{"title":"CaMKII in the Heart: From Homeostasis to Pathology.","authors":"Alicia Mattiazzi, Donald M Bers","doi":"10.1146/annurev-physiol-043024-114759","DOIUrl":"10.1146/annurev-physiol-043024-114759","url":null,"abstract":"<p><p>Calcium (Ca)/calmodulin-dependent protein kinase II (CaMKII) is a signaling molecule with critical roles in diverse cellular functions, particularly in the brain and heart, where it is highly expressed. In the heart, CaMKII regulates key processes such as contractility, pacemaking, and electrical conduction by phosphorylating a broad array of intracellular substrates, including ion channels, Ca-handling proteins, and transcription factors. However, its sensitivity to multiple signaling stimuli-including intracellular Ca, reactive oxygen species, nitric oxide, and glycolytic by-products-has made CaMKII more recognized for its pathological actions, such as promoting arrhythmias, cell death, and inflammatory signaling. In this review, we discuss CaMKII's involvement in less well-characterized physiological processes, along with its established roles in ventricular arrhythmias and cell death.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":"88 1","pages":"99-128"},"PeriodicalIF":20.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155878","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}
Per Kristian Eide, Cesar Luis Vera Quesada, Geir Ringstad
{"title":"Cerebrospinal Fluid-Mediated Brain Clearance: Insights from Human Studies.","authors":"Per Kristian Eide, Cesar Luis Vera Quesada, Geir Ringstad","doi":"10.1146/annurev-physiol-043024-120520","DOIUrl":"10.1146/annurev-physiol-043024-120520","url":null,"abstract":"<p><p>Clearance of waste products from brain metabolism and by-products of brain injury is a fundamental aspect of normal brain function. Impaired clearance may cause accumulation of proteins and other substances that are harmful to the brain. Abnormal protein aggregation due to clearance failure is a hallmark of neurodegenerative and dementia diseases. Cerebral clearance processes rely on multiple mechanisms; in recent years, it has become increasingly evident that brain fluids, primarily by the exchange of cerebrospinal fluid (CSF) and interstitial fluid, are essential for removing cerebral waste products. These fluids are integral to the glymphatic clearance system operating along perivascular pathways and clearance via meningeal lymphatic pathways. Translational human imaging research has bridged observations from animals to humans but also revealed species differences. CSF influx to the brain is enhanced by a compartmentalized subarachnoid space, and solute efflux from brain is highly dependent on CSF efflux, mainly to meningeal lymphatic vessels.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":"88 1","pages":"297-320"},"PeriodicalIF":20.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155835","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}
Annual review of physiologyPub Date : 2026-02-01Epub Date: 2025-12-02DOI: 10.1146/annurev-physiol-022724-105249
Elena Oancea, Ramses R M Nestor
{"title":"Light Out of Sight: Signaling Mechanisms for Nonvisual Opsins.","authors":"Elena Oancea, Ramses R M Nestor","doi":"10.1146/annurev-physiol-022724-105249","DOIUrl":"10.1146/annurev-physiol-022724-105249","url":null,"abstract":"<p><p>Life on earth evolved under daily cycles of sunlight, and all species developed mechanisms for detecting and responding to solar wavelengths reaching the surface of the earth. Early phototransduction studies found that our eyes detect visible wavelengths using light-activated G protein-coupled receptors named opsins. Many years after discovering the mechanisms by which rhodopsin (opsin 2) and the cone opsins (opsin 1) mediate vision, three other members of the opsin family (opsins 3, 4, and 5) were identified and, surprisingly, found to be expressed in the brain and peripheral organs. Named nonvisual opsins (NVOs), these receptors mediate physiological light responses, such as pupillary light reflex and circadian rhythms. NVOs have been the focus of an increasing number of extraocular phototransduction studies, illuminating novel ways in which light modulates human physiology. This review summarizes our current knowledge on signaling mechanisms mediating nonvisual photoreception and their physiological functions.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":"47-71"},"PeriodicalIF":20.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145659953","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}
Annual review of physiologyPub Date : 2026-02-01Epub Date: 2025-09-02DOI: 10.1146/annurev-physiol-050724-022450
Rachel Q Muir, Jiaojiao Xu, Alexandra D Medcalf, Jennifer L Pluznick
{"title":"Novel Advances in Our Understanding of Sex-Dependent Control of Blood Pressure.","authors":"Rachel Q Muir, Jiaojiao Xu, Alexandra D Medcalf, Jennifer L Pluznick","doi":"10.1146/annurev-physiol-050724-022450","DOIUrl":"10.1146/annurev-physiol-050724-022450","url":null,"abstract":"<p><p>Sex differences in blood pressure are evident from puberty through menopause, with premenopausal females exhibiting lower blood pressure than males. This review discusses key factors contributing to sex differences in blood pressure, focusing on the normotensive state. Key contributions from a number of systems are discussed, including cardiovascular and renal function, oxidative stress, immune cell involvement, the microbiome, and the roles of the nervous system and renin-angiotensin-aldosterone system. Additionally, we highlight novel advances in the field, including findings related to the G protein-coupled estrogen receptor (GPER), Klotho, olfactory receptor 558 (OLFR558), and the four-core genotype (FCG) model. Insights from clinical data and their implications for hypertension management are also considered. In sum, this review aims to integrate current knowledge on sex differences in blood pressure regulation to inform future research and clinical care.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":"321-343"},"PeriodicalIF":20.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12599063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940269","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}
Annual review of physiologyPub Date : 2026-02-01Epub Date: 2025-11-21DOI: 10.1146/annurev-physiol-040125-112145
Lorenzo Fabrizi, Maria Fitzgerald
{"title":"The Representation of Nociception and Pain in the Developing Brain.","authors":"Lorenzo Fabrizi, Maria Fitzgerald","doi":"10.1146/annurev-physiol-040125-112145","DOIUrl":"10.1146/annurev-physiol-040125-112145","url":null,"abstract":"<p><p>Pain is a fundamental human experience, but how does it begin? Noxious stimuli elicit strong behavioral and physiological responses, even in the youngest newborns, reflecting early subcortical engagement, but the actual experience of pain requires higher cortical processes. This review summarizes current knowledge on how pain associated with tissue injury is represented in the newborn brain. It explores the nature of nociceptive input to the infant brain, the role of immature cortical networks in interpreting this input, and the influence of biological and external factors on these mechanisms. We outline current methods for recording infant brain activity during clinical tissue-damaging procedures, review collected data, and address common misconceptions in the field. We also discuss the differential maturation of sensory, emotional, and cognitive brain systems involved in pain, and propose a model of how the representation of pain evolves as the underlying neural networks develop.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":"251-271"},"PeriodicalIF":20.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145572762","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}
Annual review of physiologyPub Date : 2026-02-01Epub Date: 2025-09-17DOI: 10.1146/annurev-physiol-051524-094728
Savanna N Weninger, Andrew Manley, Frank A Duca
{"title":"Managing Glucose Homeostasis Through the Gut Microbiome.","authors":"Savanna N Weninger, Andrew Manley, Frank A Duca","doi":"10.1146/annurev-physiol-051524-094728","DOIUrl":"10.1146/annurev-physiol-051524-094728","url":null,"abstract":"<p><p>The gut microbiota is a salient contributor to the development of type 2 diabetes mellitus (T2D) as a vast and complex metabolic cross talk that exists between the bacteria residing in the gastrointestinal tract and the host. This cross talk is largely influenced by external factors including diet, highlighting a potential avenue to effectively manipulate the gut microbiota to treat metabolic diseases such as diabetes. In this review, we discuss the influence of the gut microbiota on T2D development and targeting gut microbiota in both current and novel treatments for T2D, highlighting potential alternative therapies including fecal microbiota transplant, prebiotics, probiotics, synbiotics, or xenobiotics. A better understanding of both the impact of the gut microbiota in the etiology of diabetes and the therapeutic potential for manipulating the gut microbiota in metabolic disease could usher in a new approach to targeted treatment options to ameliorate T2D.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":"459-486"},"PeriodicalIF":20.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079461","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}
Annual review of physiologyPub Date : 2026-02-01Epub Date: 2025-11-04DOI: 10.1146/annurev-physiol-052824-084232
Vlad Serbulea, James M Martin, Gary K Owens
{"title":"Role of Diverse Smooth Muscle Cell Phenotypic Transitions in Atherosclerosis Development and Late-Stage Pathogenesis.","authors":"Vlad Serbulea, James M Martin, Gary K Owens","doi":"10.1146/annurev-physiol-052824-084232","DOIUrl":"10.1146/annurev-physiol-052824-084232","url":null,"abstract":"<p><p>Major adverse cardiovascular events resulting from atherosclerotic plaque instability account for a plurality of deaths worldwide despite the use of highly effective lipid-lowering therapies. Over the last three decades, the role of inflammation in atherogenesis has been tested extensively. Although preclinical studies demonstrate a clear role for inflammation in atherogenesis, clinical studies using global anti-inflammatory therapies have not been as successful as hoped, encouraging the search for new therapeutic strategies. Thanks to the advent of cell-specific lineage tracing, we have begun to appreciate the multifaceted role of smooth muscle cell phenotypic switching in modulating plaque stability. Here, we review the mechanisms controlling smooth muscle cell phenotypic switching during early and late-stage pathogenesis, which may inspire future therapies to stabilize plaques.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":"345-370"},"PeriodicalIF":20.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145443653","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}
Annual review of physiologyPub Date : 2025-02-01Epub Date: 2025-02-03DOI: 10.1146/annurev-physiol-022724-104938
Charlotte E R Smith, Haibo Ni, Eleonora Grandi
{"title":"Sex Differences in Electrophysiology and Calcium Handling in Atrial Health and Fibrillation.","authors":"Charlotte E R Smith, Haibo Ni, Eleonora Grandi","doi":"10.1146/annurev-physiol-022724-104938","DOIUrl":"10.1146/annurev-physiol-022724-104938","url":null,"abstract":"<p><p>The importance of biological sex on disease etiology and outcomes has long been underinvestigated. While recent focus on characterizing sex differences in cardiac pathophysiology has led to improved inclusion of both sexes in scientific studies and clinical trials, much is still unknown about underlying differences in normal cardiac physiology. This is particularly true for the atria, where the most common arrhythmia, atrial fibrillation (AF), occurs. AF is associated with adverse structural, electrophysiological, and calcium handling remodeling that leads to patient morbidity and mortality. Differences in the onset, prevalence, presentation, and prognosis of AF are known to differ between males and females, yet the sex-specific baseline phenotypes from which AF arises are not well characterized. This review examines what is currently known about sex differences in atrial physiology, the alterations that occur in AF, potential mechanisms underlying sex divergence, and the need for sex-targeted therapeutic strategies.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":"1-24"},"PeriodicalIF":19.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493562","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}
Annual review of physiologyPub Date : 2025-02-01Epub Date: 2025-02-03DOI: 10.1146/annurev-physiol-042022-014322
Dawn L DeMeo
{"title":"Sex, Gender, and COPD.","authors":"Dawn L DeMeo","doi":"10.1146/annurev-physiol-042022-014322","DOIUrl":"10.1146/annurev-physiol-042022-014322","url":null,"abstract":"<p><p>Sex and gender have emerged as critical considerations relevant to chronic obstructive pulmonary disease (COPD). Sex differences in lung development and physiologic response to hormones and environmental exposures influence COPD susceptibility, progression, severity, morbidity, and mortality. Gender has been poorly measured in the context of COPD, and gendered exposures further impact biology. The hormonal milieu is critical to study across the life course. Differences in immunity and inflammation likely impact sex- and gender-related features of COPD. Emerging evidence from multiple types of omics data is revealing new genes and pathways to consider as relevant to sex- and gender-divergent features of COPD. Much research to date has focused on autosomes, but the growing awareness of a role for allosomes is highlighting knowledge gaps. Reproductive aging impacts lung function and requires more investigation. Network medicine holds promise as an approach to sex and gender omics to uncover drivers of COPD in men and women.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":"471-490"},"PeriodicalIF":19.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715161","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}
Annual review of physiologyPub Date : 2025-02-01Epub Date: 2025-02-03DOI: 10.1146/annurev-physiol-022724-105119
Virgilio L Lew
{"title":"The Calcium Homeostasis of Human Red Blood Cells in Health and Disease: Interactions of PIEZO1, the Plasma Membrane Calcium Pump, and Gardos Channels.","authors":"Virgilio L Lew","doi":"10.1146/annurev-physiol-022724-105119","DOIUrl":"10.1146/annurev-physiol-022724-105119","url":null,"abstract":"<p><p>Calcium ions mediate the volume homeostasis of human red blood cells (RBCs) in the circulation. The mechanism by which calcium ions affect RBC hydration states always follows the same sequence. Deformation of RBCs traversing capillaries briefly activates mechanosensitive PIEZO1 channels, allowing Ca2+ influx down its steep inward gradient transiently overcoming the calcium pump and elevating [Ca2+]<sub>i</sub>. Elevated [Ca2+]<sub>i</sub> activates the Ca2+-sensitive Gardos channels, inducing KCl loss and cell dehydration, a sequence operated with infinite variations in vivo and under experimental conditions. The selected health and disease themes for this review focus on landmark experimental results that led to the development of highly constrained models of the circulatory changes in RBC homeostasis. Based on model predictions, a new perspective emerged, pointing to PIEZO1 dysfunction as the main trigger in the formation of the profoundly dehydrated irreversible sickle cells, the main pathogenic participants in vaso-occlusion, the root cause of sickle cell disease.</p>","PeriodicalId":8196,"journal":{"name":"Annual review of physiology","volume":" ","pages":"257-277"},"PeriodicalIF":19.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543329","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}