Professor Paul M Pilowsky

BMedSci (Hons), BMBS, PhD
"Over the past 30 years, my team and I have been investigating how the brain controls blood pressure."

Paul Pilowsky’s research is concerned with brain networks that control airways, breathing and blood pressure. Supported continuously with funding from the National Health and Medical Research Council, of which he is now a Principal Research Fellow, he moved to The University of Sydney in 1996, where he was appointed as a Professor in the Department of Physiology. In 2013, he founded the High Blood Pressure Group at the HRI.

"The pleasure of this work gives me remains unchallenged despite the passage of years."
"The main satisfaction that I achieve in my work is in observing a novel experiment reach its conclusion at the hands of a student who has never experienced science in the past, and who then themselves has the pleasure of publishing their work and presenting it to a wider audience."

Current Appointments

High Blood Pressure Group Leader

Heart Research Institute

Adjunct Professor of Physiology

University of Sydney

Principal Research Fellow

National Health and Medical Research Council of Australia


Department of Cardiology, Royal Prince Alfred Hospital.

NHMRC Academy

NSW Cardiovascular Research Network

Editorial board member

American Journal of Physiology: Reg. Int. Comp

Respiration Physiology and Neurobiology


Brain Research

American Journal of Physiology: Heart Circ. Physiology

Professor Paul M Pilowsky leads group:
Research covers areas of:
Contact Professor Paul M Pilowsky
University: Paul's website

More about Professor Paul M Pilowsky

Research project opportunities
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Our work is not just focused on molecular studies, we also study changes in activation states in histology, we aim to understand changes in regulatory states in vivo, and we also study changes in normal people undertaking mild stress, such as eating or even pregnancy, or much deeper stress such as patients unwell with cardiovascular disease. In other words, our work aims to undertake a mechanistic study of the problems outlined above. In a way that is not simply focused on a test tube, but is also concerned with real-life.

The high blood pressure research group offers many research projects for Honours, PhD and research students. Each of these projects can be scaled as required, depending on the amount of time available, so as to provide a satisfactory and worthwhile research experience for the student. Project options are listed below.

Role of PACAP in the regulation of arterial blood pressure

PACAP is a polypeptide that is present throughout the brain and plays an important role in controlling sympathetic nerve activity and BP. We have discovered that it is present in neurons in the brainstem spinal cord, sympathetic nerves and adrenal medulla that are critical in the regulation of arterial blood pressure. Two disease states that we have a major interest in investigating, in which PACAP plays an important role are epilepsy and sleep apnoea.
Studies that are currently underway include molecular studies, histological studies, physiological and pharmacological studies.

Role of microglia and inflammation in the regulation of arterial blood pressure

Traditionally, microglia – the macrophages of the brainstem – are not considered to play a soothing role in the regulation of neuronal function. Recently, we discovered that during epilepsy, microglia interact with sympathetic neurons in order to manage their level of excitation. We consider this to be an extremely important mechanistic finding and there is a great deal more to be investigated. Opportunities exist to study this question using functional neuroanatomy with novel monoclonal antibodies that we have invented and with regulatory, physiological and pharmacological methods.

Role of the brainstem in metabolic syndrome

In addition to its well-known function in monitoring oxygen and acidity in blood, the brain also monitors temperature, glucose levels, lipids and electrolytes. The ability of the brain to achieve these latter functions occurs because of its exposure in the hypothalamus to circulating concentrations of angiotensin II and insulin. Specific receptors within the hypothalamus respond to these concentrations of peptide and cause changes in the activity of cardiovascular neurons in the brainstem leading to changes in efferent sympathetic activity to different populations of neurons. Our understanding of these changes, and the way that these changes are regulated, is at its earliest stage. Certainly, it seems likely that errors in function in relation to brain monitoring of insulin could easily lead to a metabolic syndrome with weight gain, hypertension, dyslipidaemia and diabetes. It is our intention, to develop a number of projects related to the questions raised above that would be suitable for long or short term study. For example, in the past, we have studied the effects of intermittent hypoxia as a way of investigating experimental sleep apnoea. In this project, we propose intermittent hyperglycaemia and intermittent hyperlipidaemia as a method of simulating the metabolic syndrome. In order to assess the involvement of neurons in the brain that are considered to play an important role in the metabolic syndrome, we would increase or decrease the activity of the arcuate nucleus or the orexin neurons.

We would also examine known models of diabetes or obesity or hypertension and repeat the studies in these in order to see if there are any interaction effects within the brainstem or hypothalamus. Animal models to be used would include the spontaneously hypertensive rat, the obese rats, and diabetic rats.

Human studies

Opportunities are also available for students with a background in biomedical engineering to undertake studies that involve sampling of data from people or patients. Studies in the past have included changing position from lying to standing and feeding in males and females, patients with glaucoma, and women that were normal and that were normal but pregnant. The advantage that we have in our studies is that we possess a device that can measure continuous arterial blood pressure noninvasively from the finger, so that we can then derive an approximate value of sympathetic nerve activity from the systolic BP waveform. This value and the many other values that can be derived allow the student to obtain a considerable amount of data from even a small number of cases.

Selected Publications
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Bhandare A, Mohammed S, Pilowsky PM, Farnham MMJ (2015) Antagonism of PACAP or microglia function worsens the cardiovascular consequences of kainic acid induced seizures in rats. J Neurosci 35: 2283-2292.

Epileptic seizures are commonly accompanied by changes in arterial blood pressure, and sympathetic nerve activity. Sometimes these changes can be so severe that death can result. The causes of these changes are at present unknown. What is known is that seizures activate inflammatory responses in brain areas that control breathing and blood pressure. Over the past 10 years, the high blood pressure group under the direction of Professor Paul Pilowsky and Dr Melissa Farnham have investigated the role of pituitary adenylate cyclase activating polypeptide. Recently, Mr Amol Bhandare and our team published in the highly prestigious Journal of Neuroscience their findings demonstrating that the cardiovascular consequences of seizure were made worse by preventing the actions of PACAP, and by preventing the soothing actions of brain microglia. To some extent, this last finding may seem surprising because microglia like macrophages in other parts of the body are generally thought to always behave as inflammatory cells. In fact, it appears that microglia can play a dual role: sometimes soothing and sometimes inflammatory, depending on requirements. In summary, our work demonstrated for the first time that PACAP and microglia are essential for moderating the adverse cardiovascular consequences of seizure.

Current Research Grants
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National Health and Medical Research Council (NHMRC) Project Grant 1082215, How does chronic epilepsy result in cardiac electrophysiological dysfunction? 2015-2018
National Health and Medical Research Council (NHMRC) Project Grant 1065485, PACAP, Sleep apnoea and high blood pressure, 2014-2016
National Health and Medical Research Council (NHMRC) Research Fellowship 1024489, Supporting Prof. Paul Pilowsky, 2013-2016
1987     Doctor of Philosophy (PhD; Medicine) 
1983     Bachelor of Medicine, Bachelor of Surgery (BMBS) 
1980     Bachelor of Medical Sciences Hons (BMedSci 1st Class Honours)
Awards for Research
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2012     Macquarie University Faculty of Human Sciences – supervisor of the year award ($1500). Awarded for excellence in Higher Degree Research Supervision.
2009     Macquarie University Faculty of Human Sciences publication award for established researchers ($1000). Awarded to the most productive researcher in the previous calender year.
1999     Broyles-Maloney Award of the American Broncho-Esophagological Association for paper 98: Identification of posterior cricoarytenoid (PCA) motoneurons in the rat.
1996     R T Hall prize. (Joint winner) Cardiac Society of Australia and New Zealand.
1995     Elizabeth Penfold Simpson Prize. Awarded every two years by the Brain Foundation SA.  ($10,000).
1994     AMRAD “Pursuit of Excellence Award” for presentation to the International Society of Hypertension
1992     R. Douglas Wright (New Investigator Award: National Health and Medical Research Council)
1988     C J Martin Overseas Research Fellowship (jointly from the National Health and Medical Research Council of Australia and the National Heart Foundation)
1988     Ralph Reader Fellowship Award (National Heart Foundation).
1986     Young Investigators Award, to present papers at the International Union of Physiological Sciences in Vancouver, Canada, and a satellite symposium on hypertension at Whistler, Canada.
1986     Smith Kline and French – Victor MacFarlane Award from the Centre for Neuroscience (Flinders University) for the best seminar by a Postgraduate student.
1985     Young Investigators Travel Grant, to present a paper at a meeting of the High Blood Pressure Research Council of Australia in Melbourne.
1984     NHMRC Medical Postgraduate Scholarship.