1
|
Bjorness TE, Greene RW. Orexin-mediated Motivated Arousal and Reward Seeking. Peptides 2024:171280. [PMID: 39159833 DOI: 10.1016/j.peptides.2024.171280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 08/03/2024] [Accepted: 08/05/2024] [Indexed: 08/21/2024]
Abstract
The neuromodulator orexin has been identified as a key factor for motivated arousal including recent evidence that sleep deprivation-induced enhancement of reward behavior is modulated by orexin. While orexin is not necessary for either reward or arousal behavior, orexin neurons' broad projections, ability to sense the internal state of the animal, and high plasticity of signaling in response to natural rewards and drugs of abuse may underlie heightened drug seeking, particularly in a subset of highly motivated reward seekers. As such, orexin receptor antagonists have gained deserved attention for putative use in addiction treatments. Ongoing and future clinical trials are expected to identify individuals most likely to benefit from orexin receptor antagonist treatment to promote abstinence, such as those with concurrent sleep disorders or high craving, while attention to methodological considerations will aid interpretation of the numerous preclinical studies investigating disparate aspects of the role of orexin in reward and arousal.
Collapse
Affiliation(s)
- Theresa E Bjorness
- Research Service, VA North Texas Health Care System, Dallas, TX 75126, USA; Departments of Psychiatry University of Texas Southwestern Medical Center, Dallas, TX 75390-9111, USA.
| | - Robert W Greene
- Departments of Psychiatry University of Texas Southwestern Medical Center, Dallas, TX 75390-9111, USA; Department of Neuroscience, Peter O'Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX 75390-9111, USA; International Institute for Integrative Sleep Medicine, University of Tsukuba, Tsukuba, 305-8577, Japan
| |
Collapse
|
2
|
Juvodden HT, Alnæs D, Agartz I, Andreassen OA, Server A, Thorsby PM, Westlye LT, Knudsen-Heier S. Cortical thickness and sub-cortical volumes in post-H1N1 narcolepsy type 1: A brain-wide MRI case-control study. Sleep Med 2024; 116:81-89. [PMID: 38432031 DOI: 10.1016/j.sleep.2024.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE There was more than a 10-fold increase in the incidence of narcolepsy type 1 (NT1) after the H1N1 mass vaccination in 2009/2010 in several countries. NT1 is associated with loss and increase of cell groups in the hypothalamus which may be associated with secondary affected sub-cortical and cortical gray matter. We performed a case-control comparison of MRI-based global and sub-cortical volume and cortical thickness in post-H1N1 NT1 patients compared with controls. METHODS We included 54 post-H1N1 NT1 patients (51 with confirmed hypocretin-deficiency; 48 H1N1-vaccinated with Pandemrix®; 39 females, mean age 21.8 ± 11.0 years) and 114 healthy controls (77 females, mean age 23.2 ± 9.0 years). 3T MRI brain scans were obtained, and the T1-weighted MRI data were processed using FreeSurfer. Group differences among three global, 10 sub-cortical volume measures and 34 cortical thickness measures for bilateral brain regions were tested using general linear models with permutation testing. RESULTS Patients had significantly thinner brain cortex bilaterally in the temporal poles (Cohen's d = 0.68, p = 0.00080), entorhinal cortex (d = 0.60, p = 0.0018) and superior temporal gyrus (d = 0.60, p = 0.0020) compared to healthy controls. The analysis revealed no significant group differences for sub-cortical volumes. CONCLUSIONS Post-H1N1(largely Pandemrix®-vaccinated) NT1 patients have significantly thinner cortex in temporal brain regions compared to controls. We speculate that this effect can be partly attributed to the hypothalamic neuronal change in NT1, including loss of function of the widely projecting hypocretin-producing neurons and secondary effects of the abnormal sleep-wake pattern in NT1 or could be specific for post-H1N1 (largely Pandemrix®-vaccinated) NT1 patients.
Collapse
Affiliation(s)
- Hilde T Juvodden
- Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Department of Rare Disorders, Oslo University Hospital, Ullevål, Norway.
| | - Dag Alnæs
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Norway
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; K.G. Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Norway
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Norway; K.G. Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Norway
| | - Andres Server
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Per M Thorsby
- Hormone Laboratory, Department of Medical Biochemistry, Biochemical Endocrinology and Metabolism Research Group, Oslo University Hospital, Aker, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Norway; K.G. Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Norway; Department of Psychology, University of Oslo, Norway
| | - Stine Knudsen-Heier
- Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Department of Rare Disorders, Oslo University Hospital, Ullevål, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
3
|
Wenhong C, Xiaoying M, Lingli S, Binyun T, Yining W, Mingming Z, Yian L, Lixia Q, Wenyu H, Fengjin P. Assessing resting-state brain functional connectivity in adolescents and young adults with narcolepsy using functional near-infrared spectroscopy. Front Hum Neurosci 2024; 18:1373043. [PMID: 38606200 PMCID: PMC11007108 DOI: 10.3389/fnhum.2024.1373043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/13/2024] [Indexed: 04/13/2024] Open
Abstract
This study aimed to elucidate the alterations in the prefrontal cortex's functional connectivity and network topology in narcolepsy patients using functional near-infrared spectroscopy (fNIRS). Twelve narcolepsy-diagnosed patients from Guangxi Zhuang Autonomous Region's People's Hospital Sleep Medicine Department and 11 matched healthy controls underwent resting fNIRS scans. Functional connectivity and graph theory analyses were employed to assess the prefrontal cortex network's properties and their correlation with clinical features. Results indicated increased functional connectivity in these adolescent and young adult patients with narcolepsy, with significant variations in metrics like average degree centrality and node efficiency, particularly in the left middle frontal gyrus. These alterations showed correlations with clinical symptoms, including depression and sleep efficiency. However, the significance of these findings was reduced post False Discovery Rate adjustment, suggesting a larger sample size is needed for validation. In conclusion, the study offers initial observations that alterations in the prefrontal cortex's functional connectivity may potentially act as a neurobiological indicator of narcolepsy, warranting further investigation with a larger cohort to substantiate these findings and understand the underlying mechanisms.
Collapse
Affiliation(s)
- Chen Wenhong
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Mo Xiaoying
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Shi Lingli
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Tang Binyun
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Wen Yining
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Zhao Mingming
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Lu Yian
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Qin Lixia
- Guangxi Clinical Reserch Center for Sleep Medicine, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Hu Wenyu
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Pan Fengjin
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| |
Collapse
|
4
|
Juvodden HT, Alnæs D, Lund MJ, Agartz I, Andreassen OIA, Server A, Thorsby PM, Westlye LT, Knudsen Heier S. Larger hypothalamic volume in narcolepsy type 1. Sleep 2023; 46:zsad173. [PMID: 37463428 PMCID: PMC10636249 DOI: 10.1093/sleep/zsad173] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 05/18/2023] [Indexed: 07/20/2023] Open
Abstract
STUDY OBJECTIVES Narcolepsy type 1 (NT1) is a neurological sleep disorder. Postmortem studies have shown 75%-90% loss of the 50 000-70 000 hypocretin-producing neurons and 64%-94% increase in the 64 000-120 000 histaminergic neurons and conflicting indications of gliosis in the hypothalamus of NT1 patients. The aim of this study was to compare MRI-based volumes of the hypothalamus in patients with NT1 and controls in vivo. METHODS We used a segmentation tool based on deep learning included in Freesurfer and computed the volume of the whole hypothalamus, left/right part of the hypothalamus, and 10 hypothalamic subregions. We included 54 patients with post-H1N1 NT1 (39 females, mean age 21.8 ± 11.0 years) and 114 controls (77 females, mean age 23.2 ± 9.0 years). Group differences were tested with general linear models using permutation testing in Permutation Analysis of Linear Models and evaluated after 10 000 permutations, yielding two-tailed P-values. Furthermore, a stepwise Bonferroni correction was performed after dividing hypothalamus into smaller regions. RESULTS The analysis revealed larger volume for patients compared to controls for the whole hypothalamus (Cohen's d = 0.71, p = 0.0028) and for the left (d = 0.70, p = 0.0037) and right part of the hypothalamus (d = 0.65, p = 0.0075) and left (d = 0.72, p = 0.0036) and right tubular-inferior (d = 0.71, p = 0.0037) hypothalamic subregions. CONCLUSIONS In conclusion, patients with post-H1N1 NT1 showed significantly larger hypothalamic volume than controls, in particular in the tubular-inferior subregions which could reflect several processes as previous studies have indicated neuroinflammation, gliosis, and changes in the numbers of different cell types.
Collapse
Affiliation(s)
- Hilde T Juvodden
- Department of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital, Ullevål, Oslo, Norway
| | - Dag Alnæs
- Division of Mental Health and Addiction, NORMENT Centre, University of Oslo and Oslo University Hospital, Oslo, Norway
- Departement of Psychology, Pedagogy and Law, Kristiania University College, Oslo, Norway
| | - Martina J Lund
- Division of Mental Health and Addiction, NORMENT Centre, University of Oslo and Oslo University Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - OIe A Andreassen
- Division of Mental Health and Addiction, NORMENT Centre, University of Oslo and Oslo University Hospital, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Andres Server
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Per M Thorsby
- Hormone Laboratory, Department of Medical Biochemistry, Biochemical Endocrinology and Metabolism Research Group, Oslo University Hospital, Aker, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- Division of Mental Health and Addiction, NORMENT Centre, University of Oslo and Oslo University Hospital, Oslo, Norway
- K.G. Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Stine Knudsen Heier
- Department of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital, Ullevål, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
5
|
Shan L, Linssen S, Harteman Z, den Dekker F, Shuker L, Balesar R, Breesuwsma N, Anink J, Zhou J, Lammers GJ, Swaab DF, Fronczek R. Activated Wake Systems in Narcolepsy Type 1. Ann Neurol 2023; 94:762-771. [PMID: 37395722 DOI: 10.1002/ana.26736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE Narcolepsy type 1 (NT1) is assumed to be caused solely by a lack of hypocretin (orexin) neurotransmission. Recently, however, we found an 88% reduction in corticotropin-releasing hormone (CRH)-positive neurons in the paraventricular nucleus (PVN). We assessed the remaining CRH neurons in NT1 to determine whether they co-express vasopressin (AVP) to reflect upregulation. We also systematically assessed other wake-systems, since current NT1 treatments target histamine, dopamine, and norepinephrine pathways. METHODS In postmortem tissue of people with NT1 and matched controls, we immunohistochemically stained and quantified neuronal populations expressing: CRH and AVP in the PVN, and CRH in the Barrington nucleus; the key neuronal histamine-synthesizing enzyme, histidine decarboxylase (HDC) in the hypothalamic tuberomammillary nucleus (TMN); the rate-limited-synthesizing enzyme, tyrosine hydroxylase (TH), for dopamine in the mid-brain and for norepinephrine in the locus coeruleus (LC). RESULTS In NT1, there was: a 234% increase in the percentage of CRH cells co-expressing AVP, while there was an unchanged integrated optical density of CRH staining in the Barrington nucleus; a 36% increased number of histamine neurons expressing HDC, while the number of typical human TMN neuronal profiles was unchanged; a tendency toward an increased density of TH-positive neurons in the substantia nigra compacta; while the density of TH-positive LC neurons was unchanged. INTERPRETATION Our findings suggest an upregulation of activity by histamine neurons and remaining CRH neurons in NT1. This may explain earlier reports of normal basal plasma cortisol levels but lower levels after dexamethasone suppression. Alternatively, CRH neurons co-expressing AVP neurons are less vulnerable. ANN NEUROL 2023;94:762-771.
Collapse
Affiliation(s)
- Ling Shan
- Leiden University Medical Centre, Department of Neurology, Leiden, The Netherlands, and Sleep Wake Centre SEIN, Heemstede, The Netherlands
- Department Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Suzan Linssen
- Department Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Zoe Harteman
- Department Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Fleur den Dekker
- Department Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Lamis Shuker
- Department Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Rawien Balesar
- Department Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Nicole Breesuwsma
- Department Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Jasper Anink
- Department of (Neuro) Pathology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Jingru Zhou
- Leiden University Medical Centre, Department of Neurology, Leiden, The Netherlands, and Sleep Wake Centre SEIN, Heemstede, The Netherlands
| | - Gert Jan Lammers
- Leiden University Medical Centre, Department of Neurology, Leiden, The Netherlands, and Sleep Wake Centre SEIN, Heemstede, The Netherlands
| | - Dick F Swaab
- Department Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Rolf Fronczek
- Leiden University Medical Centre, Department of Neurology, Leiden, The Netherlands, and Sleep Wake Centre SEIN, Heemstede, The Netherlands
| |
Collapse
|
6
|
Wu MF, Thannickal TC, Li S, McGregor R, Lai YY, Siegel JM. Effects of sodium oxybate on hypocretin/orexin and locus coeruleus neurons. Sleep 2023; 46:zsad135. [PMID: 37155728 PMCID: PMC10848214 DOI: 10.1093/sleep/zsad135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 04/22/2023] [Indexed: 05/10/2023] Open
Abstract
Long-term use of sodium oxybate (SXB), (also called gamma-hydroxybutyrate [GHB]) attenuates the cataplexy and sleepiness of human narcolepsy. We had previously found that chronic opiate usage in humans and long-term opiate administration to mice significantly increased the number of detected hypocretin/orexin (Hcrt) neurons, decreased their size, and increased Hcrt level in the hypothalamus. We also found that opiates significantly decreased cataplexy in human narcoleptics as well as in narcoleptic mice and that cessation of locus coeruleus neuronal activity preceded and was tightly linked to cataplectic attacks in narcoleptic dogs. We tested the hypothesis that SXB produces changes similar to opiates and now report that chronic SXB administration significantly increased the size of Hcrt neurons, the reverse of what we had seen with opiates in humans and mice. Levels of Hcrt in the hypothalamus were nonsignificantly lower, in contrast to the significant increase in hypothalamic Hcrt level after opiates. SXB decreased tyrosine hydroxylase levels in the locus coeruleus, the major descending projection of the hypocretin system, also the reverse of what we saw with opioids. Therefore despite some similar effects on narcoleptic symptomatology, SXB does not produce anatomical changes similar to those elicited by opiates. Analysis of changes in other links in the cataplexy pathway might further illuminate SXB's mechanism of action on narcolepsy.
Collapse
Affiliation(s)
- Ming-Fung Wu
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Neurobiology Research, VA Greater Los Angeles Healthcare System, North Hills, CA, USA
| | - Thomas C Thannickal
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Songlin Li
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Ronald McGregor
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Yuan-Yang Lai
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Jerome M Siegel
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Neurobiology Research, VA Greater Los Angeles Healthcare System, North Hills, CA, USA
- Brain Research Institute, University of California, Los Angeles, CA, USA
| |
Collapse
|
7
|
McGregor R, Matzeu A, Thannickal TC, Wu F, Cornford M, Martin-Fardon R, Siegel JM. Sensitivity of Hypocretin System to Chronic Alcohol Exposure: A Human and Animal Study. Neuroscience 2023; 522:1-10. [PMID: 37121379 PMCID: PMC10681027 DOI: 10.1016/j.neuroscience.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/31/2023] [Accepted: 04/22/2023] [Indexed: 05/02/2023]
Abstract
Human heroin addicts and mice administered morphine for a 2 week period show a greatly increased number of hypothalamic hypocretin (Hcrt or orexin) producing neurons with a concomitant reduction in Hcrt cell size. Male rats addicted to cocaine similarly show an increased number of detectable Hcrt neurons. These findings led us to hypothesize that humans with alcohol use disorder (AUD) would show similar changes. We now report that humans with AUD have a decreased number and size of detectable Hcrt neurons. In addition, the intermingled melanin concentrating hormone (MCH) neurons are reduced in size. We saw no change in the size and number of tuberomammillary histamine neurons in AUD. Within the Hcrt/MCH neuronal field we found that microglia cell size was increased in AUD brains. In contrast, male rats with 2 week alcohol exposure, sufficient to elicit withdrawal symptoms, show no change in the number or size of Hcrt, MCH and histamine neurons, and no change in the size of microglia. The present study indicates major differences between the response of Hcrt neurons to opioids and that to alcohol in human subjects with a history of substance abuse.
Collapse
Affiliation(s)
- Ronald McGregor
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, 90095, USA; Neurobiology Research, VA Greater Los Angeles Healthcare System, North Hills, Los Angele, California 91343, USA.
| | - Alessandra Matzeu
- The Scripps Research Institute, Department of Molecular Medicine, 10550 North Torrey Pines Road, SR-107, La Jolla, CA 92037, USA
| | - Thomas C Thannickal
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, 90095, USA; Neurobiology Research, VA Greater Los Angeles Healthcare System, North Hills, Los Angele, California 91343, USA
| | - Frank Wu
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, 90095, USA; Neurobiology Research, VA Greater Los Angeles Healthcare System, North Hills, Los Angele, California 91343, USA
| | - Marcia Cornford
- Department of Pathology, Harbor University of California, Los Angeles, Medical, Center, Torrance, CA 90509, USA
| | - Rémi Martin-Fardon
- The Scripps Research Institute, Department of Molecular Medicine, 10550 North Torrey Pines Road, SR-107, La Jolla, CA 92037, USA
| | - Jerome M Siegel
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, 90095, USA; Neurobiology Research, VA Greater Los Angeles Healthcare System, North Hills, Los Angele, California 91343, USA
| |
Collapse
|
8
|
Justinussen JL, Egebjerg C, Kornum BR. How hypocretin agonists may improve the quality of wake in narcolepsy. Trends Mol Med 2023; 29:61-69. [PMID: 36400667 DOI: 10.1016/j.molmed.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/18/2022] [Accepted: 10/21/2022] [Indexed: 11/17/2022]
Abstract
Excessive daytime sleepiness (EDS) is a complex symptom characterized by a strong urge to sleep during daytime accompanied by problems such as attention deficits, anxiety, and lower cognitive performance. The efficacy of treatments for EDS is determined by their ability to decrease sleepiness, and less attention has been given to the effects these compounds have on the quality of the wake itself. Hypocretin (HCRT; orexin) signalling is implicated in narcolepsy, and hypocretin receptor 2 (HCRTR2) agonists are in clinical trials for treating EDS in narcolepsy. Here, we review preclinical research to determine how HCRTR2 agonists may affect attention and anxiety compared with other EDS treatment strategies. We conclude that such compounds may improve not only the quantity but also the quality of wake, and we hope that they will create opportunities for more nuanced treatment strategies in narcolepsy.
Collapse
Affiliation(s)
| | - Christine Egebjerg
- Department of Neuroscience, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Birgitte R Kornum
- Department of Neuroscience, University of Copenhagen, 2200 Copenhagen, Denmark.
| |
Collapse
|
9
|
Kotagal S. Update on Central Hypersomnia Disorders in Children. CURRENT SLEEP MEDICINE REPORTS 2022. [DOI: 10.1007/s40675-022-00237-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
10
|
Chavda V, Chaurasia B, Umana GE, Tomasi SO, Lu B, Montemurro N. Narcolepsy-A Neuropathological Obscure Sleep Disorder: A Narrative Review of Current Literature. Brain Sci 2022; 12:1473. [PMID: 36358399 PMCID: PMC9688775 DOI: 10.3390/brainsci12111473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/22/2022] [Accepted: 10/28/2022] [Indexed: 08/29/2023] Open
Abstract
Narcolepsy is a chronic, long-term neurological disorder characterized by a decreased ability to regulate sleep-wake cycles. Some clinical symptoms enter into differential diagnosis with other neurological diseases. Excessive daytime sleepiness and brief involuntary sleep episodes are the main clinical symptoms. The majority of people with narcolepsy experience cataplexy, which is a loss of muscle tone. Many people experience neurological complications such as sleep cycle disruption, hallucinations or sleep paralysis. Because of the associated neurological conditions, the exact pathophysiology of narcolepsy is unknown. The differential diagnosis is essential because relatively clinical symptoms of narcolepsy are easy to diagnose when all symptoms are present, but it becomes much more complicated when sleep attacks are isolated and cataplexy is episodic or absent. Treatment is tailored to the patient's symptoms and clinical diagnosis. To facilitate the diagnosis and treatment of sleep disorders and to better understand the neuropathological mechanisms of this sleep disorder, this review summarizes current knowledge on narcolepsy, in particular, genetic and non-genetic associations of narcolepsy, the pathophysiology up to the inflammatory response, the neuromorphological hallmarks of narcolepsy, and possible links with other diseases, such as diabetes, ischemic stroke and Alzheimer's disease. This review also reports all of the most recent updated research and therapeutic advances in narcolepsy. There have been significant advances in highlighting the pathogenesis of narcolepsy, with substantial evidence for an autoimmune response against hypocretin neurons; however, there are some gaps that need to be filled. To treat narcolepsy, more research should be focused on identifying molecular targets and novel autoantigens. In addition to therapeutic advances, standardized criteria for narcolepsy and diagnostic measures are widely accepted, but they may be reviewed and updated in the future with comprehension. Tailored treatment to the patient's symptoms and clinical diagnosis and future treatment modalities with hypocretin agonists, GABA agonists, histamine receptor antagonists and immunomodulatory drugs should be aimed at addressing the underlying cause of narcolepsy.
Collapse
Affiliation(s)
- Vishal Chavda
- Department of Pathology, Stanford of School of Medicine, Stanford University Medical Centre, Palo Alto, CA 94305, USA
| | - Bipin Chaurasia
- Department of Neurosurgery, Neurosurgery Clinic, Birgunj 44300, Nepal
| | - Giuseppe E. Umana
- Department of Neurosurgery, Associate Fellow of American College of Surgeons, Trauma and Gamma-Knife Centre, Cannizzaro Hospital Catania, 95100 Catania, Italy
| | | | - Bingwei Lu
- Department of Pathology, Stanford of School of Medicine, Stanford University Medical Centre, Palo Alto, CA 94305, USA
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy
| |
Collapse
|
11
|
Mukherjee P, Roy S, Ghosh D, Nandi SK. Role of animal models in biomedical research: a review. Lab Anim Res 2022; 38:18. [PMID: 35778730 PMCID: PMC9247923 DOI: 10.1186/s42826-022-00128-1] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 06/21/2022] [Indexed: 02/04/2023] Open
Abstract
The animal model deals with the species other than the human, as it can imitate the disease progression, its’ diagnosis as well as a treatment similar to human. Discovery of a drug and/or component, equipment, their toxicological studies, dose, side effects are in vivo studied for future use in humans considering its’ ethical issues. Here lies the importance of the animal model for its enormous use in biomedical research. Animal models have many facets that mimic various disease conditions in humans like systemic autoimmune diseases, rheumatoid arthritis, epilepsy, Alzheimer’s disease, cardiovascular diseases, Atherosclerosis, diabetes, etc., and many more. Besides, the model has tremendous importance in drug development, development of medical devices, tissue engineering, wound healing, and bone and cartilage regeneration studies, as a model in vascular surgeries as well as the model for vertebral disc regeneration surgery. Though, all the models have some advantages as well as challenges, but, present review has emphasized the importance of various small and large animal models in pharmaceutical drug development, transgenic animal models, models for medical device developments, studies for various human diseases, bone and cartilage regeneration model, diabetic and burn wound model as well as surgical models like vascular surgeries and surgeries for intervertebral disc degeneration considering all the ethical issues of that specific animal model. Despite, the process of using the animal model has facilitated researchers to carry out the researches that would have been impossible to accomplish in human considering the ethical prohibitions.
Collapse
Affiliation(s)
- P Mukherjee
- Department of Veterinary Clinical Complex, West Bengal University of Animal and Fishery Sciences, Mohanpur, Nadia, India
| | - S Roy
- Department of Veterinary Clinical Complex, West Bengal University of Animal and Fishery Sciences, Mohanpur, Nadia, India
| | - D Ghosh
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India
| | - S K Nandi
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India.
| |
Collapse
|
12
|
Abstract
How does dopamine, the brain's pleasure signal, regulate the dream stage of sleep?
Collapse
Affiliation(s)
- Elda Arrigoni
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Patrick M Fuller
- Department of Neurological Surgery, University of California, Davis School of Medicine, Davis, CA, USA
| |
Collapse
|
13
|
Meskill GJ, Kallweit U, Zarycranski D, Caussé C, Finance O, Ligneau X, Davis CW. Pitolisant for the treatment of cataplexy in adults with narcolepsy. Expert Opin Orphan Drugs 2022. [DOI: 10.1080/21678707.2021.2022472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Gerard J. Meskill
- Tricoastal Narcolepsy and Sleep Disorders Center, Sugar Land, Texas, USA
| | - Ulf Kallweit
- Center for Narcolepsy, Hypersomnias and Daytime Sleepiness, Universität Witten/Herdecke, Witten, Germany
| | | | | | | | | | - Craig W. Davis
- Harmony Biosciences, Plymouth Meeting, Pennsylvania, USA
| |
Collapse
|
14
|
Abstract
Sleep homeostasis is a complex neurobiologic phenomenon involving a number of molecular pathways, neurotransmitter release, synaptic activity, and factors modulating neural networks. Sleep plasticity allows for homeostatic optimization of neural networks and the replay-based consolidation of specific circuits, especially important for cognition, behavior, and information processing. Furthermore, research is currently moving from an essentially brain-focused to a more comprehensive view involving other systems, such as the immune system, hormonal status, and metabolic pathways. When dysfunctional, these systems contribute to sleep loss and fragmentation as well as to sleep need. In this chapter, the implications of neural plasticity and sleep homeostasis for the diagnosis and treatment of some major sleep disorders, such as insomnia and sleep deprivation, obstructive sleep apnea syndrome, restless legs syndrome, REM sleep behavior disorder, and narcolepsy are discussed in detail with their therapeutical implications. This chapter highlights that sleep is necessary for the maintenance of an optimal brain function and is sensitive to both genetic background and environmental enrichment. Even in pathologic conditions, sleep acts as a resilient plastic state that consolidates prior information and prioritizes network activity for efficient brain functioning.
Collapse
|
15
|
McGregor R, Wu MF, Holmes B, Lam HA, Maidment NT, Gera J, Yamanaka A, Siegel JM. Hypocretin/Orexin Interactions with Norepinephrine Contribute to the Opiate Withdrawal Syndrome. J Neurosci 2022; 42:255-263. [PMID: 34853083 PMCID: PMC8802943 DOI: 10.1523/jneurosci.1557-21.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/21/2021] [Accepted: 10/09/2021] [Indexed: 11/21/2022] Open
Abstract
We previously found that human heroin addicts and mice chronically exposed to morphine exhibit a significant increase in the number of detected hypocretin/orexin (Hcrt)-producing neurons. However, it remains unknown how this increase affects target areas of the hypocretin system involved in opioid withdrawal, including norepinephrine containing structures locus coeruleus (LC) and A1/A2 medullary regions. Using a combination of immunohistochemical, biochemical, imaging, and behavioral techniques, we now show that the increase in detected hypocretin cell number translates into a significant increase in hypocretin innervation and tyrosine hydroxylase (TH) levels in the LC without affecting norepinephrine-containing neuronal cell number. We show that the increase in TH is completely dependent on Hcrt innervation. The A1/A2 regions were unaffected by morphine treatment. Manipulation of the Hcrt system may affect opioid addiction and withdrawal.SIGNIFICANCE STATEMENT Previously, we have shown that the hypothalamic hypocretin system undergoes profound anatomic changes in human heroin addicts and in mice exposed to morphine, suggesting a role of this system in the development of addictive behaviors. The locus coeruleus plays a key role in opioid addiction. Here we report that the hypothalamic hypocretin innervation of the locus coeruleus increases dramatically with morphine administration to mice. This increase is correlated with a massive increase in tyrosine hydroxylase expression in locus coeruleus. Elimination of hypocretin neurons prevents the tyrosine hydroxylase increase in locus coeruleus and dampens the somatic and affective components of opioid withdrawal.
Collapse
Affiliation(s)
- Ronald McGregor
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California 90095
- Veterans Administration Greater Los Angeles Healthcare System, North Hills, Los Angeles, California 91343
| | - Ming-Fung Wu
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California 90095
- Veterans Administration Greater Los Angeles Healthcare System, North Hills, Los Angeles, California 91343
| | - Brent Holmes
- Veterans Administration Greater Los Angeles Healthcare System, North Hills, Los Angeles, California 91343
- Department of Medicine, University of California, Los Angeles, Los Angeles, 90095
| | - Hoa Anh Lam
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California 90095
- Hatos Center for Neuropharmacology, University of California, Los Angeles, Los Angeles, California 90095
| | - Nigel T Maidment
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California 90095
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California 90095
- Hatos Center for Neuropharmacology, University of California, Los Angeles, Los Angeles, California 90095
| | - Joseph Gera
- Veterans Administration Greater Los Angeles Healthcare System, North Hills, Los Angeles, California 91343
- Department of Medicine, University of California, Los Angeles, Los Angeles, 90095
- Jonnson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, 90095
- Molecular Biology Institute, University of California, Los Angeles, Los Angeles, 90095
| | - Akihiro Yamanaka
- Department of Neuroscience II, Research Institute of Environmental Medicine, Nagoya University, Nagoya 464-8601, Japan
| | - Jerome M Siegel
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California 90095
- Veterans Administration Greater Los Angeles Healthcare System, North Hills, Los Angeles, California 91343
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California 90095
| |
Collapse
|
16
|
Kim HC, Lee DA, Lee HJ, Shin KJ, Park KM. Alterations in the structural covariance network of the hypothalamus in patients with narcolepsy. Neuroradiology 2022; 64:1351-1357. [PMID: 35013760 DOI: 10.1007/s00234-021-02878-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/06/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The hypothalamus plays a pivotal role in the pathogenesis of narcolepsy. This study aimed to evaluate the differences in the structural covariance network of thehypothalamus based on volume differences between patients with narcolepsy and healthy controls. METHODS We retrospectively enrolled 15 patients with narcolepsy and 19 healthy controls.All subjects underwent three-dimensional T1-weighted imaging using a 3-T magnetic resonance imaging scanner. Hypothalamic subunits were segmented, and the volumes of individual hypothalamic subunits were obtained using the FreeSurfer program. Subsequently, we conducted a structural covariance network analysis of the subunit volumes with graph theory using the BRAPH program in patients with narcolepsy and in healthy controls. RESULTS There were no significant differences in the volumes of the entire right and left hypothalamus nor in the hypothalamic subunit between patients with narcolepsy and healthy controls. However, we found significant differences in the structural covariance network in the hypothalamus between these groups. The characteristic path length was significantly lower in patients with narcolepsy than in healthy controls (1.698 vs. 2.831, p = 0.001). However, other network measures did not differ between patients with narcolepsy and healthy controls. CONCLUSION We found that the structural covariance network of the hypothalamus, as assessed from the subunit volumes of hypothalamic regions using a graph theoretical analysis, is different in patients with narcolepsy compared to healthy controls. These findings may contribute to the understanding of the pathogenesis of narcolepsy.
Collapse
Affiliation(s)
- Hyung Chan Kim
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 48108, South Korea
| | - Dong Ah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 48108, South Korea
| | - Ho-Joon Lee
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Kyong Jin Shin
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 48108, South Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 48108, South Korea.
| |
Collapse
|
17
|
Arrigoni E, Fuller PM. The Role of the Central Histaminergic System in Behavioral State Control. Curr Top Behav Neurosci 2022; 59:447-468. [PMID: 34595740 DOI: 10.1007/7854_2021_263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Histamine is a small monoamine signaling molecule that plays a role in many peripheral and central physiological processes, including the regulation of wakefulness. The tuberomammillary nucleus is the sole neuronal source of histamine in the brain, and histamine neurons are thought to promote wakefulness and vigilance maintenance - under certain environmental and/or behavioral contexts - through their diffuse innervation of the cortex and other wake-promoting brain circuits. Histamine neurons also contain a number of other putative neurotransmitters, although the functional role of these co-transmitters remains incompletely understood. Within the brain histamine operates through three receptor subtypes that are located on pre- and post-synaptic membranes. Some histamine receptors exhibit constitutive activity, and hence exist in an activated state even in the absence of histamine. Newer medications used to reduce sleepiness in narcolepsy patients in fact enhance histamine signaling by blunting the constitutive activity of these histamine receptors. In this chapter, we provide an overview of the central histamine system with an emphasis on its role in behavioral state regulation and how drugs targeting histamine receptors are used clinically to treat a wide range of sleep-wake disorders.
Collapse
Affiliation(s)
- Elda Arrigoni
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
| | - Patrick M Fuller
- Department of Neurological Surgery, University of California Davis School of Medicine, Davis, CA, USA
| |
Collapse
|
18
|
The Histamine System in Zebrafish Brain: Organization, Receptors, and Behavioral Roles. Curr Top Behav Neurosci 2021; 59:291-302. [PMID: 34761361 DOI: 10.1007/7854_2021_259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Three of the four histamine receptors have been identified in zebrafish. Whereas only one histamine receptor 1 gene (hrh1) is known, two copies of histamine receptor 2 (hrh2a and hrh2b) have been identified. Although initially only one gene encoding for histamine receptor 3 (hrh3) was recognized in zebrafish, the genome database contains information for two more hrh3-like genes, whereas no genes corresponding for histamine receptor 4 with expression mainly in the immune system have been identified. Hrh1 and hrh3 show prominent uneven expression in the zebrafish brain, with the strongest expression in the dorsal telencephalon. Quantitatively significant expression of hrh1, hrh2, and hrh3 can also be found in several peripheral organs. Whereas antagonists of hrh1, hrh2, and hrh3 all affect the locomotor activity of zebrafish larvae, interpretation of the data is hampered by a lack of information on receptor binding and signaling characteristics. Zebrafish mutants lacking any of the three histamine receptors have shown modest behavioral phenotypes, possibly due to genetic compensation. None of the receptor mutant fish have shown significant sleep phenotypes. Adult zebrafish lacking hrh3 display decreased locomotor activity. The zebrafish histamine system shows significant life-long plasticity: presenilin 1 mutant zebrafish develop an abnormally large number of histamine neurons and increased thigmotaxis and anxiety-related phenotype. Overexpression of histidine decarboxylase (hdc) in larval zebrafish is associated with an increased number of hypocretin neurons, whereas translation inhibition of hdc or exposure to α-fluoromethylhistidine leads to decreased numbers of hypocretin neurons. Current pharmacological evidence suggests that this may be mediated by hrh1. Further studies using acute, e.g., pharmacogenetic or optogenetic manipulation of selected components of brain circuits, are required to understand the full range of physiological functions of zebrafish histamine receptors.
Collapse
|
19
|
Melzi S, Morel AL, Scoté-Blachon C, Liblau R, Dauvilliers Y, Peyron C. Histamine in murine narcolepsy: What do genetic and immune models tell us? Brain Pathol 2021; 32:e13027. [PMID: 34672414 PMCID: PMC8877734 DOI: 10.1111/bpa.13027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/14/2021] [Accepted: 09/27/2021] [Indexed: 12/20/2022] Open
Abstract
An increased number of histaminergic neurons, identified by labeling histidine‐decarboxylase (HDC) its synthesis enzyme, was unexpectedly found in patients with narcolepsy type 1 (NT1). In quest for enlightenment, we evaluate whether an increase in HDC cell number and expression level would be detected in mouse models of the disease, in order to provide proof of concepts reveling possible mechanisms of compensation for the loss of orexin neurons, and/or of induced expression as a consequence of local neuroinflammation, a state that likely accompanies NT1. To further explore the compensatory hypothesis, we also study the noradrenergic wake‐promoting system. Immunohistochemistry for HDC, orexin, and melanin‐concentrating hormone (MCH) was used to count neurons. Quantitative‐PCR of HDC, orexin, MCH, and tyrosine‐hydroxylase was performed to evaluate levels of mRNA expression in the hypothalamus or the dorsal pons. Both quantifications were achieved in genetic and neuroinflammatory models of narcolepsy with major orexin impairment, namely the orexin‐deficient (Orex‐KO) and orexin‐hemagglutinin (Orex‐HA) mice respectively. The number of HDC neurons and mRNA expression level were unchanged in Orex‐KO mice compared to controls. Similarly, we found no change in tyrosine‐hydroxylase mRNA expression in the dorsal pons between groups. Further, despite the presence of protracted local neuroinflammation as witnessed by the presence of reactive microglia, we found no change in the number of neurons nor the expression of HDC in Orex‐HA mice compared to controls. Importantly, no correlation was found in all conditions between HDC and orexin. Our findings indicate that, in mice, the expression of histamine and noradrenalin, two wake‐promoting systems, are not modulated by orexin level whether the lack of orexin is constitutive or induced at adult age, showing thus no compensation. They also show no recruitment of histamine by local neuroinflammation. Further studies will be needed to further define the role of histamine in the pathophysiology of NT1.
Collapse
Affiliation(s)
- Silvia Melzi
- Sleep Team, Center for Research in Neuroscience of LYON, CNRS UMR5292, INSERM U1028, University of Lyon1, Bron, France
| | - Anne-Laure Morel
- Sleep Team, Center for Research in Neuroscience of LYON, CNRS UMR5292, INSERM U1028, University of Lyon1, Bron, France
| | - Céline Scoté-Blachon
- Functional Neurogenetics platform, Center for Research in Neuroscience of LYON, CNRS UMR5292, INSERM U1028, University of Lyon1, Bron, France
| | - Roland Liblau
- Toulouse Institute for Infectious and Inflammatory diseases, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, UPS, University of Toulouse, Toulouse, France
| | - Yves Dauvilliers
- National Reference Centre for Orphan Diseases, Narcolepsy - Rare hypersomnia, Sleep Unit, Department of Neurology, CHU Montpellier, Institute for Neuroscience of Montpellier INM, INSERM U1298, University of Montpellier, Montpellier, France
| | - Christelle Peyron
- Sleep Team, Center for Research in Neuroscience of LYON, CNRS UMR5292, INSERM U1028, University of Lyon1, Bron, France
| |
Collapse
|
20
|
Seifinejad A, Vassalli A, Tafti M. Neurobiology of cataplexy. Sleep Med Rev 2021; 60:101546. [PMID: 34607185 DOI: 10.1016/j.smrv.2021.101546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/29/2021] [Accepted: 09/06/2021] [Indexed: 11/17/2022]
Abstract
Cataplexy is the pathognomonic and the most striking symptom of narcolepsy. It has originally been, and still is now, widely considered as an abnormal manifestation of rapid eye movement (REM) sleep during wakefulness due to the typical muscle atonia. The neurocircuits of cataplexy, originally confined to the brainstem as those of REM sleep atonia, now include the hypothalamus, dorsal raphe (DR), amygdala and frontal cortex, and its neurochemistry originally focused on catecholamines and acetylcholine now extend to hypocretin (HCRT) and other neuromodulators. Here, we review the neuroanatomy and neurochemistry of cataplexy and propose that cataplexy is a distinct brain state that, despite similarities with REM sleep, involves cataplexy-specific features.
Collapse
Affiliation(s)
- Ali Seifinejad
- Department of Biomedical Sciences, Faculty of Biology and Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Anne Vassalli
- Department of Biomedical Sciences, Faculty of Biology and Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Mehdi Tafti
- Department of Biomedical Sciences, Faculty of Biology and Medicine, University of Lausanne, 1005 Lausanne, Switzerland.
| |
Collapse
|
21
|
The Histaminergic System in Neuropsychiatric Disorders. Biomolecules 2021; 11:biom11091345. [PMID: 34572558 PMCID: PMC8467868 DOI: 10.3390/biom11091345] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 12/18/2022] Open
Abstract
Histamine does not only modulate the immune response and inflammation, but also acts as a neurotransmitter in the mammalian brain. The histaminergic system plays a significant role in the maintenance of wakefulness, appetite regulation, cognition and arousal, which are severely affected in neuropsychiatric disorders. In this review, we first briefly describe the distribution of histaminergic neurons, histamine receptors and their intracellular pathways. Next, we comprehensively summarize recent experimental and clinical findings on the precise role of histaminergic system in neuropsychiatric disorders, including cell-type role and its circuit bases in narcolepsy, schizophrenia, Alzheimer's disease, Tourette's syndrome and Parkinson's disease. Finally, we provide some perspectives on future research to illustrate the curative role of the histaminergic system in neuropsychiatric disorders.
Collapse
|
22
|
Shan L, Swaab DF. Changes in histaminergic system in neuropsychiatric disorders and the potential treatment consequences. Curr Neuropharmacol 2021; 20:403-411. [PMID: 34521328 PMCID: PMC9413789 DOI: 10.2174/1570159x19666210909144930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/05/2021] [Accepted: 08/26/2021] [Indexed: 11/22/2022] Open
Abstract
In contrast to that of other monoamine neurotransmitters, the association of the histaminergic system with neuropsychiatric disorders is not well documented. In the last two decades, several clinical studies involved in the development of drugs targeting the histaminergic system have been reported. These include the H3R-antagonist/inverse agonist, pitolisant, used for the treatment of excessive sleepiness in narcolepsy, and the H1R antagonist, doxepin, used to alleviate symptoms of insomnia. The current review summarizes reports from animal models, including genetic and neuroimaging studies, as well as human brain samples and cerebrospinal fluid measurements from clinical trials, on the possible role of the histaminergic system in neuropsychiatric disorders. These studies will potentially pave the way for novel histamine-related therapeutic strategies.
Collapse
Affiliation(s)
- Ling Shan
- Department of Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam. Netherlands
| | - Dick F Swaab
- Department of Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam. Netherlands
| |
Collapse
|
23
|
Different Peas in the Same Pod: The Histaminergic Neuronal Heterogeneity. Curr Top Behav Neurosci 2021; 59:303-327. [PMID: 34455575 DOI: 10.1007/7854_2021_241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The histaminergic neuronal system is recently receiving increasing attention, as much has been learned over the past 25 years about histamine role as a neurotransmitter. Indeed, this amine is crucial in maintaining arousal and provides important contributions to regulate circadian rhythms, energy, endocrine homeostasis, motor behavior, and cognition. The extent to which these distinct physiological functions are operated by independent histamine neuronal subpopulation is unclear. In the rat brain histamine neuronal cell bodies are grouped within the tuberomamillary nucleus of the posterior hypothalamus in five clusters, E1-E5, each sending overlapping axons throughout the entire central nervous system with no strict topographical pattern. These features lead to the concept that histamine regulation of a wide range of functions in the central nervous system is achieved by the histaminergic neuronal system as a whole. However, increasing experimental evidence suggesting that the histaminergic system is organized into distinct pathways modulated by selective mechanisms challenges this view. In this review, we summarized experimental evidence supporting the heterogeneity of histamine neurons, and their organization in functionally distinct circuits impinging on separate brain regions and displaying selective control mechanisms. This implies independent functions of subsets of histaminergic neurons according to their respective origin and terminal projections with relevant consequences for the development of specific compounds that affect only subsets of histamine neurons, thus increasing the target specificity.
Collapse
|
24
|
Mochizuki T. Histamine as an Alert Signal in the Brain. Curr Top Behav Neurosci 2021; 59:413-425. [PMID: 34448132 DOI: 10.1007/7854_2021_249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Sleep-wake behavior is a well-studied physiology in central histamine studies. Classical histamine H1 receptor antagonists, such as diphenhydramine and chlorpheniramine, promote sleep in animals and humans. Further, neuronal histamine release shows a clear circadian rhythm in parallel with wake behavior. However, the early stages of histamine-associated knockout mouse studies showed relatively small defects in normal sleep-wake control. To reassess the role of histamine in behavioral state control, this review summarizes the progress in sleep-wake studies of histamine-associated genetic mouse models and discusses the significance of histamine for characteristic aspects of wake behavior. Based on analysis of recent mouse models, we propose that neuronal histamine may serve as an alert signal in the brain, when high attention or a strong wake-drive is needed, such as during exploration, self-defense, learning, or to counteract hypersomnolent diseases. Enhanced histaminergic neurotransmission may help performance or sense of signals concerning internal or environmental dangers, like peripheral histamine from mast cells in response to allergic stimuli and inflammatory signals.
Collapse
Affiliation(s)
- Takatoshi Mochizuki
- Department of Biology, Graduate School of Science and Engineering, University of Toyama, Toyama, Japan.
| |
Collapse
|
25
|
Brink-Kjaer A, Christensen JAE, Cesari M, Mignot E, Sorensen HBD, Jennum P. Cortical arousal frequency is increased in narcolepsy type 1. Sleep 2021; 44:6009075. [PMID: 33249455 DOI: 10.1093/sleep/zsaa255] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/04/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES Hypocretin deficient narcolepsy (type 1, NT1) presents with multiple sleep abnormalities including sleep-onset rapid eye movement (REM) periods (SOREMPs) and sleep fragmentation. We hypothesized that cortical arousals, as scored by an automatic detector, are elevated in NT1 and narcolepsy type 2 (NT2) patients as compared to control subjects. METHODS We analyzed nocturnal polysomnography (PSG) recordings from 25 NT1 patients, 20 NT2 patients, 18 clinical control subjects (CC, suspected central hypersomnia but with normal cerebrospinal (CSF) fluid hypocretin-1 (hcrt-1) levels and normal results on the multiple sleep latency test), and 37 healthy control (HC) subjects. Arousals were automatically scored using Multimodal Arousal Detector (MAD), a previously validated automatic wakefulness and arousal detector. Multiple linear regressions were used to compare arousal index (ArI) distributions across groups. Comparisons were corrected for age, sex, body-mass index, medication, apnea-hypopnea index, periodic leg movement index, and comorbid rapid eye movement sleep behavior disorder. RESULTS NT1 was associated with an average increase in ArI of 4.02 events/h (p = 0.0246) compared to HC and CC, while no difference was found between NT2 and control groups. Additionally, a low CSF hcrt-1 level was predictive of increased ArI in all the CC, NT2, and NT1 groups. CONCLUSIONS The results further support the hypothesis that a loss of hypocretin neurons causes fragmented sleep, which can be measured as an increased ArI as scored by the MAD.
Collapse
Affiliation(s)
- Andreas Brink-Kjaer
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark.,Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Denmark.,Stanford Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, CA
| | - Julie A E Christensen
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark.,Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Denmark
| | - Matteo Cesari
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Emmanuel Mignot
- Stanford Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, CA
| | - Helge B D Sorensen
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Poul Jennum
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| |
Collapse
|
26
|
Berteotti C, Lo Martire V, Alvente S, Bastianini S, Bombardi C, Matteoli G, Ohtsu H, Lin JS, Silvani A, Zoccoli G. Orexin/Hypocretin and Histamine Cross-Talk on Hypothalamic Neuron Counts in Mice. Front Neurosci 2021; 15:660518. [PMID: 34093114 PMCID: PMC8173058 DOI: 10.3389/fnins.2021.660518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/27/2021] [Indexed: 12/14/2022] Open
Abstract
The loss of hypothalamic neurons that produce wake-promoting orexin (hypocretin) neuropeptides is responsible for narcolepsy type 1 (NT1). While the number of histamine neurons is increased in patients with NT1, results on orexin-deficient mouse models of NT1 are inconsistent. On the other hand, the effect of histamine deficiency on orexin neuron number has never been tested on mammals, even though histamine has been reported to be essential for the development of a functional orexin system in zebrafish. The aim of this study was to test whether histamine neurons are increased in number in orexin-deficient mice and whether orexin neurons are decreased in number in histamine-deficient mice. The hypothalamic neurons expressing L-histidine decarboxylase (HDC), the histamine synthesis enzyme, and those expressing orexin A were counted in four orexin knock-out mice, four histamine-deficient HDC knock-out mice, and four wild-type C57BL/6J mice. The number of HDC-positive neurons was significantly higher in orexin knock-out than in wild-type mice (2,502 ± 77 vs. 1,800 ± 213, respectively, one-tailed t-test, P = 0.011). Conversely, the number of orexin neurons was not significantly lower in HDC knock-out than in wild-type mice (2,306 ± 56 vs. 2,320 ± 120, respectively, one-tailed t-test, P = 0.459). These data support the view that orexin peptide deficiency is sufficient to increase histamine neuron number, supporting the involvement of the histamine waking system in the pathophysiology of NT1. Conversely, these data do not support a significant role of histamine in orexin neuron development in mammals.
Collapse
Affiliation(s)
- Chiara Berteotti
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, Center for Applied Biomedical Research, S. Orsola University Hospital, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Viviana Lo Martire
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, Center for Applied Biomedical Research, S. Orsola University Hospital, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Sara Alvente
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, Center for Applied Biomedical Research, S. Orsola University Hospital, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Stefano Bastianini
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, Center for Applied Biomedical Research, S. Orsola University Hospital, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Cristiano Bombardi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Gabriele Matteoli
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, Center for Applied Biomedical Research, S. Orsola University Hospital, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | | | - Jian-Sheng Lin
- Physiologie Intégrée du Système d'éveil, Centre de Recherche en Neurosciences de Lyon, INSERM U1028-CNRS UMR, Bron, France
| | - Alessandro Silvani
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, Center for Applied Biomedical Research, S. Orsola University Hospital, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Giovanna Zoccoli
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, Center for Applied Biomedical Research, S. Orsola University Hospital, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| |
Collapse
|
27
|
Shimada M, Miyagawa T, Kodama T, Toyoda H, Tokunaga K, Honda M. Metabolome analysis using cerebrospinal fluid from narcolepsy type 1 patients. Sleep 2021; 43:5837570. [PMID: 32412602 DOI: 10.1093/sleep/zsaa095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/25/2020] [Indexed: 12/14/2022] Open
Abstract
Narcolepsy type 1 (NT1) is a hypersomnia characterized by excessive daytime sleepiness and cataplexy. Inappropriate regulation of fatty acid metabolism has been suggested to be involved in the pathophysiology of NT1, but the detailed mechanisms remain uncertain. Here we performed a metabolomic analysis of cerebrospinal fluid samples from 14 NT1 and 17 control subjects using a novel capillary electrophoresis coupled with Fourier transform mass spectrometry. A total of 268 metabolites were identified and the amount of histidine was the most significantly increased in NT1 patients (p = 4.0 × 10-4). Validation analysis using high-performance liquid chromatography (HPLC) including independent replication samples also identified the association of histidine (p = 2.02 × 10-3). Further, levels of histamine, which is synthesized from histidine, were also examined using HPLC and were found to be significantly decreased in NT1 patients (p = 6.12 × 10-4). Pathway analysis with nominally significant metabolites identified several pathways related to the metabolism of glycogenic amino acids, suggesting that glycogenesis is enhanced in NT1 as a compensatory mechanism for fatty acid metabolism. We performed further exploratory analysis, searching for metabolites associated with sleep variables from polysomnography and the multiple sleep latency test. As a result, 5'-deoxy-5'-methylthioadenosine showed a significant association with apnea-hypopnea index (p = 2.66 ×10-6). Moreover, gamma aminobutyric acid displayed a negative correlation with rapid eye movement sleep latency (REML), and thus might represent an intriguing target for future studies to elucidate how the controlling circuit of REM sleep is associated with abnormally short REML in NT1.
Collapse
Affiliation(s)
- Mihoko Shimada
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taku Miyagawa
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tohru Kodama
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Hiromi Toyoda
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Genome Medical Science Project (Toyama), National Center for Global Health and Medicine (NCGM), Tokyo, Japan
| | - Makoto Honda
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Seiwa Hospital, Institute of Neuropsychiatry, Tokyo, Japan
| |
Collapse
|
28
|
Kaushik MK, Aritake K, Cherasse Y, Imanishi A, Kanbayashi T, Urade Y, Yanagisawa M. Induction of narcolepsy-like symptoms by orexin receptor antagonists in mice. Sleep 2021; 44:6145803. [PMID: 33609365 DOI: 10.1093/sleep/zsab043] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/27/2021] [Indexed: 12/19/2022] Open
Abstract
Orexins/hypocretins are hypothalamic neuropeptides that promote and stabilize wakefulness by binding to the orexin receptor type-1 (OX1R) and type-2 (OX2R). Disruption of orexinergic signaling results in the sleep disorder narcolepsy in mice, rats, dogs, and humans. The orexin receptor antagonist suvorexant promotes sleep by blocking both OX1R and OX2R. Whereas suvorexant has been clinically approved for the treatment of insomnia because it is well tolerated in experimental animals as well as in human patients, a logical question remains as to why orexin receptor antagonists do not induce overt narcolepsy-like symptoms. Here we show that acute and chronic suvorexant promotes both rapid eye movement (REM) and non-REM (NREM) sleep without inducing cataplexy in mice. Interestingly, chronic suvorexant increases OX2R mRNA and decreases orexin mRNA and peptide levels, which remain low long after termination of suvorexant administration. When mice are chronically treated with suvorexant and then re-challenged with the antagonist after a 1-week washout, however, cataplexy and sleep-onset REM (SOREM) are observed, which are exacerbated by chocolate administration. Heterozygous orexin knockout mice, with lower brain orexin levels, show cataplexy and SOREM after acute suvorexant administration. Furthermore, we find that acute suvorexant can induce cataplexy and SOREM in wild-type mice when co-administered with chocolate under stress-free (temporally anesthetized) conditions. Taken together, these results suggest that suvorexant can inhibit orexin synthesis resulting in susceptibility to narcolepsy-like symptoms in mice under certain conditions.
Collapse
Affiliation(s)
- Mahesh K Kaushik
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
| | - Kosuke Aritake
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
| | - Yoan Cherasse
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
| | - Aya Imanishi
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Takashi Kanbayashi
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
| | - Yoshihiro Urade
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
- Isotope Science Center, The University of Tokyo, Tokyo, Japan
| | - Masashi Yanagisawa
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
- Department of Molecular Genetics, University of Texas Southwestern Medical Center at Dallas, Dallas, TX
- Life Science Center, Tsukuba Advanced Research Alliance, University of Tsukuba, Tsukuba, Japan
- R&D Center for Frontiers of MIRAI in Policy and Technology, University of Tsukuba, Tsukuba, Japan
| |
Collapse
|
29
|
Shan L, Fronczek R, Lammers GJ, Swaab DF. The tuberomamillary nucleus in neuropsychiatric disorders. HANDBOOK OF CLINICAL NEUROLOGY 2021; 180:389-400. [PMID: 34225943 DOI: 10.1016/b978-0-12-820107-7.00024-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The tuberomamillary nucleus (TMN) is located within the posterior part of the hypothalamus. The histamine neurons in it synthesize histamine by means of the key enzyme histidine decarboxylase (HDC) and from the TMN, innervate a large number of brain areas, such as the cerebral cortex, hippocampus, amygdala as well as the thalamus, hypothalamus, and basal ganglia. Brain histamine is reduced to an inactivated form, tele-methylhistamine (t-MeHA), by histamine N-methyltransferase (HMT). In total, there are four types of histamine receptors (H1-4Rs) in the brain, all of which are G-protein coupled. The histaminergic system controls several basal physiological functions, including the sleep-wake cycle, energy and endocrine homeostasis, sensory and motor functions, and cognitive functions such as attention, learning, and memory. Histaminergic dysfunction may contribute to clinical disorders such as Parkinson's disease, Alzheimer's disease, Huntington's disease, narcolepsy type 1, schizophrenia, Tourette syndrome, and autism spectrum disorder. In the current chapter, we focus on the role of the histaminergic system in these neurological/neuropsychiatric disorders. For each disorder, we first discuss human data, including genetic, postmortem brain, and cerebrospinal fluid studies. Then, we try to interpret the human changes by reviewing related animal studies and end by discussing, if present, recent progress in clinical studies on novel histamine-related therapeutic strategies.
Collapse
Affiliation(s)
- Ling Shan
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands; Sleep Wake Centre SEIN, Heemstede, The Netherlands; Department Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.
| | - Rolf Fronczek
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands; Sleep Wake Centre SEIN, Heemstede, The Netherlands
| | - Gert Jan Lammers
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands; Sleep Wake Centre SEIN, Heemstede, The Netherlands
| | - Dick F Swaab
- Department Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| |
Collapse
|
30
|
Berteotti C, Liguori C, Pace M. Dysregulation of the orexin/hypocretin system is not limited to narcolepsy but has far-reaching implications for neurological disorders. Eur J Neurosci 2020; 53:1136-1154. [PMID: 33290595 DOI: 10.1111/ejn.15077] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/05/2020] [Accepted: 10/05/2020] [Indexed: 12/23/2022]
Abstract
Neuropeptides orexin A and B (OX-A/B, also called hypocretin 1 and 2) are released selectively by a population of neurons which projects widely into the entire central nervous system but is localized in a restricted area of the tuberal region of the hypothalamus, caudal to the paraventricular nucleus. The OX system prominently targets brain structures involved in the regulation of wake-sleep state switching, and also orchestrates multiple physiological functions. The degeneration and dysregulation of the OX system promotes narcoleptic phenotypes both in humans and animals. Hence, this review begins with the already proven involvement of OX in narcolepsy, but it mainly discusses the new pre-clinical and clinical insights of the role of OX in three major neurological disorders characterized by sleep impairment which have been recently associated with OX dysfunction, such as Alzheimer's disease, stroke and Prader Willi syndrome, and have been emerged over the past 10 years to be strongly associated with the OX dysfunction and should be more considered in the future. In the light of the impairment of the OX system in these neurological disorders, it is conceivable to speculate that the integrity of the OX system is necessary for a healthy functioning body.
Collapse
Affiliation(s)
- Chiara Berteotti
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Claudio Liguori
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marta Pace
- Genetics and Epigenetics of Behaviour Laboratory, Istituto Italiano di Tecnologia, Genova, Italy
| |
Collapse
|
31
|
Mahoney CE, Mochizuki T, Scammell TE. Dual orexin receptor antagonists increase sleep and cataplexy in wild type mice. Sleep 2020; 43:zsz302. [PMID: 31830270 PMCID: PMC7294412 DOI: 10.1093/sleep/zsz302] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/26/2019] [Indexed: 11/13/2022] Open
Abstract
Orexin receptor antagonists are clinically useful for treating insomnia, but thorough blockade of orexin signaling could cause narcolepsy-like symptoms. Specifically, while sleepiness is a desirable effect, an orexin antagonist could also produce cataplexy, sudden episodes of muscle weakness often triggered by strong, positive emotions. In this study, we examined the effects of dual orexin receptor antagonists (DORAs), lemborexant (E2006) and almorexant, on sleep-wake behavior and cataplexy during the dark period in wild-type (WT) mice and prepro-orexin knockout (OXKO) mice. In WT mice, lemborexant at 10 and 30 mg/kg quickly induced NREM sleep in a dose-dependent fashion. In contrast, lemborexant did not alter sleep-wake behavior in OXKO mice. Under the baseline condition, cataplexy was rare in lemborexant-treated WT mice, but when mice were given chocolate as a rewarding stimulus, lemborexant dose-dependently increased cataplexy. Almorexant produced similar results. Collectively, these results demonstrate that DORAs potently increase NREM and REM sleep in mice via blockade of orexin signaling, and higher doses can cause cataplexy when co-administered with a likely rewarding stimulus.
Collapse
Affiliation(s)
- Carrie E Mahoney
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Takatoshi Mochizuki
- Graduate School of Science and Engineering, University of Toyama, Gofuku, Japan
| | - Thomas E Scammell
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| |
Collapse
|
32
|
Sanchez-Alavez M, Benedict J, Wills DN, Ehlers CL. Effect of suvorexant on event-related oscillations and EEG sleep in rats exposed to chronic intermittent ethanol vapor and protracted withdrawal. Sleep 2020; 42:5304584. [PMID: 30715515 DOI: 10.1093/sleep/zsz020] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/07/2018] [Indexed: 01/27/2023] Open
Abstract
STUDY OBJECTIVES Insomnia is a prominent complaint in patients with alcohol use disorders (AUD). However, despite the importance of sleep in the maintenance of sobriety, treatment options for sleep disturbance associated with a history of AUD are currently limited. Recent clinical trials have demonstrated that suvorexant, a dual Hct/OX receptor antagonist, normalizes sleep in patients with primary insomnia; yet, its potential for the treatment of sleep pathology associated with AUD has not been investigated in either preclinical or clinical studies. METHODS This study employed a model whereby ethanol vapor exposure or control conditions were administered for 8 weeks to adult rats. Waking event-related oscillations (EROs) and EEG sleep were evaluated at baseline before exposure and again following 24 hr of withdrawal from the exposure. Subsequently, the ability of vehicle (VEH) and two doses (10, 30 mg/kg IP) of suvorexant to modify EROs, sleep, and the sleep EEG was investigated. RESULTS After 24 hr following EtOH withdrawal, the ethanol-treated group had increases in waking ERO θ and β activity, more fragmented sleep (shorter duration and increased frequency of slow wave (SW) and rapid eye movement [REM] sleep episodes), and increased θ and β power in REM and SW sleep. Suvorexant induced a dose-dependent decrease in the latency to REM and SW sleep onsets but also produced REM and SW sleep fragmentation and increased β energy in waking EROs when compared with VEH. CONCLUSIONS Taken together, these studies suggest that suvorexant has overall sleep-promoting effects, but it may exacerbate some aspects of sleep and EEG pathology.
Collapse
Affiliation(s)
| | - Jessica Benedict
- Department of Neurosciences, The Scripps Research Institute, La Jolla, CA
| | - Derek N Wills
- Department of Neurosciences, The Scripps Research Institute, La Jolla, CA
| | - Cindy L Ehlers
- Department of Neurosciences, The Scripps Research Institute, La Jolla, CA
| |
Collapse
|
33
|
Piras C, Pintus R, Pruna D, Dessì A, Atzori L, Fanos V. Pediatric Acute-onset Neuropsychiatric Syndrome and Mycoplasma Pneumoniae Infection: A Case Report Analysis with a Metabolomics Approach. Curr Pediatr Rev 2020; 16:183-193. [PMID: 31642785 PMCID: PMC8193809 DOI: 10.2174/1573396315666191022102925] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/26/2019] [Accepted: 10/02/2019] [Indexed: 01/27/2023]
Abstract
Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) is a clinical condition characterized by a sudden and dramatic obsessive-compulsive disorder with a suggested post-infectious immune-mediated etiology. This condition is accompanied by an extensive series of relatively serious neuropsychiatric symptoms. The diagnosis of PANS is made by "exclusion", as the individual PANS symptoms overlap with a multiplicity of psychiatric disorders with the onset in childhood. A number of researchers accumulated evidence to support the hypothesis that PANS was closely associated with a number of infections. In the last decade, metabolomics played an essential role in improving the knowledge of complex biological systems and identifying potential new biomarkers as indicators of pathological progressions or pharmacologic responses to therapy. The metabolome is considered the most predictive phenotype, capable of recognizing epigenetic differences, reflecting more closely the clinical reality at any given moment and thus providing extremely dynamic data. In the present work, the most recent hypothesis and suggested mechanisms of this condition are reviewed and the case of a 10 - year-old girl with PANS is described, before and after clarithromycin treatment. The main results of this case report are discussed from a metabolomics point of view. The alteration of several metabolic pathways concerning the microbial activity highlights the possible role of the microbiome in the development of PANS. Furthermore, different metabolic perturbations at the level of protein biosynthesis, energy and amino acid metabolisms are observed and discussed. Based on our observations, it is believed that metabolomics is a promising technology to unravel the mysteries of PANS in the near future.
Collapse
Affiliation(s)
- Cristina Piras
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Roberta Pintus
- Department of Surgical Sciences, Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, Azienda Ospedaliera Universitaria, Cagliari, Italy
| | - Dario Pruna
- Pediatric Neurology and Epileptology Unit, Brotzu Hospital Trust, Cagliari, Italy
| | - Angelica Dessì
- Department of Surgical Sciences, Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, Azienda Ospedaliera Universitaria, Cagliari, Italy
| | - Luigi Atzori
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Vassilios Fanos
- Department of Surgical Sciences, Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, Azienda Ospedaliera Universitaria, Cagliari, Italy
| |
Collapse
|
34
|
Scammell TE, Jackson AC, Franks NP, Wisden W, Dauvilliers Y. Histamine: neural circuits and new medications. Sleep 2019; 42:5099478. [PMID: 30239935 PMCID: PMC6335869 DOI: 10.1093/sleep/zsy183] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Indexed: 12/12/2022] Open
Abstract
Histamine was first identified in the brain about 50 years ago, but only in the last few years have researchers gained an understanding of how it regulates sleep/wake behavior. We provide a translational overview of the histamine system, from basic research to new clinical trials demonstrating the usefulness of drugs that enhance histamine signaling. The tuberomammillary nucleus is the sole neuronal source of histamine in the brain, and like many of the arousal systems, histamine neurons diffusely innervate the cortex, thalamus, and other wake-promoting brain regions. Histamine has generally excitatory effects on target neurons, but paradoxically, histamine neurons may also release the inhibitory neurotransmitter GABA. New research demonstrates that activity in histamine neurons is essential for normal wakefulness, especially at specific circadian phases, and reducing activity in these neurons can produce sedation. The number of histamine neurons is increased in narcolepsy, but whether this affects brain levels of histamine is controversial. Of clinical importance, new compounds are becoming available that enhance histamine signaling, and clinical trials show that these medications reduce sleepiness and cataplexy in narcolepsy.
Collapse
Affiliation(s)
- Thomas E Scammell
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Alexander C Jackson
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT
| | - Nicholas P Franks
- Department of Life Sciences and UK Dementia Research Institute, Imperial College London, UK
| | - William Wisden
- Department of Life Sciences and UK Dementia Research Institute, Imperial College London, UK
| | - Yves Dauvilliers
- Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Service de Neurologie, Hôpital Gui-de-Chauliac, Université Montpellier, INSERM, Montpellier, France
| |
Collapse
|
35
|
Narcolepsy — clinical spectrum, aetiopathophysiology, diagnosis and treatment. Nat Rev Neurol 2019; 15:519-539. [DOI: 10.1038/s41582-019-0226-9] [Citation(s) in RCA: 204] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2019] [Indexed: 12/15/2022]
|
36
|
Barateau L, Lopez R, Dauvilliers Y. Clinical neurophysiology of CNS hypersomnias. HANDBOOK OF CLINICAL NEUROLOGY 2019; 161:353-367. [PMID: 31307613 DOI: 10.1016/b978-0-444-64142-7.00060-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Central nervous system hypersomnias (narcolepsy type 1 and type 2, idiopathic hypersomnia, and Kleine-Levin syndrome) are orphan sleep disorders in which the predominant symptom is excessive daytime sleepiness. The evaluation of sleepiness requires rigorous clinical and neurophysiologic approaches that may include the Epworth Sleepiness Scale, multiple sleep latency tests, and the maintenance of wakefulness test. However, to date, no gold standard measurement of excessive sleepiness exists, and there are no quantifiable biologic markers. The main pathophysiologic feature of central hypersomnias is thought to reflect a deficiency of arousal systems, rather than an overactivity of sleep systems or an imbalance between those systems. Impaired neurotransmission of hypocretin/orexin (neuropeptides of the lateral hypothalamus) is involved in the neurobiology of narcolepsy with cataplexy (NT1). NT1 is a well-characterized disorder, due to the destruction of hypocretin/orexin neurons by a probable autoimmune process. The biologic hallmarks of the other central hypersomnias remain unknown, and neurophysiologic biomarkers are still of major importance for the diagnosis and characterization of those disorders.
Collapse
Affiliation(s)
- Lucie Barateau
- Department of Neurology, Sleep-Wake Disorders Center, Hôpital Gui-de-Chauliac, Montpellier, France; National Reference Network for Narcolepsy, Montpellier, France
| | - Régis Lopez
- Department of Neurology, Sleep-Wake Disorders Center, Hôpital Gui-de-Chauliac, Montpellier, France; National Reference Network for Narcolepsy, Montpellier, France
| | - Yves Dauvilliers
- Department of Neurology, Sleep-Wake Disorders Center, Hôpital Gui-de-Chauliac, Montpellier, France; National Reference Network for Narcolepsy, Montpellier, France.
| |
Collapse
|
37
|
Pittenger C. The histidine decarboxylase model of tic pathophysiology: a new focus on the histamine H 3 receptor. Br J Pharmacol 2019; 177:570-579. [PMID: 30714121 DOI: 10.1111/bph.14606] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/12/2018] [Accepted: 01/07/2019] [Indexed: 12/16/2022] Open
Abstract
Histamine dysregulation was implicated as a rare cause of Tourette syndrome and other tic disorders a decade ago by a landmark genetic study in a high density family pedigree, which implicated a hypomorphic mutation in the histidine decarboxylase (Hdc) gene as a rare but high penetrance genetic cause. Studies in Hdc knockout (KO) mice have confirmed that this mutation causes tic-relevant behavioural and neurochemical abnormalities that parallel what is seen in patients and thus validate the KO as a potentially informative model of tic pathophysiology. Recent studies have focused on the potential role of the histamine H3 receptor in this model, and by association in tic disorders and related neuropsychiatric conditions. The H3 receptor is up-regulated in the striatum in Hdc KO mice. As the H3 receptor has constitutive activity in the absence of ligand, this receptor up-regulation may have significant cellular effects despite the absence of neurotransmitter histamine in these mice. Activation in vivo of H3 receptors in wild type mice regulates signalling in striatal medium spiny neurons (MSNs) that interacts non-linearly with dopamine receptor signalling. Baseline signalling alterations in MSNs in Hdc KO mice resemble those seen after H3 receptor agonist treatment in wild type animals. H3 receptor agonist treatment in the KOs further accentuates most of these signalling abnormalities and produces behavioural stereotypy. Together, these data suggest the intriguing hypothesis that constitutive signalling by up-regulated H3 receptors explains many of the molecular and behavioural abnormalities seen in these animals. LINKED ARTICLES: This article is part of a themed section on New Uses for 21st Century. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.3/issuetoc.
Collapse
|
38
|
Sarkanen T, Alakuijala A, Partinen M. Ullanlinna Narcolepsy Scale in diagnosis of narcolepsy. Sleep 2019; 42:5208781. [PMID: 30476331 DOI: 10.1093/sleep/zsy238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 10/12/2018] [Indexed: 01/06/2023] Open
Abstract
STUDY OBJECTIVES To validate Ullanlinna Narcolepsy Scale (UNS) as a screening tool for narcolepsy in a clinical population and to compare it with Swiss Narcolepsy Scale (SNS) and Epworth Sleepiness Scale (ESS). METHODS UNS questionnaires of 267 participants visiting Helsinki Sleep Clinic were analyzed. The diagnoses of the participants were narcolepsy type 1 (NT1, n = 89), narcolepsy type 2 (NT2, n = 10), other hypersomnias (n = 24), sleep apnea (n = 37), restless legs syndrome or periodic limb movement disorder (n = 56), and other sleep-related disorders (n = 51). In addition, ESS and SNS scores in a subset of sample (total N = 167) were analyzed and compared to UNS. RESULTS Mean UNS score in NT1 was 22.0 (95% confidence interval [CI] = 20.4 to 23.6, range 9-43), which was significantly higher than in other disorders, including NT2 (mean 13.7, 95% CI = 10.3 to 17.1, range 7-21, p = .0013). Sensitivity and specificity of UNS in separating NT1 from other disorders were 83.5% and 84.1%, respectively. Positive and negative predictive values were 82.5% and 85.1%, respectively. Sensitivities of SNS and ESS in NT1 were 77.2% and 88.6%, and specificities 88.6% and 45.5%, respectively. There were no differences in receiver operating characteristic curves between UNS and SNS. UNS had moderate negative correlation with hypocretin-1 levels (rs = -.564, p < .001), and mean sleep latency in multiple sleep latency test (rs= -.608, p < .001). CONCLUSIONS UNS has high specificity and sensitivity for NT1 in a sleep clinic setting. UNS scores below 9 strongly suggest against the diagnosis of narcolepsy.
Collapse
Affiliation(s)
- Tomi Sarkanen
- Department of Neurology, Tampere University Hospital, Tampere, Finland
- Department of Neurological Sciences, University of Helsinki, Helsinki, Finland
| | - Anniina Alakuijala
- Department of Neurological Sciences, University of Helsinki, Helsinki, Finland
- Department of Clinical Neurophysiology, HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Markku Partinen
- Department of Neurological Sciences, University of Helsinki, Helsinki, Finland
- Helsinki Sleep Clinic, Vitalmed Research Centre, Helsinki, Finland
| |
Collapse
|
39
|
Abstract
Narcolepsy is the most common neurological cause of chronic sleepiness. The discovery about 20 years ago that narcolepsy is caused by selective loss of the neurons producing orexins (also known as hypocretins) sparked great advances in the field. Here, we review the current understanding of how orexin neurons regulate sleep-wake behaviour and the consequences of the loss of orexin neurons. We also summarize the developing evidence that narcolepsy is an autoimmune disorder that may be caused by a T cell-mediated attack on the orexin neurons and explain how these new perspectives can inform better therapeutic approaches.
Collapse
Affiliation(s)
- Carrie E Mahoney
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Andrew Cogswell
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Igor J Koralnik
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Thomas E Scammell
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
40
|
Baumann CR. Clinical Sleep-Wake Disorders I: Focus on Hypersomnias and Movement Disorders During Sleep. Handb Exp Pharmacol 2019; 253:245-259. [PMID: 30341725 DOI: 10.1007/164_2018_126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Central disorders of hypersomnolence are characterized by daily periods of irrepressible need to sleep or daytime lapses into sleep, as defined in the current version of the International Criteria of Sleep Disorders. Thus, the unifying symptom is excessive daytime sleepiness which is not caused by any other sleep-wake disorder. Relevant disorders including narcolepsy type 1 and 2, idiopathic hypersomnia, Kleine-Levin syndrome, and insufficient sleep syndrome will be discussed. Other central disorders of hypersomnolence include hypersomnias due to medical or psychiatric disorders or because of medication or substance use.In sleep-related movement disorders, the cardinal symptom consists of simple, often stereotyped movements occurring during sleep. The most frequent disorder in this category of sleep-wake disorders is restless legs syndrome, which is often associated with period limb movements during sleep.
Collapse
Affiliation(s)
- Christian R Baumann
- Department of Neurology, University Hospital Zurich, University of Zurich, Zürich, Switzerland.
| |
Collapse
|
41
|
Almeneessier AS, Alballa NS, Alsalman BH, Aleissi S, Olaish AH, BaHammam AS. A 10-Year Longitudinal Observational Study Of Cataplexy In A Cohort Of Narcolepsy Type 1 Patients. Nat Sci Sleep 2019; 11:231-239. [PMID: 31695532 PMCID: PMC6814360 DOI: 10.2147/nss.s229105] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 09/29/2019] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Narcolepsy type 1 (NT1) is thought to have a chronic persistent course. This study aimed to assess the natural course of cataplexy in patients with NT1 at 2, 6, and 10 years after stabilizing symptoms. Other secondary objectives included assessing sleep quality, body mass index (BMI), and comorbidities at recruitment and 10 years later. PATIENTS AND METHODS Cataplexy symptoms, the Epworth sleepiness scale (ESS), sleep quality (assessed using the Pittsburgh sleep quality index [PSQI]), BMI, and comorbid conditions were prospectively monitored in 38 patients with NT1. The study sample comprised 38 patients with narcolepsy (males=27). The mean ages at disease onset and recruitment were 17.7 ± 5.6 years and 24.3 ± 8.6 years, respectively. RESULTS In 42% of the cohort, the anti-cataplectic medications were stopped at the end of the study without disturbing symptoms of cataplexy. Additionally, there was an apparent significant reduction in the frequency of cataplexy over time. The mean ESS score decreased by more than 4 points from 19.4 ± 2.9 to 15 ± 4.3 (p<0.001) while on the same pharmacotherapy. The number of patients with a PSQI score of <5 (indicating good sleep quality) increased from 6 (15.8%) to 15 (39.5%) (p=0.004). The BMI increased from 30 ± 5.1 to 33.3 ± 6 kg/m2 (p=0.001). No changes were documented in comorbidities. CONCLUSION The findings suggest that the course of NT1 is not stable. Over a 10-year period, cataplexy symptoms improved or disappeared in a large proportion of patients, and there was an improvement in daytime sleepiness and nighttime sleep quality. More prospective studies that repeatedly monitor CSF-HCRT are needed to confirm the current findings.
Collapse
Affiliation(s)
- Aljohara S Almeneessier
- Department of Medicine, College of Medicine, the University Sleep Disorders Center, Riyadh, Saudi Arabia.,Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nouf S Alballa
- Department of Medicine, College of Medicine, the University Sleep Disorders Center, Riyadh, Saudi Arabia
| | - Budoor H Alsalman
- Department of Medicine, College of Medicine, the University Sleep Disorders Center, Riyadh, Saudi Arabia
| | - Salih Aleissi
- Department of Medicine, College of Medicine, the University Sleep Disorders Center, Riyadh, Saudi Arabia
| | - Awad H Olaish
- Department of Medicine, College of Medicine, the University Sleep Disorders Center, Riyadh, Saudi Arabia
| | - Ahmed S BaHammam
- Department of Medicine, College of Medicine, the University Sleep Disorders Center, Riyadh, Saudi Arabia
| |
Collapse
|
42
|
Franco P, Dauvilliers Y, Inocente CO, Guyon A, Villanueva C, Raverot V, Plancoulaine S, Lin JS. Impaired histaminergic neurotransmission in children with narcolepsy type 1. CNS Neurosci Ther 2018; 25:386-395. [PMID: 30225986 DOI: 10.1111/cns.13057] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 08/03/2018] [Accepted: 08/04/2018] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Narcolepsy is a sleep disorder characterized in humans by excessive daytime sleepiness and cataplexy. Greater than fifty percent of narcoleptic patients have an onset of symptoms prior to the age of 18. Current general agreement considers the loss of hypothalamic hypocretin (orexin) neurons as the direct cause of narcolepsy notably cataplexy. To assess whether brain histamine (HA) is also involved, we quantified the cerebrospinal fluid (CSF) levels of HA and tele-methylhistamine (t-MeHA), the direct metabolite of HA between children with orexin-deficient narcolepsy type 1 (NT1) and controls. METHODS We included 24 children with NT1 (12.3 ± 3.6 years, 11 boys, 83% cataplexy, 100% HLA DQB1*06:02) and 21 control children (11.2 ± 4.2 years, 10 boys). CSF HA and t-MeHA were measured in all subjects using a highly sensitive liquid chromatographic-electrospray/tandem mass spectrometric assay. CSF hypocretin-1 values were determined in the narcoleptic patients. RESULTS Compared with the controls, NT1 children had higher CSF HA levels (771 vs 234 pmol/L, P < 0.001), lower t-MeHA levels (879 vs 1924 pmol/L, P < 0.001), and lower t-MeHA/HA ratios (1.1 vs 8.2, P < 0.001). NT1 patients had higher BMI z-scores (2.7 ± 1.6 vs 1.0 ± 2.3, P = 0.006) and were more often obese (58% vs 29%, P = 0.05) than the controls. Multivariable analyses including age, gender, and BMI z-score showed a significant decrease in CSF HA levels when the BMI z-score increased in patients (P = 0.007) but not in the controls. No association was found between CSF HA, t-MeHA, disease duration, age at disease onset, the presence of cataplexy, lumbar puncture timing, and CSF hypocretin levels. CONCLUSIONS Narcolepsy type 1 children had a higher CSF HA level together with a lower t-MeHA level leading to a significant decrease in the t-MeHA/HA ratios. These results suggest a decreased HA turnover and an impairment of histaminergic neurotransmission in narcoleptic children and support the use of a histaminergic therapy in the treatment against narcolepsy.
Collapse
Affiliation(s)
- Patricia Franco
- Integrative Physiology of the Brain Arousal System, CRNL, INSERM-U1028, CNRS, UMR5292, University Lyon1, Lyon, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome (CNR narcolepsie-hypersomnie), Bron, France.,Pediatric Sleep Unit, Mother- Children Hospital, Hospices Civils de Lyon, University Lyon1, Lyon, France
| | - Yves Dauvilliers
- National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome (CNR narcolepsie-hypersomnie), Bron, France.,Sleep Unit, Department of Neurology, Gui de Chauliac Hospital, CHU Montpellier, Montpellier, France.,Inserm, U1061, Univ Montpellier 1, Montpellier, France
| | - Clara Odilia Inocente
- Integrative Physiology of the Brain Arousal System, CRNL, INSERM-U1028, CNRS, UMR5292, University Lyon1, Lyon, France
| | - Aurore Guyon
- Integrative Physiology of the Brain Arousal System, CRNL, INSERM-U1028, CNRS, UMR5292, University Lyon1, Lyon, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic hypersomnia and Kleine-Levin Syndrome (CNR narcolepsie-hypersomnie), Bron, France.,Pediatric Sleep Unit, Mother- Children Hospital, Hospices Civils de Lyon, University Lyon1, Lyon, France
| | - Carine Villanueva
- Department of Endocrinology, Mother- Children Hospital, Hospices Civils de Lyon, University Lyon1, France
| | - Veronique Raverot
- Laboratoire de Hormonologie, Groupement Est, Hospices Civils de Lyon, University Lyon1, Lyon, France
| | - Sabine Plancoulaine
- INSERM, UMR1153, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Villejuif, Paris-Descartes University, Paris, France
| | - Jian-Sheng Lin
- Integrative Physiology of the Brain Arousal System, CRNL, INSERM-U1028, CNRS, UMR5292, University Lyon1, Lyon, France
| |
Collapse
|
43
|
Juvodden HT, Alnæs D, Lund MJ, Agartz I, Andreassen OA, Dietrichs E, Thorsby PM, Westlye LT, Knudsen S. Widespread white matter changes in post-H1N1 patients with narcolepsy type 1 and first-degree relatives. Sleep 2018; 41:5054638. [PMID: 30016530 DOI: 10.1093/sleep/zsy145] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hilde T Juvodden
- Department of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital, Ullevål, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dag Alnæs
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Martina J Lund
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Espen Dietrichs
- Department of Neurology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Per M Thorsby
- Department of Medical Biochemistry, Hormone Laboratory, Oslo University Hospital, Aker, Norway
| | - Lars T Westlye
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Stine Knudsen
- Department of Rare Disorders, Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Oslo University Hospital, Ullevål, Norway
| |
Collapse
|
44
|
Thannickal TC, John J, Shan L, Swaab DF, Wu MF, Ramanathan L, McGregor R, Chew KT, Cornford M, Yamanaka A, Inutsuka A, Fronczek R, Lammers GJ, Worley PF, Siegel JM. Opiates increase the number of hypocretin-producing cells in human and mouse brain and reverse cataplexy in a mouse model of narcolepsy. Sci Transl Med 2018; 10:10/447/eaao4953. [PMID: 29950444 PMCID: PMC8235614 DOI: 10.1126/scitranslmed.aao4953] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/18/2017] [Accepted: 01/26/2018] [Indexed: 01/18/2023]
Abstract
The changes in brain function that perpetuate opiate addiction are unclear. In our studies of human narcolepsy, a disease caused by loss of immunohistochemically detected hypocretin (orexin) neurons, we encountered a control brain (from an apparently neurologically normal individual) with 50% more hypocretin neurons than other control human brains that we had studied. We discovered that this individual was a heroin addict. Studying five postmortem brains from heroin addicts, we report that the brain tissue had, on average, 54% more immunohistochemically detected neurons producing hypocretin than did control brains from neurologically normal subjects. Similar increases in hypocretin-producing cells could be induced in wild-type mice by long-term (but not short-term) administration of morphine. The increased number of detected hypocretin neurons was not due to neurogenesis and outlasted morphine administration by several weeks. The number of neurons containing melanin-concentrating hormone, which are in the same hypothalamic region as hypocretin-producing cells, did not change in response to morphine administration. Morphine administration restored the population of detected hypocretin cells to normal numbers in transgenic mice in which these neurons had been partially depleted. Morphine administration also decreased cataplexy in mice made narcoleptic by the depletion of hypocretin neurons. These findings suggest that opiate agonists may have a role in the treatment of narcolepsy, a disorder caused by hypocretin neuron loss, and that increased numbers of hypocretin-producing cells may play a role in maintaining opiate addiction.
Collapse
Affiliation(s)
- Thomas C. Thannickal
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA.,Neurobiology Research, Veterans Administration Greater Los Angeles Healthcare System, 16111 Plummer Street, North Hills, CA 91343, USA
| | - Joshi John
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA.,Neurobiology Research, Veterans Administration Greater Los Angeles Healthcare System, 16111 Plummer Street, North Hills, CA 91343, USA
| | - Ling Shan
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA.,Neurobiology Research, Veterans Administration Greater Los Angeles Healthcare System, 16111 Plummer Street, North Hills, CA 91343, USA
| | - Dick F. Swaab
- Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, Netherlands
| | - Ming-Fung Wu
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA.,Neurobiology Research, Veterans Administration Greater Los Angeles Healthcare System, 16111 Plummer Street, North Hills, CA 91343, USA
| | - Lalini Ramanathan
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA.,Neurobiology Research, Veterans Administration Greater Los Angeles Healthcare System, 16111 Plummer Street, North Hills, CA 91343, USA
| | - Ronald McGregor
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA.,Neurobiology Research, Veterans Administration Greater Los Angeles Healthcare System, 16111 Plummer Street, North Hills, CA 91343, USA
| | - Keng-Tee Chew
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA.,Neurobiology Research, Veterans Administration Greater Los Angeles Healthcare System, 16111 Plummer Street, North Hills, CA 91343, USA
| | - Marcia Cornford
- Department of Pathology, Harbor University of California, Los Angeles, Medical Center, Torrance, CA 90509, USA
| | - Akihiro Yamanaka
- Department of Neuroscience II, Research Institute of Environmental Medicine, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
| | - Ayumu Inutsuka
- Department of Neuroscience II, Research Institute of Environmental Medicine, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
| | - Rolf Fronczek
- Leiden University Medical Centre, Department of Neurology, Leiden, Netherlands.,Sleep Wake Centre, Stichting Epilepsie Instellingen Nederland, Heemstede, Netherlands
| | - Gert Jan Lammers
- Leiden University Medical Centre, Department of Neurology, Leiden, Netherlands.,Sleep Wake Centre, Stichting Epilepsie Instellingen Nederland, Heemstede, Netherlands
| | - Paul F. Worley
- The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Jerome M. Siegel
- Neuropsychiatric Institute and Brain Research Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA.,Neurobiology Research, Veterans Administration Greater Los Angeles Healthcare System, 16111 Plummer Street, North Hills, CA 91343, USA.,Corresponding author.
| |
Collapse
|
45
|
Büchele F, Baumann CR, Poryazova R, Werth E, Valko PO. Remitting narcolepsy? Longitudinal observations in a hypocretin-deficient cohort. Sleep 2018; 41:5032742. [PMID: 29868885 DOI: 10.1093/sleep/zsy118] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Fabian Büchele
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christian R Baumann
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Rositsa Poryazova
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Esther Werth
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Philipp O Valko
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
46
|
Black SW, Sun JD, Santiago P, Laihsu A, Kimura N, Yamanaka A, Bersot R, Humphries PS. Partial ablation of the orexin field induces a sub-narcoleptic phenotype in a conditional mouse model of orexin neurodegeneration. Sleep 2018; 41:5025920. [DOI: 10.1093/sleep/zsy116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/29/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sarah Wurts Black
- In Vivo Biology Department, Reset Therapeutics, South San Francisco, CA
| | - Jessica D Sun
- In Vivo Biology Department, Reset Therapeutics, South San Francisco, CA
| | - Pamela Santiago
- In Vivo Biology Department, Reset Therapeutics, South San Francisco, CA
| | - Alex Laihsu
- In Vivo Biology Department, Reset Therapeutics, South San Francisco, CA
| | - Nikki Kimura
- In Vivo Biology Department, Reset Therapeutics, South San Francisco, CA
| | - Akihiro Yamanaka
- Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan
| | - Ross Bersot
- In Vivo Biology Department, Reset Therapeutics, South San Francisco, CA
| | - Paul S Humphries
- In Vivo Biology Department, Reset Therapeutics, South San Francisco, CA
| |
Collapse
|
47
|
Enevoldsen LH, Tindborg M, Hovmand NL, Christoffersen C, Ellingsgaard H, Suetta C, Stallknecht BM, Jennum PJ, Kjær A, Gammeltoft S. Functional brown adipose tissue and sympathetic activity after cold exposure in humans with type 1 narcolepsy. Sleep 2018; 41:4996398. [DOI: 10.1093/sleep/zsy092] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Lotte Hahn Enevoldsen
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Denmark
| | - Marie Tindborg
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | | | - Christina Christoffersen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
- Department of Clinical Biochemistry, Rigshospitalet, Denmark
| | | | - Charlotte Suetta
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Denmark
| | - Bente Merete Stallknecht
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | | | - Andreas Kjær
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
- Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Denmark
| | | |
Collapse
|
48
|
Sadam H, Pihlak A, Kivil A, Pihelgas S, Jaago M, Adler P, Vilo J, Vapalahti O, Neuman T, Lindholm D, Partinen M, Vaheri A, Palm K. Prostaglandin D2 Receptor DP1 Antibodies Predict Vaccine-induced and Spontaneous Narcolepsy Type 1: Large-scale Study of Antibody Profiling. EBioMedicine 2018; 29:47-59. [PMID: 29449194 PMCID: PMC5925455 DOI: 10.1016/j.ebiom.2018.01.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/23/2018] [Accepted: 01/31/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Neuropathological findings support an autoimmune etiology as an underlying factor for loss of orexin-producing neurons in spontaneous narcolepsy type 1 (narcolepsy with cataplexy; sNT1) as well as in Pandemrix influenza vaccine-induced narcolepsy type 1 (Pdmx-NT1). The precise molecular target or antigens for the immune response have, however, remained elusive. METHODS Here we have performed a comprehensive antigenic repertoire analysis of sera using the next-generation phage display method - mimotope variation analysis (MVA). Samples from 64 children and adolescents were analyzed: 10 with Pdmx-NT1, 6 with sNT1, 16 Pandemrix-vaccinated, 16 H1N1 infected, and 16 unvaccinated healthy individuals. The diagnosis of NT1 was defined by the American Academy of Sleep Medicine international criteria of sleep disorders v3. FINDINGS Our data showed that although the immunoprofiles toward vaccination were generally similar in study groups, there were also striking differences in immunoprofiles between sNT1 and Pdmx-NT1 groups as compared with controls. Prominent immune response was observed to a peptide epitope derived from prostaglandin D2 receptor (DP1), as well as peptides homologous to B cell lymphoma 6 protein. Further validation confirmed that these can act as true antigenic targets in discriminating NT1 diseased along with a novel epitope of hemagglutinin of H1N1 to delineate exposure to H1N1. INTERPRETATION We propose that DP1 is a novel molecular target of autoimmune response and presents a potential diagnostic biomarker for NT1. DP1 is involved in the regulation of non-rapid eye movement (NREM) sleep and thus alterations in its functions could contribute to the disturbed sleep regulation in NT1 that warrants further studies. Together our results also show that MVA is a helpful method for finding novel peptide antigens to classify human autoimmune diseases, possibly facilitating the design of better therapies.
Collapse
Affiliation(s)
- Helle Sadam
- Protobios Llc, Mäealuse 4, 12618 Tallinn, Estonia; Department of Gene Technology, Tallinn University of Technology, Akadeemia Tee 15, 12618 Tallinn, Estonia
| | - Arno Pihlak
- Protobios Llc, Mäealuse 4, 12618 Tallinn, Estonia; Department of Gene Technology, Tallinn University of Technology, Akadeemia Tee 15, 12618 Tallinn, Estonia
| | - Anri Kivil
- Protobios Llc, Mäealuse 4, 12618 Tallinn, Estonia
| | | | | | - Priit Adler
- Institute of Computer Science, University of Tartu, Liivi 2-314, 50409 Tartu, Estonia; Quretec LLC, Ülikooli 6a, 51003 Tartu, Estonia
| | - Jaak Vilo
- Institute of Computer Science, University of Tartu, Liivi 2-314, 50409 Tartu, Estonia; Quretec LLC, Ülikooli 6a, 51003 Tartu, Estonia
| | - Olli Vapalahti
- Department of Virology, Medicum, Haartmaninkatu 3, 00014 University of Helsinki, Finland; Department of Veterinary Biosciences, University of Helsinki, Agnes Sjöbergin Katu 2, 00014 University of Helsinki, Finland; Virology and Immunology, HUSLAB, Helsinki University Hospital, 00290 Helsinki, Finland
| | - Toomas Neuman
- Protobios Llc, Mäealuse 4, 12618 Tallinn, Estonia; IPDx Immunoprofiling Diagnostics GmbH, Deutscher Platz 5e, 04103 Leipzig, Germany
| | - Dan Lindholm
- Department of Biochemistry and Developmental Biology, Medicum, Haartmaninkatu 8, 00014 University of Helsinki, Finland; Minerva Foundation Medical Research Institute, Tukholmankatu 8, 00290 Helsinki, Finland
| | - Markku Partinen
- Finnish Narcolepsy Research Center, Helsinki Sleep Clinic, Vitalmed Research Center, Valimotie 21, 00380, Helsinki, Finland
| | - Antti Vaheri
- Department of Virology, Medicum, Haartmaninkatu 3, 00014 University of Helsinki, Finland
| | - Kaia Palm
- Protobios Llc, Mäealuse 4, 12618 Tallinn, Estonia; Department of Gene Technology, Tallinn University of Technology, Akadeemia Tee 15, 12618 Tallinn, Estonia.
| |
Collapse
|
49
|
Łażewska D, Kieć-Kononowicz K. Progress in the development of histamine H 3 receptor antagonists/inverse agonists: a patent review (2013-2017). Expert Opin Ther Pat 2018; 28:175-196. [PMID: 29334795 DOI: 10.1080/13543776.2018.1424135] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Since years, ligands blocking histamine H3 receptor (H3R) activity (antagonists/inverse agonists) are interesting targets in the search for new cures for CNS disorders. Intensive works done by academic and pharmaceutical company researchers have led to many potent and selective H3R antagonists/inverse agonists. Some of them have reached to clinical trials. AREAS COVERED Patent applications from January 2013 to September 2017 and the most important topics connected with H3R field are analysed. Espacenet, Patentscope, Pubmed, GoogleScholar or Cochrane Library online databases were principially used to collect all the materials. EXPERT OPINION The research interest in histamine H3R field is still high although the number of patent applications has decreased during the past 4 years (around 20 publications). Complexity of histamine H3R biology e.g. many isoforms, constitutive activity, heteromerization with other receptors (dopamine D2, D1, adenosine A2A) and pharmacology make not easy realization and evaluation of therapeutic potential of anti-H3R ligands. First results from clinical trials have verified potential utility of histamine H3R antagonist/inverse agonists in some diseases. However, more studies are necessary for better understanding of an involvement of the histaminergic system in CNS-related disorders and helping more ligands approach to clinical trials and the market. Lists of abbreviations: hAChEI - human acetylcholinesterase inhibitor; hBuChEI - human butyrylcholinesterase inhibitor; hMAO - human monoamine oxidase; MAO - monoamine oxidase.
Collapse
Affiliation(s)
- Dorota Łażewska
- a Department of Technology and Biotechnology of Drugs , Jagiellonian University Medical College , Kraków , Poland
| | - Katarzyna Kieć-Kononowicz
- a Department of Technology and Biotechnology of Drugs , Jagiellonian University Medical College , Kraków , Poland
| |
Collapse
|
50
|
Lopez R, Barateau L, Evangelista E, Chenini S, Robert P, Jaussent I, Dauvilliers Y. Temporal Changes in the Cerebrospinal Fluid Level of Hypocretin-1 and Histamine in Narcolepsy. Sleep 2017; 40:2979189. [PMID: 28364477 PMCID: PMC5806580 DOI: 10.1093/sleep/zsw010] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Study Objectives: To follow the temporal changes of cerebrospinal fluid (CSF) biomarker levels in
narcoleptic patients with unexpected hypocretin level at referral. Methods: From 2007 to 2015, 170 human leukocyte antigen (HLA) DQB1*06:02-positive patients with
primary narcolepsy and definite (n = 155, 95 males, 60 females, 36
children) or atypical cataplexy (n = 15, 4 males, 3 children) were
referred to our center. Cerebrospinal hypocretin deficiency was found in 95.5% and 20%
of patients with definitive and atypical cataplexy, respectively. CSF hypocretin-1
(n = 6) and histamine/tele-methylhistamine (n = 5)
levels were assessed twice (median interval: 14.4 months) in four patients with definite
and in two with atypical cataplexy and hypocretin level greater than 100 pg/mL at
baseline. Results: CSF hypocretin levels decreased from normal/intermediate to undetectable levels in
three of the four patients with definite cataplexy and remained stable in the other
(>250 pg/mL). Hypocretin level decreased from 106 to 27 pg/mL in one patient with
atypical cataplexy, and remained stable in the other (101 and 106 pg/mL). CSF histamine
and tele-methylhistamine levels remained stable, but for one patient showing increased
frequency of cataplexy and a strong decrease (−72.5%) of tele-methylhistamine levels
several years after disease onset. No significant association was found between relative
or absolute change in hypocretin level and demographic/clinical features. Conclusions: These findings show that in few patients with narcolepsy with cataplexy, symptoms and
CSF marker levels can change over time. In these rare patients with cataplexy without
baseline hypocretin deficiency, CSF markers should be monitored over time with potential
for immune therapies in early stages to try limiting hypocretin neuron loss.
Collapse
Affiliation(s)
- Régis Lopez
- Unité des Troubles du Sommeil Service de Neurologie, Centre National de Référence Narcolepsie Hypersomnies, Hôpital Gui-de-Chauliac, Montpellier F-34000, France.,Inserm U1061, Montpellier F-34000, France.,Université de Montpellier, Montpellier F-34000, France
| | - Lucie Barateau
- Unité des Troubles du Sommeil Service de Neurologie, Centre National de Référence Narcolepsie Hypersomnies, Hôpital Gui-de-Chauliac, Montpellier F-34000, France.,Université de Montpellier, Montpellier F-34000, France
| | - Elisa Evangelista
- Unité des Troubles du Sommeil Service de Neurologie, Centre National de Référence Narcolepsie Hypersomnies, Hôpital Gui-de-Chauliac, Montpellier F-34000, France.,Université de Montpellier, Montpellier F-34000, France
| | - Sofiene Chenini
- Unité des Troubles du Sommeil Service de Neurologie, Centre National de Référence Narcolepsie Hypersomnies, Hôpital Gui-de-Chauliac, Montpellier F-34000, France.,Université de Montpellier, Montpellier F-34000, France
| | | | - Isabelle Jaussent
- Inserm U1061, Montpellier F-34000, France.,Université de Montpellier, Montpellier F-34000, France
| | - Yves Dauvilliers
- Unité des Troubles du Sommeil Service de Neurologie, Centre National de Référence Narcolepsie Hypersomnies, Hôpital Gui-de-Chauliac, Montpellier F-34000, France.,Inserm U1061, Montpellier F-34000, France.,Université de Montpellier, Montpellier F-34000, France
| |
Collapse
|