regenerative changes creates an escalating cascade of events causing cancer-related syndrome, such as cachexia, that threatens the homeostasis of the entire body and can, per se, be deadly. In this article, we will review the recent advances in the understanding of cancer as a systemic malady.</p>","PeriodicalId":20193,"journal":{"name":"Physiological reviews","volume":" ","pages":"1623-1680"},"PeriodicalIF":28.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Physiological reviewsPub Date : 2026-07-01Epub Date: 2026-02-24DOI: 10.1152/physrev.00033.2025
Margarita Divenko, Jason C Mills
{"title":"Stomach at the crossroads: nuclear receptor signaling at the interface between what we are and what we eat.","authors":"Margarita Divenko, Jason C Mills","doi":"10.1152/physrev.00033.2025","DOIUrl":"10.1152/physrev.00033.2025","url":null,"abstract":"<p><p>The stomach is home to numerous nuclear receptor transcription factors (NRs) that can respond to food, toxins, and other ingested agents. Conversely, signals secreted from other organs (e.g., hormones) can engage gastric NRs to modulate gastric physiology. Thus, there is a rich potential interface between external and internal signals that gastric NRs might respond to and interpret. Here, we seek to comprehensively review the role of NRs in gastric homeostasis and disease pathogenesis. NRs are evolutionarily conserved proteins that regulate gene transcription by interpreting hormonal and environmental signals. We explore NR roles in normal stomach development, cell fate determination, and responses to dietary compounds and xenobiotics. The last topic is of particular recent importance <i>1</i>) because NRs stimulated by ingested agents might directly regulate gastric physiology like the relative activity of acid-secreting and stem cells and <i>2</i>) because the stomach is one of the first organs to encounter dietary compounds and pollutants. Additionally, we review the emerging yet understudied field of gastro-endocrinology, exploring how systemic endocrine circuits influence the stomach's function. We also discuss how NRs contribute to pathological conditions like precancerous lesions and cancer. Additionally, we summarize known agonists, antagonists, and coregulatory proteins, highlighting potential therapeutic targets. Understanding NR roles could pave the way for a better understanding of dietary and environmental toxin exposure and also lead to innovative treatments for gastric disorders, including gastritis, gastric intestinal metaplasia, and gastric cancer.</p>","PeriodicalId":20193,"journal":{"name":"Physiological reviews","volume":" ","pages":"1495-1533"},"PeriodicalIF":28.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Transitional Cell States at the Crossroad of Development, Disease, and Repair-Regeneration.","authors":"Xiangyi Ke,Wellington V Cardoso","doi":"10.1152/physrev.00041.2025","DOIUrl":"https://doi.org/10.1152/physrev.00041.2025","url":null,"abstract":"Cells undergoing transitional states have been broadly referred to as plastic intermediates emerging between stable identities in multiple biological contexts. Once regarded as indistinct midpoints on lineage trajectories, these states are now recognized as discrete, biologically meaningful epigenetically permissive states, exquisitely responsive to environmental and stress signals at critical junctures of biological events that confer competence to proceed along their trajectories. These high-plasticity nodes have emerged as central regulators of developmental progression and determinants of disease outcomes, serving as functional bottlenecks in which resolution or persistence dictates normal or maladaptive pathological responses. Recent single-cell and multiomiocs technologies enabled their detection with unprecedented resolution, revealing conserved regulatory themes, including stress-response activation and striking context-dependence shaped by niche cues and tissue architecture. Yet challenges remain in capturing their rapid heterogeneous dynamic in the multiple contexts, and defining their function, in vivo. Here we summarize current concepts on the identification, diversity, role and regulation of these cell states in events from early development to adult homeostasis, repair and diseases. The increasing recognition that transitional states can be productive conduits or pathological traps underscores their relevance in these processes and potential for the identification of therapeutic targets for intervention in disease, cancer and regenerative medicine.","PeriodicalId":20193,"journal":{"name":"Physiological reviews","volume":"136 1","pages":""},"PeriodicalIF":33.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147726319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fadi Khalaf, Stephanie Wojtowicz-Piotrowski, Zachary Ricciuti, Ghazaleh Dadashizadeh, Dalia Barayan, Marc G. Jeschke
{"title":"Endocrine Disruptions in Thermal Injuries: Exploring Immune System Interactions","authors":"Fadi Khalaf, Stephanie Wojtowicz-Piotrowski, Zachary Ricciuti, Ghazaleh Dadashizadeh, Dalia Barayan, Marc G. Jeschke","doi":"10.1152/physrev.00035.2025","DOIUrl":"https://doi.org/10.1152/physrev.00035.2025","url":null,"abstract":"Physiological Reviews, Ahead of Print. <br/>","PeriodicalId":20193,"journal":{"name":"Physiological reviews","volume":"283 1","pages":""},"PeriodicalIF":33.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147666431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nidhi Jalan-Sakrikar, Abid A. Anwar, Ahmad Ali, Navine Nasser-Ghodsi, Antonia Felzen, Robert C. Huebert, Nicholas F. LaRusso, Steven P. O'Hara
{"title":"Cholangiocyte Biology in Primary Sclerosing Cholangitis and Other Cholangiopathies: Pathogenesis, Clinical Insights, and Experimental Tools","authors":"Nidhi Jalan-Sakrikar, Abid A. Anwar, Ahmad Ali, Navine Nasser-Ghodsi, Antonia Felzen, Robert C. Huebert, Nicholas F. LaRusso, Steven P. O'Hara","doi":"10.1152/physrev.00022.2025","DOIUrl":"https://doi.org/10.1152/physrev.00022.2025","url":null,"abstract":"Physiological Reviews, Ahead of Print. <br/>","PeriodicalId":20193,"journal":{"name":"Physiological reviews","volume":"10 1","pages":""},"PeriodicalIF":33.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147666432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shubham Dubey,Junaid Khan,A S Alishlash,Sadis Matalon
{"title":"The Cell with Many Faces: Lung Macrophage Plasticity and Function in Response to Environmental and Pathogenic Insults.","authors":"Shubham Dubey,Junaid Khan,A S Alishlash,Sadis Matalon","doi":"10.1152/physrev.00038.2025","DOIUrl":"https://doi.org/10.1152/physrev.00038.2025","url":null,"abstract":"Alveolar macrophages (AM) are pivotal immune sentinels, essential for maintaining tissue homeostasis and mediating immune responses to inhaled particles and pathogens. They demonstrate remarkable plasticity by transitioning from pro-inflammatory (M1) and anti-inflammatory/reparative (M2) phenotypes in response to local signals. Upon exposure to environmental agents, such as particulate matter, atypical respiratory pathogens opportunistic gram-negative bacteria, or respiratory viruses they undergo dynamic activation that profoundly influences their functional repertoire. Acute or chronic environmental/biological insults disrupt normal AM activities such as phagocytosis, efferocytosis, cytokine production, inciting oxidative stress, inflammasome activation, and in some cases, forms of programmed cell death such as pyroptosis. Although these responses are indispensable for eliminating noxious particles and pathogens, such as Mycoplasma pneumoniae or Klebsiella pneumoniae, Influenza A, or SARS-CoV-2, they can also derail the resolution phase by perpetuating inflammation, driving tissue remodeling and fibrosis, and thereby fueling chronic lung disorders such as chronic obstructive pulmonary disease (COPD), pneumoconiosis, and post-COVID interstitial lung disease. Moreover, environmental and microbial exposures modify AM by altering receptor repertoires, intracellular phenotype by signaling cascades, and crosstalk with epithelial and mesenchymal cells that collectively determine the disease trajectory. Elucidating how diverse environmental agents, together with pathogens such as Mycoplasma pneumoniae, Klebsiella pneumoniae, Influenza A, and SARS-CoV-2, shape AM biology is therefore pivotal for understanding the pathogenesis of COPD, pneumoconiosis, and progressive fibrotic lung disease, and COVID-19 related pulmonary sequelae. This review brings together the current insights into exposure-driven modulation of AM functions, highlighting recent advances and identifying knowledge gaps relevant for therapeutic targeting of exposure-induced and pathogen-mediated lung pathology.","PeriodicalId":20193,"journal":{"name":"Physiological reviews","volume":"9 1","pages":""},"PeriodicalIF":33.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The nonexcitable smooth muscle: Remodeling the smooth muscle ion transport toolkit in disease.","authors":"Martin T Johnson,Mohamed Trebak","doi":"10.1152/physrev.00031.2025","DOIUrl":"https://doi.org/10.1152/physrev.00031.2025","url":null,"abstract":"Smooth muscle is vital to hollow organs such as vessels, airways, bladder, prostate, uterus, and gastrointestinal tract. Its ability to contract and relax is essential for organ function. In vessels, vascular smooth muscle cells-or arterial myocytes-help regulate blood pressure and ensure proper blood flow to tissues. However, during disease such as atherosclerosis, hypertension, and restenosis, these myocytes undergo a major transformation. They shift from a quiescent, contractile state to an active, synthetic one. In this synthetic state, they behave like inflammatory cells: secreting cytokines and signaling molecules, remodeling the surrounding matrix, and becoming migratory and proliferative. This shift is tied to a remodeling of their ion transport repertoire. Here, we build and refine a cohesive model whereby synthetic myocytes adopt a phenotype resembling non-excitable cells. We propose that their ion transport toolkit changes as a coordinated unit, creating a distinct calcium signaling signature that supports their new roles in growth, movement, inflammation and secretion-while sacrificing their contractile features. Focusing mainly on arterial myocytes, we examine how disease-driven changes in ion transport reshape the calcium signaling landscape. This shift moves away from classical excitation-contraction-mediated by L-type calcium channels and ryanodine receptors-and toward channels such as store-operated STIM/Orai and transient receptor potential (TRP) channels, which are activated by growth and vasoactive factors and operate best at hyperpolarized membrane potentials. We also explore the remodeling of ion channels, transporters and pumps within internal organelles and emphasize how understanding these changes could reveal new therapeutic targets for treating disease.","PeriodicalId":20193,"journal":{"name":"Physiological reviews","volume":"16 1","pages":""},"PeriodicalIF":33.6,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147524781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}