HOME

TheInfoList



OR:

A chemoreceptor, also known as chemosensor, is a specialized
sensory receptor Sensory neurons, also known as afferent neurons, are neurons in the nervous system, that convert a specific type of stimulus, via their receptors, into action potentials or graded potentials. This process is called sensory transduction. The ...
which transduces a
chemical substance A chemical substance is a form of matter having constant chemical composition and characteristic properties. Some references add that chemical substance cannot be separated into its constituent elements by physical separation methods, i.e., wit ...
(
endogenous Endogenous substances and processes are those that originate from within a living system such as an organism, tissue, or cell. In contrast, exogenous substances and processes are those that originate from outside of an organism. For example, ...
or induced) to generate a biological signal. This signal may be in the form of an
action potential An action potential occurs when the membrane potential of a specific cell location rapidly rises and falls. This depolarization then causes adjacent locations to similarly depolarize. Action potentials occur in several types of animal cells ...
, if the chemoreceptor is a
neuron A neuron, neurone, or nerve cell is an electrically excitable cell that communicates with other cells via specialized connections called synapses. The neuron is the main component of nervous tissue in all animals except sponges and placozoa ...
, or in the form of a
neurotransmitter A neurotransmitter is a signaling molecule secreted by a neuron to affect another cell across a synapse. The cell receiving the signal, any main body part or target cell, may be another neuron, but could also be a gland or muscle cell. Neu ...
that can activate a
nerve fiber An axon (from Greek ἄξων ''áxōn'', axis), or nerve fiber (or nerve fibre: see spelling differences), is a long, slender projection of a nerve cell, or neuron, in vertebrates, that typically conducts electrical impulses known as action p ...
if the chemoreceptor is a specialized cell, such as
taste receptor A taste receptor or tastant is a type of cellular receptor which facilitates the sensation of taste. When food or other substances enter the mouth, molecules interact with saliva and are bound to taste receptors in the oral cavity and other loc ...
s, or an internal
peripheral chemoreceptor Peripheral chemoreceptors (of the carotid and aortic bodies) are so named because they are sensory extensions of the peripheral nervous system into blood vessels where they detect changes in chemical concentrations. As transducers of patterns of v ...
, such as the carotid bodies. In
physiology Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemic ...
, a chemoreceptor detects changes in the normal environment, such as an increase in blood levels of
carbon dioxide Carbon dioxide ( chemical formula ) is a chemical compound made up of molecules that each have one carbon atom covalently double bonded to two oxygen atoms. It is found in the gas state at room temperature. In the air, carbon dioxide is t ...
(hypercapnia) or a decrease in blood levels of
oxygen Oxygen is the chemical element with the symbol O and atomic number 8. It is a member of the chalcogen group in the periodic table, a highly reactive nonmetal, and an oxidizing agent that readily forms oxides with most elements ...
(hypoxia), and transmits that information to the
central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all p ...
which engages body responses to restore
homeostasis In biology, homeostasis ( British also homoeostasis) (/hɒmɪə(ʊ)ˈsteɪsɪs/) is the state of steady internal, physical, and chemical conditions maintained by living systems. This is the condition of optimal functioning for the organism and ...
. In
bacteria Bacteria (; singular: bacterium) are ubiquitous, mostly free-living organisms often consisting of one biological cell. They constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria were am ...
, chemoreceptors are essential in the mediation of
chemotaxis Chemotaxis (from '' chemo-'' + '' taxis'') is the movement of an organism or entity in response to a chemical stimulus. Somatic cells, bacteria, and other single-cell or multicellular organisms direct their movements according to certain chemica ...
.


Cellular chemoreceptors


In prokaryotes

Bacteria utilize complex long helical proteins as chemoreceptors, permitting signals to travel long distances across the cell's membrane. Chemoreceptors allow bacteria to react to chemical stimuli in their environment and regulate their movement accordingly. In
archaea Archaea ( ; singular archaeon ) is a domain of single-celled organisms. These microorganisms lack cell nuclei and are therefore prokaryotes. Archaea were initially classified as bacteria, receiving the name archaebacteria (in the Archaeba ...
,
transmembrane receptors Cell surface receptors (membrane receptors, transmembrane receptors) are receptors that are embedded in the plasma membrane of cells. They act in cell signaling by receiving (binding to) extracellular molecules. They are specialized integral m ...
comprise only 57% of chemoreceptors, while in bacteria the percentage rises to 87%. This is an indicator that chemoreceptors play a heightened role in the sensing of
cytosolic The cytosol, also known as cytoplasmic matrix or groundplasm, is one of the liquids found inside cells (intracellular fluid (ICF)). It is separated into compartments by membranes. For example, the mitochondrial matrix separates the mitochondrio ...
signals in archaea.


In eukaryotes

Primary cilia, present in many types of mammalian
cells Cell most often refers to: * Cell (biology), the functional basic unit of life Cell may also refer to: Locations * Monastic cell, a small room, hut, or cave in which a religious recluse lives, alternatively the small precursor of a monastery w ...
, serve as ''cellular antennae''. The motile function of these cilia is lost in favour of their sensory specialization.


Plant chemoreceptors

Plants have various mechanisms to perceive danger in their environment. Plants are able to detect pathogens and microbes through surface level receptor kinases (PRK). Additionally, receptor-like proteins (RLPs) containing ligand binding receptor domains capture
pathogen-associated molecular pattern Pathogen-associated molecular patterns (PAMPs) are small molecular motifs conserved within a class of microbes. They are recognized by toll-like receptors (TLRs) and other pattern recognition receptors (PRRs) in both plants and animals. A vast arra ...
s (PAMPS) and
damage-associated molecular pattern Damage-associated molecular patterns (DAMPs) are molecules within cells that are a component of the innate immune response released from damaged or dying cells due to trauma or an infection by a pathogen. They are also known as danger-associated ...
s (DAMPS) which consequently initiates the plant's innate immunity for a defense response. Plant receptor kinases are also used for growth and hormone induction among other important biochemical processes. These reactions are triggered by a series of
signaling pathway In biology, cell signaling (cell signalling in British English) or cell communication is the ability of a cell to receive, process, and transmit signals with its environment and with itself. Cell signaling is a fundamental property of all cellul ...
s which are initiated by plant chemically sensitive receptors.
Plant hormone Plant hormone (or phytohormones) are signal molecules, produced within plants, that occur in extremely low concentrations. Plant hormones control all aspects of plant growth and development, from embryogenesis, the regulation of organ size, pat ...
receptors can either be integrated in plant cells or situate outside the cell, in order to facilitate chemical structure and composition. There are 5 major categories of hormones that are unique to plants which once bound to the receptor, will trigger a response in target cells. These include
auxin Auxins (plural of auxin ) are a class of plant hormones (or plant-growth regulators) with some morphogen-like characteristics. Auxins play a cardinal role in coordination of many growth and behavioral processes in plant life cycles and are essenti ...
,
abscisic acid Abscisic acid (ABA) is a plant hormone. ABA functions in many plant developmental processes, including seed and bud dormancy, the control of organ size and stomatal closure. It is especially important for plants in the response to environmental s ...
,
gibberellin Gibberellins (GAs) are plant hormones that regulate various developmental processes, including stem elongation, germination, dormancy, flowering, flower development, and leaf and fruit senescence. GAs are one of the longest-known classes of plan ...
,
cytokinin Cytokinins (CK) are a class of plant hormones that promote cell division, or cytokinesis, in plant roots and shoots. They are involved primarily in cell growth and differentiation, but also affect apical dominance, axillary bud growth, and lea ...
, and
ethylene Ethylene (IUPAC name: ethene) is a hydrocarbon which has the formula or . It is a colourless, flammable gas with a faint "sweet and musky" odour when pure. It is the simplest alkene (a hydrocarbon with carbon-carbon double bonds). Ethylene ...
. Once bound, hormones can induce, inhibit, or maintain function of the target response.


Classes

There are two main classes of chemoreceptor: direct and distance. * Examples of ''distance chemoreceptors'' are: **
olfactory receptor neuron An olfactory receptor neuron (ORN), also called an olfactory sensory neuron (OSN), is a sensory neuron within the olfactory system. Structure Humans have between 10 and 20 million olfactory receptor neurons (ORNs). In vertebrates, ORNs are ...
s in the
olfactory system The olfactory system, or sense of smell, is the sensory system used for smelling ( olfaction). Olfaction is one of the special senses, that have directly associated specific organs. Most mammals and reptiles have a main olfactory system and an ...
: Olfaction involves the ability to detect chemicals in the gaseous state. In vertebrates, the olfactory system detects
odor An odor (American English) or odour (Commonwealth English; see spelling differences) is caused by one or more volatilized chemical compounds that are generally found in low concentrations that humans and animals can perceive via their sense ...
s and
pheromone A pheromone () is a secreted or excreted chemical factor that triggers a social response in members of the same species. Pheromones are chemicals capable of acting like hormones outside the body of the secreting individual, to affect the behavio ...
s in the nasal cavity. Within the olfactory system there are two anatomically distinct organs: the main olfactory epithelium (MOE) and the
vomeronasal organ The vomeronasal organ (VNO), or Jacobson's organ, is the paired auxiliary olfactory (smell) sense organ located in the soft tissue of the nasal septum, in the nasal cavity just above the roof of the mouth (the hard palate) in various tetrapo ...
(VNO). It was initially thought that the MOE is responsible for the detection of odorants, while the VNO detects pheromones. The current view, however, is that both systems can detect odorants and pheromones. Olfaction in invertebrates differs from olfaction in vertebrates. For example, in insects, olfactory sensilla are present on their antennae. * Examples of ''direct chemoreceptors'' include: **
Taste receptor A taste receptor or tastant is a type of cellular receptor which facilitates the sensation of taste. When food or other substances enter the mouth, molecules interact with saliva and are bound to taste receptors in the oral cavity and other loc ...
s in the gustatory system: The primary use of gustation as a type of chemoreception is for the detection of tasteants. Aqueous chemical compounds come into contact with chemoreceptors in the mouth, such as taste buds on the tongue, and trigger responses. These chemical compounds can either trigger an appetitive response for nutrients, or a defensive response against toxins depending on which receptors fire. Fish and crustaceans, who are constantly in an aqueous environment, use their gustatory system to identify certain chemicals in the mixture for the purpose of localization and ingestion of food. **Insects use contact chemoreception to recognize certain chemicals such as cuticular hydrocarbons and chemicals specific to host plants. Contact chemoreception is more commonly seen in insects but is also involved in the mating behavior of some vertebrates. The contact chemoreceptor is specific to one type of chemical.


Sensory organs

*Olfaction: In terrestrial vertebrates, olfaction occurs in the
nose A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passe ...
. Volatile chemical stimuli enter the nose and eventually reach the
olfactory epithelium The olfactory epithelium is a specialized epithelial tissue inside the nasal cavity that is involved in smell. In humans, it measures 9 cm2 and lies on the roof of the nasal cavity about 7 cm above and behind the nostrils. The olfactory ...
which houses the chemoreceptor cells known as olfactory sensory neurons often referred to as OSNs. Embedded in the olfactory epithelium are three types of cells: supporting cells, basal cells, and OSNs. While all three types of cells are integral to normal function of the epithelium, only OSN serve as receptor cells, i.e. responding to the chemicals and generating an action potential that travels down the
olfactory nerve The olfactory nerve, also known as the first cranial nerve, cranial nerve I, or simply CN I, is a cranial nerve that contains sensory nerve fibers relating to the sense of smell. The afferent nerve fibers of the olfactory receptor neurons t ...
to reach the brain. In insects, antennae act as distance chemoreceptors. For example, antennae on moths are made up of long feathery hairs that increase sensory surface area. Each long hair from the main antenna also has smaller sensilla that are used for volatile olfaction. Since moths are mainly nocturnal animals, the development of greater olfaction aids them in navigating the night. *Gustation: In many terrestrial vertebrates, the
tongue The tongue is a muscular organ in the mouth of a typical tetrapod. It manipulates food for mastication and swallowing as part of the digestive process, and is the primary organ of taste. The tongue's upper surface (dorsum) is covered by taste ...
serves as the primary gustatory sensory organ. As a muscle located in the mouth, it acts to manipulate and discern the composition of food in the initial stages of digestion. The tongue is rich in vasculature, allowing the chemoreceptors located on the top surface of the organ to transmit sensory information to the brain. Salivary glands in the mouth allow for molecules to reach chemoreceptors in an aqueous solution. The chemoreceptors of the tongue fall into two distinct superfamilies of
G protein-coupled receptor G protein-coupled receptors (GPCRs), also known as seven-(pass)-transmembrane domain receptors, 7TM receptors, heptahelical receptors, serpentine receptors, and G protein-linked receptors (GPLR), form a large group of evolutionarily-related p ...
s. GPCR's are intramembrane proteins than bind to an extracellular ligand- in this case chemicals from food- and begin a diverse array of signaling cascades that can result in an action potential registering as input in an organism's brain. Large quantities of chemoreceptors with discrete ligand-binding domains provide for the five basic tastes: sour, salty, bitter, sweet, and
savory Savory or Savoury may refer to: Common usage * Herbs of the genus ''Satureja'', particularly: ** Summer savory (''Satureja hortensis''), an annual herb, used to flavor food ** Winter savory (''Satureja montana''), a perennial herb, also used to ...
. The salty and sour tastes work directly through the ion channels, the sweet and bitter taste work through
G protein-coupled receptor G protein-coupled receptors (GPCRs), also known as seven-(pass)-transmembrane domain receptors, 7TM receptors, heptahelical receptors, serpentine receptors, and G protein-linked receptors (GPLR), form a large group of evolutionarily-related p ...
s, and the savory sensation is activated by
glutamate Glutamic acid (symbol Glu or E; the ionic form is known as glutamate) is an α-amino acid that is used by almost all living beings in the biosynthesis of proteins. It is a non-essential nutrient for humans, meaning that the human body can synt ...
.Gustatory chemosensors are not just present on the tongue but also on different cells of the gut epithelium where they communicates the sensory information to several effector systems involved in the regulation of appetite, immune responses, and gastrointestinal motility. *Contact Chemoreception: Contact chemoreception is dependent on the physical contact of the receptor with the stimulus. The receptors are short hairs or cones that have a single pore at, or close to the tip of the projection. They are known as uniporous receptors. Some receptors are flexible, while others are rigid and do not bend with contact. They are mostly found in the mouthparts, but can also occur on the antennae or legs of some insects. There is a collection of dendrites located near the pores of the receptors, yet the distribution of these dendrites changes depending on the organism being examined. The method of transduction of the signal from the dendrites differs depending on the organism and the chemical it is responding to. When inputs from the environment are significant to the survival of the organism, the input must be detected. As all life processes are ultimately based on
chemistry Chemistry is the scientific study of the properties and behavior of matter. It is a natural science that covers the elements that make up matter to the compounds made of atoms, molecules and ions: their composition, structure, proper ...
it is natural that detection and passing on of the external input will involve chemical events. The chemistry of the environment is, of course, relevant to survival, and detection of chemical input from the outside may well articulate directly with cell chemicals. Chemoreception is important for the detection of food, habitat, conspecifics including mates, and predators. For example, the emissions of a predator's food source, such as odors or pheromones, may be in the air or on a surface where the food source has been. Cells in the head, usually the air passages or mouth, have chemical receptors on their surface that change when in contact with the emissions. It passes in either chemical or electrochemical form to the central processor, the
brain A brain is an organ (biology), organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as Visual perception, vision. I ...
or
spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the sp ...
. The resulting output from the CNS (
central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all p ...
) makes body actions that will engage the food and enhance survival.


Physiology

* Carotid bodies and
aortic bodies The aortic bodies are one of several small clusters of peripheral chemoreceptors located along the aortic arch. They are important in measuring partial pressures of oxygen and carbon dioxide in the blood, and blood pH. Structure The aortic bodies ...
detect changes primarily in pCO2 and H+ ion concentration. They also sense decrease in partial pressure of O2, but to a lesser degree than for pCO2 and H+ ion concentration. * The chemoreceptor trigger zone is an area of the medulla in the brain that receives inputs from
blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the cir ...
-borne
drug A drug is any chemical substance that causes a change in an organism's physiology or psychology when consumed. Drugs are typically distinguished from food and substances that provide nutritional support. Consumption of drugs can be via inhala ...
s or
hormone A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs by complex biological processes to regulate physiology and behavior. Hormones are required ...
s, and communicates with the
vomiting center The area postrema, a paired structure in the medulla oblongata of the brainstem, is a circumventricular organ having permeable capillaries and sensory neurons that enable its dual role to detect circulating chemical messengers in the blood and t ...
(area postrema) to induce
vomiting Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenter ...
. * Primary cilia play important roles in chemosensation. In adult tissues, these cilia regulate cell proliferation in response to external stimuli, such as tissue damage. In humans, improper functioning of primary cilia is associated with important diseases known as
ciliopathies A ciliopathy is any genetic disorder that affects the cellular cilia or the cilia anchoring structures, the basal bodies, or ciliary function. Primary cilia are important in guiding the process of development, so abnormal ciliary function while ...
.


Control of breathing

Particular chemoreceptors, called ASICs, detect the levels of
carbon dioxide Carbon dioxide ( chemical formula ) is a chemical compound made up of molecules that each have one carbon atom covalently double bonded to two oxygen atoms. It is found in the gas state at room temperature. In the air, carbon dioxide is t ...
in the blood. To do this, they monitor the concentration of
hydrogen ion A hydrogen ion is created when a hydrogen atom loses or gains an electron. A positively charged hydrogen ion (or proton) can readily combine with other particles and therefore is only seen isolated when it is in a gaseous state or a nearly particle ...
s in the blood, which decrease the pH of the blood. This can be a direct consequence of an increase in carbon dioxide concentration, because aqueous carbon dioxide in the presence of
carbonic anhydrase The carbonic anhydrases (or carbonate dehydratases) () form a family of enzymes that catalyze the interconversion between carbon dioxide and water and the dissociated ions of carbonic acid (i.e. bicarbonate and hydrogen ions). The active sit ...
reacts to form a
proton A proton is a stable subatomic particle, symbol , H+, or 1H+ with a positive electric charge of +1 ''e'' elementary charge. Its mass is slightly less than that of a neutron and 1,836 times the mass of an electron (the proton–electron mass ...
and a
bicarbonate In inorganic chemistry, bicarbonate (IUPAC-recommended nomenclature: hydrogencarbonate) is an intermediate form in the deprotonation of carbonic acid. It is a polyatomic anion with the chemical formula . Bicarbonate serves a crucial biochemi ...
ion. The response is that the respiratory centre (in the medulla), sends nervous impulses to the external intercostal muscles and the
diaphragm Diaphragm may refer to: Anatomy * Thoracic diaphragm, a thin sheet of muscle between the thorax and the abdomen * Pelvic diaphragm or pelvic floor, a pelvic structure * Urogenital diaphragm or triangular ligament, a pelvic structure Other * Diap ...
, via the intercostal nerve and the
phrenic nerve The phrenic nerve is a mixed motor/sensory nerve which originates from the C3-C5 spinal nerves in the neck. The nerve is important for breathing because it provides exclusive motor control of the diaphragm, the primary muscle of respiration. ...
, respectively, to increase breathing rate and the volume of the lungs during inhalation. Chemoreceptors that regulate the depth and rhythm of breathing are broken down into two categories. * central chemoreceptors are located on the ventrolateral surface of
medulla oblongata The medulla oblongata or simply medulla is a long stem-like structure which makes up the lower part of the brainstem. It is anterior and partially inferior to the cerebellum. It is a cone-shaped neuronal mass responsible for autonomic (invol ...
and detect changes in pH of cerebrospinal fluid. They have also been shown experimentally to respond to hypercapnic hypoxia (elevated , decreased O2), and eventually desensitize, partly due to redistribution of bicarbonate out of the cerebrospinal fluid (CSF) and increased renal excretion of bicarbonate. These are sensitive to pH and . * peripheral chemoreceptors: consists of aortic and carotid bodies. Aortic body detects changes in blood oxygen and carbon dioxide, but not pH, while
carotid body The carotid body is a small cluster of chemoreceptor cells, and supporting sustentacular cells. The carotid body is located in the adventitia, in the bifurcation (fork) of the common carotid artery, which runs along both sides of the neck. The ...
detects all three. They do not desensitize. Their effect on breathing rate is less than that of the central chemoreceptors.


Heart rate

The response to stimulation of chemoreceptors on the heart rate is complicated. Chemoreceptors in the heart or nearby large arteries, as well as chemoreceptors in the lungs, can affect heart rate. Activation of these peripheral chemoreceptors from sensing decreased O2, increased CO2 and a decreased pH is relayed to cardiac centers by the vagus and glossopharyngeal nerves to the medulla of the brainstem. This increases the sympathetic nervous stimulation on the heart and a corresponding increase in heart rate and contractility in most cases. These factors include activation of stretch receptors due to increased ventilation and the release of circulating catecholamines. However, if respiratory activity is arrested (e.g. in a patient with a high cervical spinal cord injury), then the primary cardiac reflex to transient hypercapnia and hypoxia is a profound
bradycardia Bradycardia (also sinus bradycardia) is a slow resting heart rate, commonly under 60 beats per minute (BPM) as determined by an electrocardiogram. It is considered to be a normal heart rate during sleep, in young and healthy or elderly adults, ...
and coronary vasodilation through vagal stimulation and systemic vasoconstriction by sympathetic stimulation. In normal cases, if there is reflexive increase in respiratory activity in response to chemoreceptor activation, the increased sympathetic activity on the cardiovascular system would act to increase heart rate and contractility.


See also

*
Cell surface receptor Cell surface receptors (membrane receptors, transmembrane receptors) are receptors that are embedded in the plasma membrane of cells. They act in cell signaling by receiving (binding to) extracellular molecules. They are specialized integral m ...
* Chemosensory clusters * Chemoreceptor trigger zone * Diffuse chemosensory system * Haptic technology *
Molecular sensor A molecular sensor or chemosensor is a molecular structure (organic or inorganic complexes) that is used for sensing of an analyte to produce a detectable change or a signal. The action of a chemosensor, relies on an interaction occurring at the mo ...
*
Odor An odor (American English) or odour (Commonwealth English; see spelling differences) is caused by one or more volatilized chemical compounds that are generally found in low concentrations that humans and animals can perceive via their sense ...
*
Olfaction The sense of smell, or olfaction, is the special sense through which smells (or odors) are perceived. The sense of smell has many functions, including detecting desirable foods, hazards, and pheromones, and plays a role in taste. In humans, ...
* Solitary chemosensory cells *
Sensory receptor Sensory neurons, also known as afferent neurons, are neurons in the nervous system, that convert a specific type of stimulus, via their receptors, into action potentials or graded potentials. This process is called sensory transduction. The ...
*
Taste The gustatory system or sense of taste is the sensory system that is partially responsible for the perception of taste (flavor). Taste is the perception produced or stimulated when a substance in the mouth reacts chemically with taste receptor ...
*
Vomeronasal organ The vomeronasal organ (VNO), or Jacobson's organ, is the paired auxiliary olfactory (smell) sense organ located in the soft tissue of the nasal septum, in the nasal cavity just above the roof of the mouth (the hard palate) in various tetrapo ...


References


External links

* *Association of Chemoreception Sciences http://www.achems.org/ {{Respiratory physiology Sensory receptors Gas sensors Analytical chemistry Respiratory physiology Vomiting