Felippe, Igor S.A., Babbage, Thalia L., Shaheen, Rajaa, Bassetto, Marcella, Fan, Jui Lin, Pauza, Audrys, Gold, Olivia, Thakkar, Pratik, Dawes, Matthew, Bates, Melissa L., McBryde, Fiona, Fountain, Samuel J.
ORCID: https://orcid.org/0000-0002-6028-0548, Fisher, James P. and Paton, Julian F.R.
(2026)
Vitamin B6 (Pyridoxal 5′ Phosphate) antagonises carotid body P2X3 receptors in hypertension.
Cardiovascular Research, 122 (2).
pp. 285-296.
ISSN 0008-6363
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Abstract
Aims: ATP acting on P2X3 receptors (P2X3R) within carotid bodies (CBs) underpins chemoreflex-mediated sympathetic overactivity in spontaneously hypertensive rats (SHR). Pyridoxal 5′ phosphate (PLP), the active form of vitamin B6, has been reported to act as a non-selective P2X receptor blocker. Hence, we hypothesised that PLP antagonism of P2X3R in the CB would treat hypertension. Methods and results: Herein, we employed a multipronged approach to investigate PLP’s capability to attenuate CB hyperexcitability in hypertension. First, PLP inhibited Ca2+ responses evoked by α, β-methylene ATP in cell lines expressing human (h) P2X3R with an IC50 of 8.7 µM. Next, in-silico data predicted that PLP binds to the same site of Gefapixant, supporting an allosteric antagonism. Using an isolated perfused carotid artery bifurcation-CB preparation, arterial infusion of PLP (50 µM; 15 min) attenuated CBs sensory firing in SHR (P = 0.012). Using the in situ working-heart brainstem preparation, carotid artery injections of PLP (1–5 mM) attenuated the chemoreflex-evoked sympathetic (P = 0.023) but not phrenic (P = 0.62) responses; the CB was stimulated with potassium cyanide (KCN,50 µL; 0.04%). In awake telemetered SHR (n = 6), intravenous infusion of PLP (48 mg/Kg/h; 30 min) attenuated KCN-evoked chemoreflex responses and reduced systolic, diastolic, and mean blood pressures (ΔMBP = −15.6 mmHg; P = 0.025). Translating our results, we performed a small double-blind, randomised clinical trial. In volunteers with hypertension (n = 14), oral supplementation with pyridoxine hydrochloride (600 mg) attenuated the hypoxic ventilatory response only in patients with high peripheral chemoreflex sensitivity (P = 0.021). Conclusion: Our findings suggest that PLP binds to and antagonises P2X3R and is a viable candidate for larger clinical trials to treat CB dysregulation in cardiovascular diseases.
| Item Type: | Article |
|---|---|
| Additional Information: | Data availability: The authors declare that all supporting data have been made publicly available at Figshare and can be accessed using DOI (http://dx.doi.org/10.17608/k6.auckland.28191725). Raw data is available from the corresponding author upon reasonable request. |
| Uncontrolled Keywords: | carotid body,chemoreflex,hypertension,p2x3 receptors,pyridoxal 5′ phosphate,vitamin b6,physiology,cardiology and cardiovascular medicine,physiology (medical),sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/1300/1314 |
| Faculty \ School: | Faculty of Science > School of Biological Sciences |
| UEA Research Groups: | Faculty of Science > Research Groups > Cells and Tissues |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 13 May 2026 15:34 |
| Last Modified: | 18 Jun 2026 20:59 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/103009 |
| DOI: | 10.1093/cvr/cvaf195 |
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