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Zhang FX, Xie XH, Guo ZX, Wang HD, Li H, Wu KLK, Chan YS, Li YQ. Evaluating proxies for motion sickness in rodent. IBRO Neurosci Rep 2023; 15:107-115. [PMID: 38204574 PMCID: PMC10776324 DOI: 10.1016/j.ibneur.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 06/29/2023] [Indexed: 01/12/2024] Open
Abstract
Motions sickness (MS) occurs when the brain receives conflicting sensory signals from vestibular, visual and proprioceptive systems about a person's ongoing position and/or motion in relation to space. MS is typified by symptoms such as nausea and emesis and implicates complex physiological aspects of sensations and sensorimotor reflexes. Use of animal models has been integral to unraveling the physiological causality of MS. The commonly used rodents (rat and mouse), albeit lacking vomiting reflex, reliably display phenotypic behaviors of pica (eating of non-nutritive substance) and conditioned taste aversion (CTAver) or avoidance (CTAvoi) which utilize neural substrates with pathways that cause gastrointestinal malaise akin to nausea/emesis. As such, rodent pica and CTAver/CTAvoi have been widely used as proxies for nausea/emesis in studies dealing with neural mechanisms of nausea/emesis and MS, as well as for evaluating therapeutics. This review presents the rationale and experimental evidence that support the use of pica and CTAver/CTAvoi as indices for nausea and emesis. Key experimental steps and cautions required when using rodent MS models are also discussed. Finally, future directions are suggested for studying MS with rodent pica and CTAver/CTAvoi models.
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Affiliation(s)
- Fu-Xing Zhang
- Department of Human Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, School of Basic Medicine, The Fourth Military Medical University, Xi’an, PR China
| | - Xiao-Hang Xie
- Department of Human Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, School of Basic Medicine, The Fourth Military Medical University, Xi’an, PR China
| | - Zi-Xin Guo
- Department of Human Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, School of Basic Medicine, The Fourth Military Medical University, Xi’an, PR China
| | - Hao-Dong Wang
- Department of Human Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, School of Basic Medicine, The Fourth Military Medical University, Xi’an, PR China
| | - Hui Li
- Department of Human Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, School of Basic Medicine, The Fourth Military Medical University, Xi’an, PR China
| | - Kenneth Lap Kei Wu
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Ying-Shing Chan
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| | - Yun-Qing Li
- Department of Human Anatomy, Histology and Embryology & K.K. Leung Brain Research Centre, School of Basic Medicine, The Fourth Military Medical University, Xi’an, PR China
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Lagami D, Shupak A, Jamison A, Tal D. The Vestibular Time Constant and Clinical Response to Antimotion Sickness Medication. Ear Hear 2023; 44:1404-1409. [PMID: 37221635 DOI: 10.1097/aud.0000000000001385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The therapeutic effects of antimotion sickness medications involve suppression of several components along the vestibular system. Scopolamine-based medications have proved to be the most effective anti-seasickness agents. However, there is high variability in individual responses. The vestibular nuclei, in which the vestibular time constant is modulated, contain acetylcholine receptors which are affected by scopolamine. The hypothesis of the study was that successful seasickness prevention by scopolamine requires vestibular suppression to be reflected by the shortening of the vestibular time constant. DESIGN Subjects were 30 naval crew members suffering from severe seasickness and were treated with oral scopolamine. The study participants were defined as responsive or non-responsive to the anti-seasickness medication according to the clinical outcome: successful response to scopolamine was defined as a reduction of seasickness severity from the highest score of 7 according to the Wiker scale to 4 or less. Scopolamine and placebo were assigned to each subject in a crossover, double-blind design. The horizontal semicircular canal time constant was evaluated by a computerized rotatory chair before, 1 and 2 hours after drug or placebo administration. RESULTS The vestibular time constant was significantly shortened from 16.01 ± 3.43 seconds to 12.55 ± 2.40 seconds ( p < 0.001) in the scopolamine-responsive group but not in the nonresponsive group. In contrast, vestibular time constant values were 13.73 ± 4.08 and 12.89 ± 4.48 for baseline and 2 hours measurements, respectively. This change was not statistically significant. CONCLUSIONS Reduction in the vestibular time constant after scopolamine administration can be used to predict whether motion sickness alleviation will occur. This will enable the administration of appropriate pharmaceutical treatment without the need for prior exposure to sea conditions.
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Affiliation(s)
- Daniel Lagami
- Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, IDF Medical Corps, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Brain Sciences, Weizmann Institute of Science, Rehovot, Israel
| | - Avi Shupak
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Unit of Otoneurology, Lin Medical Center, Haifa, Israel
- Department of Communication Science and Disorders, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Anna Jamison
- Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, IDF Medical Corps, Haifa, Israel
| | - Dror Tal
- Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, IDF Medical Corps, Haifa, Israel
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Zhang T, Guan T, Yao H, Wang LA, Wang Y, Guan Z. Brown Slime Cap Mushroom (Chroogomphus rutilus, Agaricomycetes) Polysaccharide Resists Motion Sickness by Inhibiting the Activity of the Serotonin System in Mice. Int J Med Mushrooms 2023; 25:1-13. [PMID: 37947060 DOI: 10.1615/intjmedmushrooms.2023050471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Motion sickness (MS) is a disorder of the autonomic nervous system caused by abnormal exercise with symptoms such as nausea, vomiting and drowsiness. More than 90% of the human population has experienced different degrees of MS. At present, anticholinergics, antihistamines, and sympathomimetic drugs are used for treating MS, but these drugs generally have some adverse reactions and are not suitable for all people. Therefore, it is necessary to develop anti-MS drugs that have high efficiency and no adverse effects. Previous studies have found that Chroogomphus rutilus polysaccharide (CRP) is effective at preventing and treating MS in rats and mice. However, its mechanism of action is not clear. To clarify whether the CRP has anti-MS effects in mice, and to clarify its mechanism, we performed behavioral, biochemical, and morphological tests in a Kunming mouse model. Our results indicate that CRPs can significantly relieve the symptoms of MS, and their effect is equivalent to that of scopolamine, a commonly used anti-MS medicine. Our results indicate that CRPs may directly act on the gastrointestinal chromaffin cells to inhibit the synthesis and release of serotonin (5-hydroxytryptamine, or 5-HT) and thus reduce the signal from the gastrointestinal tract.
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Affiliation(s)
- Tao Zhang
- Hebei Research Center of the Basic Discipline of Cell Biology, Hebei Key Laboratory of Physiology, College of Life Sciences, Hebei Normal University, Shijiazhuang, 050024, P.R. China
| | - Tianyuan Guan
- Department of Neurology, Hebei General Hospital, Shijiazhuang, 050051, P.R. China
| | - Hui Yao
- Hebei Research Center of the Basic Discipline of Cell Biology, Hebei Key Laboratory of Physiology, College of Life Sciences, Hebei Normal University, Shijiazhuang, 050024, P.R. China
| | - Li-An Wang
- Hebei Research Center of the Basic Discipline of Cell Biology, Hebei Key Laboratory of Physiology, College of Life Sciences, Hebei Normal University, Shijiazhuang, 050024, P.R. China
| | - Yanqin Wang
- Hebei Research Center of the Basic Discipline of Cell Biology, Hebei Key Laboratory of Physiology, College of Life Sciences, Hebei Normal University, Shijiazhuang, 050024, P.R. China
| | - Zhenlong Guan
- Hebei Research Center of the Basic Discipline of Cell Biology, Hebei Key Laboratory of Physiology, College of Life Sciences, Hebei Normal University, Shijiazhuang, 050024, P.R. China
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Deshetty UM, Tamatam A, Patil MM. Menthol, a bioactive constituent of Mentha, attenuates motion sickness in mice model: Involvement of dopaminergic system. J Food Biochem 2021; 45:e13863. [PMID: 34245039 DOI: 10.1111/jfbc.13863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/25/2021] [Accepted: 06/30/2021] [Indexed: 10/20/2022]
Abstract
Motion sickness (MS) occurs due to contradicting vestibular and visual inputs to the brain causing nausea and vomiting. Antidopaminergic drugs being effective in reducing MS create a path for effective therapy against MS by regulating dopamine levels. We aimed to evaluate the role of the striatum and brainstem dopamine and dopamine D2 receptor (DRD2) in MS and the efficacy of menthol (MNT) to modulate dopamine and DRD2 in vitro and in vivo for possible amelioration of MS. Evaluation of efficacy of MNT to inhibit dopamine release from PC12 cells and anti-MS efficacy in BALB/c mice model was performed. Dopamine, DRD2 expression in PC12 cells, mice striatum, and brainstem were detected using HPLC-ECD, RT-PCR, and Western blot analysis, respectively. DRD2 expression increased in calcium ionophore-treated PC12 cells compared with control cells. Pretreatment with 50 μg/ml menthol decreased dopamine and DRD2 expression. Similarly, dopamine and DRD2 levels in mice striatum and brainstem of MS group (rotation induced) increased significantly compared with control group NC (no rotation). Pretreatment with menthol at 50 mg/kg concentration (rotation induced) showed decreased dopamine and DRD2 expression, thus indicating ameliorative effect on MS. Hence, we suggest that increased striatum and brainstem dopamine and DRD2 levels might lead to MS symptoms, and menthol could be used as a potent herbal alternative medicine for MS. PRACTICAL APPLICATIONS: Antidopaminergic drugs being effective in reducing motion sickness (MS) creates a path for effective therapy against MS by regulating dopamine levels. Increased striatum and brainstem dopamine and Dopamine D2 receptor (DRD2) levels might lead to the MS symptoms induced by rotation stimulation in mice model. Menthol showed a prophylactic effect on rotation-induced MS by reducing striatal and brainstem dopamine levels, DRD2 mRNA, and protein expression. Menthol could be used as an herbal alternative to antidopaminergics to minimize the associated adverse effects.
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Affiliation(s)
- Uma Maheswari Deshetty
- Nutrition, Biochemistry & Toxicology Division, Defence Food Research Laboratory, Mysore, India
| | - Anand Tamatam
- Nutrition, Biochemistry & Toxicology Division, Defence Food Research Laboratory, Mysore, India
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Zhong W, Shahbaz O, Teskey G, Beever A, Kachour N, Venketaraman V, Darmani NA. Mechanisms of Nausea and Vomiting: Current Knowledge and Recent Advances in Intracellular Emetic Signaling Systems. Int J Mol Sci 2021; 22:5797. [PMID: 34071460 PMCID: PMC8198651 DOI: 10.3390/ijms22115797] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 02/07/2023] Open
Abstract
Nausea and vomiting are common gastrointestinal complaints that can be triggered by diverse emetic stimuli through central and/or peripheral nervous systems. Both nausea and vomiting are considered as defense mechanisms when threatening toxins/drugs/bacteria/viruses/fungi enter the body either via the enteral (e.g., the gastrointestinal tract) or parenteral routes, including the blood, skin, and respiratory systems. While vomiting is the act of forceful removal of gastrointestinal contents, nausea is believed to be a subjective sensation that is more difficult to study in nonhuman species. In this review, the authors discuss the anatomical structures, neurotransmitters/mediators, and corresponding receptors, as well as intracellular emetic signaling pathways involved in the processes of nausea and vomiting in diverse animal models as well as humans. While blockade of emetic receptors in the prevention of vomiting is fairly well understood, the potential of new classes of antiemetics altering postreceptor signal transduction mechanisms is currently evolving, which is also reviewed. Finally, future directions within the field will be discussed in terms of important questions that remain to be resolved and advances in technology that may help provide potential answers.
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Affiliation(s)
- Weixia Zhong
- Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766, USA; (W.Z.); (G.T.); (V.V.)
| | - Omar Shahbaz
- School of Medicine, Universidad Iberoamericana, Av. Francia 129, Santo Domingo 10203, Dominican Republic;
| | - Garrett Teskey
- Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766, USA; (W.Z.); (G.T.); (V.V.)
| | - Abrianna Beever
- Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA 91766, USA; (A.B.); (N.K.)
| | - Nala Kachour
- Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA 91766, USA; (A.B.); (N.K.)
| | - Vishwanath Venketaraman
- Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766, USA; (W.Z.); (G.T.); (V.V.)
- Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA 91766, USA; (A.B.); (N.K.)
| | - Nissar A. Darmani
- Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766, USA; (W.Z.); (G.T.); (V.V.)
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Idoux E, Tagliabue M, Beraneck M. No Gain No Pain: Relations Between Vestibulo-Ocular Reflexes and Motion Sickness in Mice. Front Neurol 2018; 9:918. [PMID: 30483206 PMCID: PMC6240678 DOI: 10.3389/fneur.2018.00918] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 10/10/2018] [Indexed: 01/07/2023] Open
Abstract
Motion sickness occurs when the vestibular system is subjected to conflicting sensory information or overstimulation. Despite the lack of knowledge about the actual underlying mechanisms, several drugs, among which scopolamine, are known to prevent or alleviate the symptoms. Here, we aim at better understanding how motion sickness affects the vestibular system, as well as how scopolamine prevents motion sickness at the behavioral and cellular levels. We induced motion sickness in adult mice and tested the vestibulo-ocular responses to specific stimulations of the semi-circular canals and of the otoliths, with or without scopolamine, as well as the effects of scopolamine and muscarine on central vestibular neurons recorded on brainstem slices. We found that both motion sickness and scopolamine decrease the efficacy of the vestibulo-ocular reflexes and propose that this decrease in efficacy might be a protective mechanism to prevent later occurrences of motion sickness. To test this hypothesis, we used a behavioral paradigm based on visuo-vestibular interactions which reduces the efficacy of the vestibulo-ocular reflexes. This paradigm also offers protection against motion sickness, without requiring any drug. At the cellular level, we find that depending on the neuron, scopolamine can have opposite effects on the polarization level and firing frequency, indicating the presence of at least two types of muscarinic receptors in the medial vestibular nucleus. The present results set the basis for future studies of motion sickness counter-measures in the mouse model and offers translational perspectives for improving the treatment of affected patients.
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Affiliation(s)
- Erwin Idoux
- Center for Neurophysics, Physiology, Pathology, CNRS UMR 8119, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Centre National D'Etudes Spatiales, Paris, France
| | - Michele Tagliabue
- Center for Neurophysics, Physiology, Pathology, CNRS UMR 8119, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Mathieu Beraneck
- Center for Neurophysics, Physiology, Pathology, CNRS UMR 8119, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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7
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Koch A, Cascorbi I, Westhofen M, Dafotakis M, Klapa S, Peter Kuhtz-Buschbeck J. The Neurophysiology and Treatment of Motion Sickness. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 115:687-696. [PMID: 30406755 PMCID: PMC6241144 DOI: 10.3238/arztebl.2018.0687] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 03/28/2018] [Accepted: 08/09/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Seasickness and travel sickness are classic types of motion illness. Modern simulation systems and virtual reality representations can also induce comparable symptoms. Such manifestations can be alleviated or prevented by various measures. METHODS This review is based on pertinent publications retrieved by a PubMed search, with special attention to clinical trials and review articles. RESULTS Individuals vary in their susceptibility to autonomic symptoms, ranging from fatigue to massive vomiting, induced by passive movement at relatively low frequencies (0.2 to 0.4 Hz) in situations without any visual reference to the horizontal plane. Younger persons and women are considered more susceptible, and twin studies have revealed a genetic component as well. The various types of motion sickness are adequately explained by the intersensory conflict model, incorporating the vestibular, visual, and proprioceptive systems and extended to include consideration of postural instability and asymmetry of the otolith organs. Scopolamine and H1-antihistamines, such as dimenhydrinate and cinnarizine, can be used as pharmacotherapy. The symptoms can also be alleviated by habituation through long exposure or by the diminution of vestibular stimuli. CONCLUSION The various types of motion sickness can be treated with general measures to lessen the intersensory conflict, behavioral changes, and drugs.
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Affiliation(s)
- Andreas Koch
- Naval Institute of Maritime Medicine, Kronshagen, Institute of Experimental Medicine, Section Maritime Medicine Christian-Albrechts-Universität, Kiel
| | - Ingolf Cascorbi
- Institute of Experimental and Clinical Pharmacology, University Hospital Schleswig-Holstein, Campus Kiel
| | - Martin Westhofen
- Clinic for Otorhinolaryngology and Plastic Surgery of the Head and Throat, RWTH Aachen
| | | | - Sebastian Klapa
- Naval Institute of Maritime Medicine, Kronshagen, Institute of Experimental Medicine, Section Maritime Medicine Christian-Albrechts-Universität, Kiel
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Fujii T, Kitamura Y, Mizuguchi H, Okamoto K, Sanada N, Yamada T, Sugiyama M, Michinaga S, Kitayama M, Fukui H, Takeda N. Effects of irradiation with narrowband-ultraviolet B on up-regulation of histamine H 1 receptor mRNA and induction of apoptosis in HeLa cells and nasal mucosa of rats. J Pharmacol Sci 2018; 138:54-62. [PMID: 30301597 DOI: 10.1016/j.jphs.2018.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 08/21/2018] [Accepted: 08/28/2018] [Indexed: 01/01/2023] Open
Abstract
Narrowband-ultraviolet B (NB-UVB) phototherapy is used for the treatment of atopic dermatitis. Previously, we reported that irradiation with 200 mJ/cm2 of 310 nm NB-UVB suppressed phorbol-12-myristate-13-acetate (PMA)-induced up-regulation of histamine H1 receptor (H1R) gene expression without induction of apoptosis in HeLa cells. However, the effect of NB-UVB irradiation on nasal symptoms is still unclear. Here, we show that low dose irradiation with 310 nm NB-UVB alleviates nasal symptoms in toluene 2,4-diisocyanate (TDI)-sensitized allergy model rats. Irradiation with 310 nm NB-UVB suppressed PMA-induced H1R mRNA up-regulation in HeLa cells dose-dependently at doses of 75-200 mJ/cm2 and reversibly at a dose of 150 mJ/cm2 without induction of apoptosis. While, at doses of more than 200 mJ/cm2, irradiation with 310 nm NB-UVB induced apoptosis. Western blot analysis showed that the suppressive effect of NB-UVB irradiation on H1R gene expression was through the inhibition of ERK phosphorylation. In TDI-sensitized rat, intranasal irradiation with 310 nm NB-UVB at an estimated dose of 100 mJ/cm2 once a day for three days suppressed TDI-induced sneezes and up-regulation of H1R mRNA in nasal mucosa without induction of apoptosis. These findings suggest that repeated intranasal irradiation with low dose of NB-UVB could be clinically used as phototherapy of AR.
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Affiliation(s)
- Tatsuya Fujii
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan
| | - Yoshiaki Kitamura
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan.
| | - Hiroyuki Mizuguchi
- Laboratory of Pharmacology, Faculty of Pharmacy, Osaka Ohtani University, Osaka, 584-8540, Japan
| | - Kentaro Okamoto
- Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Nanae Sanada
- Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Takuya Yamada
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan; Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Manabu Sugiyama
- Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Shotaro Michinaga
- Laboratory of Pharmacology, Faculty of Pharmacy, Osaka Ohtani University, Osaka, 584-8540, Japan
| | - Mika Kitayama
- Molecular Pharmacology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 770-8503, Japan
| | - Hiroyuki Fukui
- Molecular Studies for Incurable Diseases, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan
| | - Noriaki Takeda
- Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, 770-8503, Japan
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Tal D, Shemy S, Kaminski-Graif G, Wiener G, Hershkovitz D. Vestibular evoked myogenic potentials and motion sickness medications. Clin Neurophysiol 2016; 127:2350-4. [PMID: 27178852 DOI: 10.1016/j.clinph.2016.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 03/03/2016] [Accepted: 03/07/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Seasickness is a widespread problem among naval crew, and has a major impact on their performance at sea. The three pharmacological agents most commonly employed in the treatment of seasickness are dimenhydrinate, cinnarizine, and scopolamine. At present, the effectiveness of anti-seasickness drugs is tested by a process of "trial and error", while sailing and exposed to sea conditions. A physiological test to evaluate the action of a drug might save crew members long periods of suffering, as well as simplifying the procedure of selecting the appropriate treatment for each individual. The cervical vestibular evoked myogenic potentials (cVEMP) test has come to be recognized as a reliable procedure for the objective evaluation of saccular function. It was the hypothesis of the present study that cVEMP otolith responses may be affected by anti-motion sickness drugs, which might thus make cVEMP a useful clinical neurophysiological tool for the assessment of drug absorption and efficacy. METHODS Thirty male sailors who regularly took medication for the treatment of seasickness participated in the study. Participants underwent the cVEMP test pre- and 1h post-drug administration. RESULTS A statistically significant decrease in p13 latency was found after administration of scopolamine compared with baseline (14.46ms vs. 15.09ms, p=0.0049), with significant prolongation of the binaural average inter-latency in this group. No differences were found in the dimenhydrinate and cinnarizine study groups. CONCLUSIONS This study demonstrated that scopolamine absorption can be verified by changes in cVEMP latencies. SIGNIFICANCE The potential of the cVEMP test for predicting action of scopolamine on the vestibular system.
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Affiliation(s)
- Dror Tal
- Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, Israel Defense Forces Medical Corps, Haifa, Israel.
| | - Shir Shemy
- Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, Israel Defense Forces Medical Corps, Haifa, Israel
| | - Gil Kaminski-Graif
- Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, Israel Defense Forces Medical Corps, Haifa, Israel
| | - Guy Wiener
- Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, Israel Defense Forces Medical Corps, Haifa, Israel
| | - Dov Hershkovitz
- Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, Israel Defense Forces Medical Corps, Haifa, Israel
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Guimaraes DD, Andrews PLR, Rudd JA, Braga VA, Nalivaiko E. Ondansetron and promethazine have differential effects on hypothermic responses to lithium chloride administration and to provocative motion in rats. Temperature (Austin) 2015; 2:543-53. [PMID: 27227074 PMCID: PMC4843929 DOI: 10.1080/23328940.2015.1071700] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 07/06/2015] [Accepted: 07/07/2015] [Indexed: 12/05/2022] Open
Abstract
We recently reported that provocative motion (rotation in a home cage) causes hypothermic responses in rats, similar to the hypothermic responses associated with motion sickness in humans. Many stimuli inducing emesis in species with an emetic reflex also provoke hypothermia in the rat, therefore we hypothesized that a fall in body temperature may reflect a “nausea-like” state in these animals. As rats do not possess an emetic reflex, we employed a pharmacological approach to test this hypothesis. In humans, motion- and chemically-induced nausea have differential sensitivity to anti-emetics. We thus tested whether the hypothermia induced in rats by provocative motion (rotation at 0.7 Hz) and by the emetic LiCl (63 mg/kg i.p.) have a similar differential pharmacological sensitivity. Both provocations caused a comparable robust fall in core body temperature (−1.9 ± 0.3°C and −2.0 ± 0.2°C for chemical and motion provocations, respectively). LiCl−induced hypothermia was completely prevented by ondansetron (2mg/kg, i.p., a 5-HT3 receptor antagonist that reduces cancer chemotherapy-induced nausea and vomiting), but was insensitive to promethazine (10 mg/kg, i.p., a predominantly histamine-H1 and muscarinic receptor antagonist that is commonly used to treat motion sickness). Conversely, motion-induced hypothermia was unaffected by ondansetron but promethazine reduced the rate of temperature decline from 0.20 ± 0.02 to 0.11 ± 0.03°C/min (P < 0.05) with a trend to decrease the magnitude. We conclude that this differential pharmacological sensitivity of the hypothermic responses of vestibular vs. chemical etiology in rats mirrors the observations in other pre-clinical models and humans, and thus supports the idea that a “nausea-like” state in rodents is associated with disturbances in thermoregulation.
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Affiliation(s)
- Drielle D Guimaraes
- Centre for Biotechnology; Federal University of Paraiba ; Joao Pessoa, Brazil
| | - Paul L R Andrews
- Division of Biomedical Sciences; St George's University of London ; London, UK
| | - John A Rudd
- School of Biomedical Sciences and Brain and Mind Institue; Chinese University of Hong Kong ; Hong Kong, China
| | - Valdir A Braga
- Centre for Biotechnology; Federal University of Paraiba ; Joao Pessoa, Brazil
| | - Eugene Nalivaiko
- School of Biomedical Sciences and Pharmacy; University of Newcastle ; NSW Australia
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Rudd JA, Nalivaiko E, Matsuki N, Wan C, Andrews PL. The involvement of TRPV1 in emesis and anti-emesis. Temperature (Austin) 2015; 2:258-76. [PMID: 27227028 PMCID: PMC4843889 DOI: 10.1080/23328940.2015.1043042] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/13/2015] [Accepted: 04/16/2015] [Indexed: 12/29/2022] Open
Abstract
Diverse transmitter systems (e.g. acetylcholine, dopamine, endocannabinoids, endorphins, glutamate, histamine, 5-hydroxytryptamine, substance P) have been implicated in the pathways by which nausea and vomiting are induced and are targets for anti-emetic drugs (e.g. 5-hydroxytryptamine3 and tachykinin NK1 antagonists). The involvement of TRPV1 in emesis was discovered in the early 1990s and may have been overlooked previously as TRPV1 pharmacology was studied in rodents (mice, rats) lacking an emetic reflex. Acute subcutaneous administration of resiniferatoxin in the ferret, dog and Suncus murinus revealed that it had “broad–spectrum” anti-emetic effects against stimuli acting via both central (vestibular system, area postrema) and peripheral (abdominal vagal afferents) inputs. One of several hypotheses discussed here is that the anti-emetic effect is due to acute depletion of substance P (or another peptide) at a critical site (e.g. nucleus tractus solitarius) in the central emetic pathway. Studies in Suncus murinus revealed a potential for a long lasting (one month) effect against the chemotherapeutic agent cisplatin. Subsequent studies using telemetry in the conscious ferret compared the anti-emetic, hypothermic and hypertensive effects of resiniferatoxin (pungent) and olvanil (non-pungent) and showed that the anti-emetic effect was present (but reduced) with olvanil which although inducing hypothermia it did not have the marked hypertensive effects of resiniferatoxin. The review concludes by discussing general insights into emetic pathways and their pharmacology revealed by these relatively overlooked studies with TRPV1 activators (pungent an non-pungent; high and low lipophilicity) and antagonists and the potential clinical utility of agents targeted at the TRPV1 system.
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Key Words
- 12-HPETE, 12-hydroperoxy-eicosatetraenoic acid
- 5-HT, 5-hydroxytryptamine
- 5-HT3, 5-hdroxytryptamine3
- 8-OH-DPAT, (±)-8-Hydroxy-2-dipropylaminotetralin
- AM404
- AM404, N-arachidonoylaminophenol
- AMT, anandamide membrane transporter
- AP, area postrema
- BBB, blood brain barrier
- CB1, cannabinoid1
- CGRP, calcitonin gene-related peptide
- CINV, chemotherapy-induced nausea and vomiting
- CP 99,994
- CTA, conditioned taste aversion
- CVO's, circumventricular organs
- D2, dopamine2
- DRG, dorsal root ganglia
- FAAH, fatty acid amide hydrolase
- H1, histamine1
- LTB4, leukotriene B4
- NADA, N-arachidonoyl-dopamine
- NK1, neurokinin1
- POAH, preoptic anterior hypothalamus
- RTX
- Suncus murinus
- TRPV1
- TRPV1, transient receptor potential vanilloid receptor1
- anti-emetic
- capsaicin
- ferret
- i.v., intravenous
- nausea
- olvanil
- thermoregulation
- vanilloid
- vomiting
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Affiliation(s)
- John A Rudd
- Brain and Mind Institute; Chinese University of Hong Kong; Shatin; New Territories, Hong Kong SAR; School of Biomedical Sciences; Faculty of Medicine; Chinese University of Hong Kong; Shatin; New Territories, Hong Kong SAR
| | - Eugene Nalivaiko
- School of Biomedical Sciences and Pharmacy; University of Newcastle ; Callaghan, NSW, Australia
| | - Norio Matsuki
- Laboratory of Chemical Pharmacology; Graduate School of Pharmaceutical Sciences; The University of Tokyo ; Tokyo, Japan
| | - Christina Wan
- School of Biomedical Sciences; Faculty of Medicine; Chinese University of Hong Kong ; Shatin; New Territories, Hong Kong SAR
| | - Paul Lr Andrews
- Division of Biomedical Sciences; St George's University of London ; London, UK
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Gordon P, LeGrand SB, Walsh D. Nausea and vomiting in advanced cancer. Eur J Pharmacol 2013; 722:187-91. [PMID: 24211678 DOI: 10.1016/j.ejphar.2013.10.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 10/08/2013] [Accepted: 10/09/2013] [Indexed: 11/26/2022]
Abstract
Nausea and vomiting are very common symptoms in cancer both treatment and non-treatment related. Many complications of advanced cancer such as gastroparesis, bowel and outlet obstructions, and brain tumors may have nausea and vomiting or either symptom alone. In a non-obstructed situation, nausea may be more difficult to manage and is more objectionable to patients. There is little research on management of these symptoms except the literature on chemotherapy induced nausea where guidelines exist. This article will review the etiologies of nausea and vomiting in advanced cancer and the medications which have been used to treat them. An etiology based protocol to approach the symptom is outlined.
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Affiliation(s)
- Pamela Gordon
- The Harry R. Horvitz Center for Palliative Medicine(1), Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute(2), Cleveland, OH 44195, USA
| | - Susan B LeGrand
- The Harry R. Horvitz Center for Palliative Medicine(1), Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute(2), Cleveland, OH 44195, USA.
| | - Declan Walsh
- The Harry R. Horvitz Center for Palliative Medicine(1), Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute(2), Cleveland, OH 44195, USA
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13
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Tal D, Hershkovitz D, Kaminski-Graif G, Wiener G, Samuel O, Shupak A. Vestibular evoked myogenic potentials and habituation to seasickness. Clin Neurophysiol 2013; 124:2445-9. [PMID: 23800706 DOI: 10.1016/j.clinph.2013.05.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 04/29/2013] [Accepted: 05/26/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Seasickness may impose severe limitations on the performance of ships' crew. Cervical vestibular evoked myogenic potentials (cVEMP) assess the function of the saccule, the organ responsible for monitoring vertical linear acceleration, which has been found to be the most provocative motion stimulus in the evolution of motion sickness. We used the cVEMP test in a prospective evaluation of susceptibility and habituation to seasickness. METHODS Forty-six naval recruits underwent the cVEMP test before exposure to sea conditions. After 6 months' sailing experience, participants completed a questionnaire evaluating their initial and current seasickness severity. Based on their most recent experience, subjects were divided into three groups: non-vomiting non-habituating (NV-NH), vomiting (V), and non-vomiting habituating (NV-H). RESULTS Statistically significant lower thresholds for cVEMP were found in subjects who habituated to sea conditions (NV-H), compared with those remaining severely susceptible (V) (77.0 dB HL vs. 84.9 dB HL; p<0.01). CONCLUSIONS The ability to produce the cVEMP at lower thresholds represents a broader dynamic range, in which the reflex can respond to a wider array of stimuli amplitudes. SIGNIFICANCE The present study demonstrates the potential of the cVEMP test for predicting future habituation to seasickness.
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Affiliation(s)
- Dror Tal
- Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, IDF Medical Corps, Haifa, Israel.
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14
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Ledic D, Sosa I, Linic IS, Cvijanovic O, Kovacevic M, Desnica A, Banicek I. Vomiting as a reliable sign of concussion. Med Hypotheses 2011; 78:23-5. [PMID: 21983351 DOI: 10.1016/j.mehy.2011.09.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 08/17/2011] [Accepted: 09/16/2011] [Indexed: 10/16/2022]
Abstract
Concussion is the most common type of traumatic brain injury, with headache being the most frequent symptom of mild traumatic brain injury (MTBI) (including dizziness, vomiting, nausea, lack of motor coordination or difficulty balancing). Concussion may be caused by a blow to the head, or by acceleration forces without a direct impact. Often, MTBI occurs as the result of a sports injury. Loss of consciousness is always present, unlike vomiting. Therefore, we hypothesize vomiting to be considered as a cardinal sign of concussion. Stimulation of vomiting centres finally triggers vomiting. Professional boxers and mixed martial arts competitions reluctantly agree with stringent rules and protective clothing. We discuss the issue of further protection for those engaged in these and other sports.
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Affiliation(s)
- Darko Ledic
- Rijeka University Medical Faculty, Department of Forensic Medicine and Criminalistics, and Rijeka University Hospital, Department of Surgery, Rijeka, Croatia
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15
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Nobel G, Tribukait A, Mekjavic IB, Eiken O. Histaminergic and cholinergic neuron systems in the impairment of human thermoregulation during motion sickness. Brain Res Bull 2010; 82:193-200. [PMID: 20394809 DOI: 10.1016/j.brainresbull.2010.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2010] [Revised: 03/31/2010] [Accepted: 04/06/2010] [Indexed: 11/15/2022]
Abstract
Motion sickness (MS) exaggerates body cooling during cold-water immersion. The aim of the present study was to investigate whether such MS-induced predisposition to hypothermia is influenced by two anti-MS drugs: the histamine-receptor blocker dimenhydrinate (DMH) and the muscarine-receptor blocker scopolamine (Scop). Nine healthy male subjects were immersed in 15 degrees C water for a maximum of 90min in five conditions: (1) control (CN): no medication, no MS provocation; (2) MS-control (MS-CN): no medication, MS provocation; (3) MS-placebo (MS-P): placebo DMH and placebo Scop, MS provocation; (4) MS-DMH: DMH and placebo Scop, MS provocation; (5) MS-Scop: Scop and placebo DMH, MS provocation. MS was induced by use of a rotating chair. Throughout the experiments rectal temperature (T(re)), the difference in temperature between the non-immersed right forearm and third finger (T(ff)) as an index of peripheral vasoconstriction, and oxygen uptake (VO(2)) as a measure of shivering thermogenesis, were recorded. DMH and Scop were similarly efficacious in ameliorating nausea. The fall in T(re) was greater in the MS-CN and MS-P conditions than in the CN condition. DMH, but not Scop, prevented the MS-induced increase in body-core cooling. MS attenuated the cold-induced vasoconstriction, an effect which was fully prevented by DMH but only partially by Scop. MS provocation did not affect VO(2) in any condition. The results suggest that the MS-induced predisposition to hypothermia is predominantly mediated by histaminergic mechanisms and that DMH might be useful in conjunction with maritime accidents or other scenarios where exposure to cold and MS are imminent features.
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Affiliation(s)
- Gerard Nobel
- Department of Environmental Physiology, Royal Institute of Technology, School for Technology and Health, Berzelius v. 13, SE 171 65 Stockholm, Sweden.
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16
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Dev S, Mizuguchi H, Das AK, Maeyama K, Horinaga S, Kato S, Tamada M, Hattori M, Umehara H, Fukui H. Kujin suppresses histamine signaling at the transcriptional level in toluene 2,4-diisocyanate-sensitized rats. J Pharmacol Sci 2009; 109:606-17. [PMID: 19352071 DOI: 10.1254/jphs.09003fp] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Kujin, the dried root of Sophorae flavescensis, has been used in Chinese folklore medicine against allergy. Evaluation of its anti-allergic potential as well as its mechanism of action has rarely been established. We investigated the effect of Kujin on toluene-2,4-diisocyanate (TDI)-induced allergic behavior and related histamine signaling including mRNA levels of histamine H(1) receptor (H1R) and histidine decarboxylase (HDC), H1R and HDC activities, and histamine content in rat nasal mucosa. We also investigated the effect of Kujin on the mRNA levels of helper T cell type 2 (Th2)-cytokine genes closely related to histamine signaling. TDI provocation caused acute allergic symptoms accompanied with up-regulations of H1R and HDC mRNAs and increases in HDC activity, histamine content, and [(3)H]mepyramine binding activity in the nasal mucosa, all of which were significantly suppressed by pretreatment with Kujin for 3 weeks. Kujin also suppressed the TDI-induced IL-4 and IL-5 mRNA elevations. These data suggest that oral administration of Kujin showed anti-allergic activity through suppression of histamine signaling by the inhibition of TDI-induced H1R and HDC mRNA elevations followed by decrease in H1R, HDC protein level, and histamine content in the nasal mucosa of TDI-sensitized rats. Suppression of Th2-cytokine signaling by Kujin also suggests that it could affect the histamine-cytokine network.
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Affiliation(s)
- Shrabanti Dev
- Department of Molecular Pharmacology, Institute of Health-Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
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17
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Mizuguchi H, Hatano M, Matsushita C, Umehara H, Kuroda W, Kitamura Y, Takeda N, Fukui H. Repeated pre-treatment with antihistamines suppresses [corrected] transcriptional up-regulations of histamine H(1) receptor and interleukin-4 genes in toluene-2,4-diisocyanate-sensitized rats. J Pharmacol Sci 2008; 108:480-6. [PMID: 19075512 DOI: 10.1254/jphs.08222fp] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Antihistamines are effective for treatment of seasonal nasal allergy. Recently, prophylactic treatment with antihistamines in patients with pollinosis was reported to be more effective when started before the pollen season. The administration with antihistamines from 2 to 6 weeks before onset of the pollen season is recommended for management of allergic rhinitis in Japan. To determine the reason for the effectiveness of prophylactic treatment with antihistamines, the effects of repeated pre-treatment with antihistamines before provocation with toluene 2,4-diisocyanate (TDI) on their nasal allergy-like behavior and up-regulations of histamine H(1) receptors (H1R) and interleukin (IL)-4 mRNAs in their nasal mucosa were examined. Provocation with TDI induced sneezing and up-regulations of H1R and IL-4 mRNAs in the nasal mucosa of TDI-sensitized rats. Repeated pre-treatments with antihistamines including epinastine, olopatadine, or d-chlorpheniramine for 1 to 5 weeks before provocation with TDI suppressed TDI-induced sneezing and the up-regulations of H1R and IL-4 mRNAs in the nasal mucosa more than their administrations once or for 3 days before TDI provocation. Our data indicate that repeated pre-treatment with antihistamines before provocation with TDI is more effective than their single treatment in reducing nasal allergy-like behavior by causing additional suppression of up-regulations of H1R and IL-4 mRNAs in the nasal mucosa.
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Affiliation(s)
- Hiroyuki Mizuguchi
- Department of Molecular Pharmacology, Institute of Health-Biosciences, The University of Tokushima Graduate School, Japan
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18
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Abstract
Histamine is a transmitter in the nervous system and a signaling molecule in the gut, the skin, and the immune system. Histaminergic neurons in mammalian brain are located exclusively in the tuberomamillary nucleus of the posterior hypothalamus and send their axons all over the central nervous system. Active solely during waking, they maintain wakefulness and attention. Three of the four known histamine receptors and binding to glutamate NMDA receptors serve multiple functions in the brain, particularly control of excitability and plasticity. H1 and H2 receptor-mediated actions are mostly excitatory; H3 receptors act as inhibitory auto- and heteroreceptors. Mutual interactions with other transmitter systems form a network that links basic homeostatic and higher brain functions, including sleep-wake regulation, circadian and feeding rhythms, immunity, learning, and memory in health and disease.
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Affiliation(s)
- Helmut L Haas
- Institute of Neurophysiology, Heinrich-Heine-University, Duesseldorf, Germany.
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19
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Hyperirritable stomach as a cause of nausea and vomiting: clinical and radiographic findings. AJR Am J Roentgenol 2008; 190:1517-20. [PMID: 18492901 DOI: 10.2214/ajr.07.3317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of our study was to characterize the clinical and radiographic features of the hyperirritable stomach and to determine if it is associated with extraintestinal causes of nausea and vomiting in the absence of gastric outlet obstruction, gastroparesis, or intestinal obstruction or ileus. CONCLUSION The hyperirritable stomach was characterized on barium studies in 15 patients by rapid emesis of ingested barium, a collapsed stomach with little or no retained debris or fluid, and normal emptying of residual barium into nondilated duodenum and proximal jejunum. Fourteen (93%) of these 15 patients had extraintestinal causes of nausea and vomiting, and 13 (93%) of 14 with clinical follow-up had marked improvement or resolution of symptoms after treatment. Radiologists therefore should evaluate the stomach and duodenum even after rapid emesis of ingested barium in patients with nausea and vomiting to differentiate a hyperirritable stomach from mechanical or functional gastrointestinal obstruction.
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20
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McDonough JA, Persyn JT, Nino JA, Dixon H, Boland EJ, Wang Z, Putcha L. Microcapsule-gel formulation of promethazine HCl for controlled nasal delivery: a motion sickness medication. J Microencapsul 2007; 24:109-16. [PMID: 17454422 DOI: 10.1080/09687860600945628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The current method of choice for astronauts to treat space motion sickness is an intra-muscular injection of promethazine hydrochloride (PMZ HCl) which is invasive and causes considerable local irritation and discomfort at the site of injection. Intra-nasal delivery is considered a feasible alternative route for administration of medications to treat space motion sickness. The purpose of this research is to develop a PMZ HCl formulation that can be administered intra-nasally without irritation (i.e. leukocyte infiltration) in the nasal epithelium when dosed at PMZ HCl concentrations greater than the cytotoxic limit. The biocompatibility of PMZ HCl was tested in vitro and was shown to be cytotoxic at concentrations greater than 10(-5) molar regardless of pH. A controlled-release microencapsulated dosage formulation was developed using spinning disk atomization and release rates for the PMZ HCl microcapsules were determined in phosphate buffered saline. An animal study was conducted to determine the irritation response of rat nasal mucosa when dosed with encapsulated and non-encapsulated PMZ HCl.
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Affiliation(s)
- J A McDonough
- Southwest Research Institute, San Antonio, TX 78238, USA
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21
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Nachum Z, Shupak A, Gordon CR. Transdermal scopolamine for prevention of motion sickness : clinical pharmacokinetics and therapeutic applications. Clin Pharmacokinet 2006; 45:543-66. [PMID: 16719539 DOI: 10.2165/00003088-200645060-00001] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
A transdermal therapeutic system for scopolamine (TTS-S) was developed to counter the adverse effects and short duration of action that has restricted the usefulness of scopolamine when administered orally or parenterally. The plaster contains a reservoir of 1.5 mg of scopolamine programmed to deliver 0.5 mg over a 3-day period. A priming dose (140 microg) is incorporated into the adhesive layer to saturate certain binding sites within the skin and to accelerate the achievement of steady-state blood levels. The remainder is released at a constant rate of approximately 5 microg/hour. The protective plasma concentration of scopolamine is estimated to be 50 pg/mL. TTS-S attains that concentration after 6 hours; a steady state of about 100 pg/mL is achieved 8-12 hours after application. Yet 20-30% of subjects failed to attain the estimated protective concentration, and plasma concentrations measured in subjects who failed to respond to TTS-S were lower than in responders. These findings may explain some of the treatment failures. Overall, the product appears to be the approximate functional equivalent of a 72-hour slow intravenous infusion. A combination of transdermal and oral scopolamine (0.3 or 0.6 mg) was effective and well tolerated in producing desired plasma concentrations 1-hour post-treatment. TTS-S has proved to be significantly superior to placebo in reducing the incidence and severity of motion sickness by 60-80%. It was more effective than oral meclizine or cinnarizine, similar to oral scopolamine 0.6 mg or promethazine plus ephedrine, and the same as or superior to dimenhydrinate. The addition of ephedrine or the use of two patches did not improve its efficacy, but rather increased the rate of adverse effects. TTS-S was most effective against motion sickness 8-12 hours after application. Despite previous evidence to the contrary, a recent bioavailability study demonstrated similar intraindividual absorption and sustained clinical efficacy with long-term use of the drug. The adverse effects produced by TTS-S, although less frequent, are qualitatively typical of those reported for the oral and parenteral formulations of this agent. Dry mouth occurs in about 50-60% of subjects, drowsiness in up to 20%, and allergic contact dermatitis in 10%. Transient impairment of ocular accommodation has also been observed, in some cases possibly the result of finger-to-eye contamination. Low-dose pyridostigmine was found effective in preventing cycloplegia but not mydriasis. Adverse CNS effects, including toxic psychosis (mainly in elderly and paediatric patients), have been reported only occasionally, as have difficulty in urinating, headache, rashes and erythema. Adverse effects were not correlated with plasma scopolamine concentrations. TTS-S produced only about half the incidence of drowsiness caused by oral dimenhydrinate or cinnarizine, and a level of adverse effects similar to that found with oral meclizine. Performance is not affected by short-term use. Prolonged or repeated application may cause some impairment of memory storage for new information. However, sea studies revealed significantly less reports of a decrement in performance or drowsiness due to prevention of sea sickness. The recommended dosage is a single TTS-S patch applied to the postauricular area at least 6-8 hours before the anti-motion sickness effect is required. For faster protection, the patch may be applied 1 hour before the journey in combination with oral scopolamine (0.3 or 0.6 mg). After 72 hours, the patch should be removed and a new one applied behind the opposite ear. Its place in therapy is mainly on long journeys (6-12 hours or longer), to avoid repeated oral doses, or when oral therapy is ineffective or intolerable.
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Affiliation(s)
- Zohar Nachum
- Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, IDF Medical Corps, Haifa, IsraelDepartment of Obstetrics and Gynecology, Ha'Emek Medical Center, Afula, Israel.
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22
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Marsh KJ, Wallis IR, Andrew RL, Foley WJ. The detoxification limitation hypothesis: where did it come from and where is it going? J Chem Ecol 2006; 32:1247-66. [PMID: 16770716 DOI: 10.1007/s10886-006-9082-3] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2005] [Revised: 03/02/2006] [Accepted: 03/03/2006] [Indexed: 12/14/2022]
Abstract
The detoxification limitation hypothesis is firmly entrenched in the literature to explain various aspects of the interaction between herbivores and plant toxins. These include explanations for the existence of specialist and generalist herbivores and for the prevalence of each of these. The hypothesis suggests that the ability of mammalian herbivores to eliminate plant secondary metabolites (PSMs) largely determines which plants, and how much, they can eat. The value of the hypothesis is that it provides a clear framework for understanding how plant toxins might limit diet breadth. Thus, it is surprising, given its popularity, that there are few studies that provide experimental support either for or against the detoxification limitation hypothesis. There are two likely reasons for this. First, Freeland and Janzen did not formally propose the hypothesis, although it is implicit in their paper. Second, it is a difficult hypothesis to test, requiring an understanding of the metabolic pathways that lead to toxin elimination. Recent attempts to test the hypothesis appear promising. Results suggest that herbivores can recognize mounting saturation of a detoxification pathway and adjust their feeding accordingly to avoid intoxication. One strategy they use is to ingest a food containing a toxin that is metabolized by a different pathway. This demonstrates that careful selection of food plants is a key to existing in a chemically complex environment. As more studies characterize the detoxification products of PSMs, we will better understand how widespread this phenomenon is.
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Affiliation(s)
- Karen J Marsh
- School of Botany and Zoology, Australian National University, Canberra, ACT.
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23
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Abstract
This review discusses the physiology and pharmacological treatment of vertigo and related disorders. Classes of medications useful in the treatment of vertigo include anticholinergics, antihistamines, benzodiazepines, calcium channel antagonists and dopamine receptor antagonists. These medications often have multiple actions. They may modify the intensity of symptoms (e.g. vestibular suppressants) or they may affect the underlying disease process (e.g. calcium channel antagonists in the case of vestibular migraine). Most of these agents, particularly those that are sedating, also have a potential to modulate the rate of compensation for vestibular damage. This consideration has become more relevant in recent years, as vestibular rehabilitation physical therapy is now often recommended in an attempt to promote compensation. Accordingly, therapy of vertigo is optimised when the prescriber has detailed knowledge of the pharmacology of medications being administered as well as the precise actions being sought. There are four broad causes of vertigo, for which specific regimens of drug therapy can be tailored. Otological vertigo includes disorders of the inner ear such as Ménière's disease, vestibular neuritis, benign paroxysmal positional vertigo (BPPV) and bilateral vestibular paresis. In both Ménière's disease and vestibular neuritis, vestibular suppressants such as anticholinergics and benzodiazepines are used. In Ménière's disease, salt restriction and diuretics are used in an attempt to prevent flare-ups. In vestibular neuritis, only brief use of vestibular suppressants is now recommended. Drug treatments are not presently recommended for BPPV and bilateral vestibular paresis, but physical therapy treatment can be very useful in both. Central vertigo includes entities such as vertigo associated with migraine and certain strokes. Prophylactic agents (L-channel calcium channel antagonists, tricyclic antidepressants, beta-blockers) are the mainstay of treatment for migraine-associated vertigo. In individuals with stroke or other structural lesions of the brainstem or cerebellum, an eclectic approach incorporating trials of vestibular suppressants and physical therapy is recommended. Psychogenic vertigo occurs in association with disorders such as panic disorder, anxiety disorder and agoraphobia. Benzodiazepines are the most useful agents here. Undetermined and ill-defined causes of vertigo make up a large remainder of diagnoses. An empirical approach to these patients incorporating trials of medications of general utility, such as benzodiazepines, as well as trials of medication withdrawal when appropriate, physical therapy and psychiatric consultation is suggested.
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Affiliation(s)
- Timothy C Hain
- Department of Neurology, Northwestern University, Chicago, Illinois 60611, USA.
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Söderpalm AH, Schuster A, de Wit H. Antiemetic efficacy of smoked marijuana: subjective and behavioral effects on nausea induced by syrup of ipecac. Pharmacol Biochem Behav 2001; 69:343-50. [PMID: 11509190 DOI: 10.1016/s0091-3057(01)00533-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Although the public debate about the legalization of marijuana has continued for as long as 25 years, few controlled studies have been conducted to assess its potential medical benefits. The present study examined the antiemetic effect of smoked marijuana cigarettes (8.4 and 16.9 mg Delta(9)-tetrahydrocannabinol [THC]) compared to a highly potent antiemetic drug, ondansetron (8 mg) in 13 healthy volunteers. Nausea and emesis were induced by syrup of ipecac. Marijuana significantly reduced ratings of "queasiness" and slightly reduced the incidence of vomiting compared to placebo. Ondansetron completely eliminated the emetic effects of ipecac. These findings support and extend previous results, indicating that smoked marijuana reduces feelings of nausea and also reduces emesis in this model. However, its effects are very modest relative to ondansetron, and the psychoactive effects of marijuana are likely to limit its clinical usefulness in the general population.
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Affiliation(s)
- A H Söderpalm
- Department of Psychiatry, The University of Chicago, MC3077, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
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25
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Abstract
Histamine-releasing neurons are located exclusively in the TM of the hypothalamus, from where they project to practically all brain regions, with ventral areas (hypothalamus, basal forebrain, amygdala) receiving a particularly strong innervation. The intrinsic electrophysiological properties of TM neurons (slow spontaneous firing, broad action potentials, deep after hyperpolarisations, etc.) are extremely similar to other aminergic neurons. Their firing rate varies across the sleep-wake cycle, being highest during waking and lowest during rapid-eye movement sleep. In contrast to other aminergic neurons somatodendritic autoreceptors (H3) do not activate an inwardly rectifying potassium channel but instead control firing by inhibiting voltage-dependent calcium channels. Histamine release is enhanced under extreme conditions such as dehydration or hypoglycemia or by a variety of stressors. Histamine activates four types of receptors. H1 receptors are mainly postsynaptically located and are coupled positively to phospholipase C. High densities are found especially in the hypothalamus and other limbic regions. Activation of these receptors causes large depolarisations via blockade of a leak potassium conductance, activation of a non-specific cation channel or activation of a sodium-calcium exchanger. H2 receptors are also mainly postsynaptically located and are coupled positively to adenylyl cyclase. High densities are found in hippocampus, amygdala and basal ganglia. Activation of these receptors also leads to mainly excitatory effects through blockade of calcium-dependent potassium channels and modulation of the hyperpolarisation-activated cation channel. H3 receptors are exclusively presynaptically located and are negatively coupled to adenylyl cyclase. High densities are found in the basal ganglia. These receptors mediated presynaptic inhibition of histamine release and the release of other neurotransmitters, most likely via inhibition of presynaptic calcium channels. Finally, histamine modulates the glutamate NMDA receptor via an action at the polyamine binding site. The central histamine system is involved in many central nervous system functions: arousal; anxiety; activation of the sympathetic nervous system; the stress-related release of hormones from the pituitary and of central aminergic neurotransmitters; antinociception; water retention and suppression of eating. A role for the neuronal histamine system as a danger response system is proposed.
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Affiliation(s)
- R E Brown
- Institut für Neurophysiologie, Heinrich-Heine-Universität, D-40001, Düsseldorf, Germany.
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26
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Affiliation(s)
- E M Quigley
- Sections of Gastroenterology and Hepatology University of Nebraska Medical Center Omaha, Nebraska, USA
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27
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Abstract
The management of Meniere's disease often creates a formidable clinical challenge. Drugs may be helpful in treating the acute attacks of vertigo, and in more long-term management. These remedies are largely symptomatic and there are few properly controlled studies of their efficacy. A critical overview of the scientific and clinical basis for these various pharmacological agents is discussed.
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28
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Hu S. Effects of dimenhydrinate on electroencephalographic activity. Percept Mot Skills 1997; 84:1105-6. [PMID: 9172229 DOI: 10.2466/pms.1997.84.3.1105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Spontaneous EEGs of 10 undergraduates showed no changes within 90 min. for peak frequency (Hz) of alpha band or for percentage distribution of alpha band between dimenhydrinate and placebo conditions.
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Affiliation(s)
- S Hu
- Department of Psychology, Humboldt State University, Arcata, CA 95521, USA.
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29
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Vibert N, De Waele C, Serafin M, Babalian A, Mühlethaler M, Vidal PP. The vestibular system as a model of sensorimotor transformations. A combined in vivo and in vitro approach to study the cellular mechanisms of gaze and posture stabilization in mammals. Prog Neurobiol 1997; 51:243-86. [PMID: 9089790 DOI: 10.1016/s0301-0082(96)00057-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
To understand the cellular mechanisms underlying behaviours in mammals, the respective contributions of the individual properties characterizing each neuron, as opposed to the properties emerging from the organization of these neurons in functional networks, have to be evaluated. This requires the use, in the same species, of various in vivo and in vitro experimental preparations. The present review is meant to illustrate how such a combined in vivo in vitro approach can be used to investigate the vestibular-related neuronal networks involved in gaze and posture stabilization, together with their plasticity, in the adult guinea-pig. Following first a general introduction on the vestibular system, the second section describes various in vivo experiments aimed at characterizing gaze and posture stabilization in that species. The third and fourth parts of the review deal with the combined in vivo-in vitro investigations undertaken to unravel the physiological and pharmacological properties of vestibulo-ocular and vestibulo-spinal networks, together with their functional implications. In particular, we have tried to use the central vestibular neurons as examples to illustrate how the preparation of isolated whole brain can be used to bridge the gap between the results obtained through in vitro, intracellular recordings on slices and those collected in vivo, in the behaving animal.
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Affiliation(s)
- N Vibert
- Laboratoire de Physiologie de la Perception et de l' Action, CNRS-College de France, UMR C-9950, Paris, France
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30
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Abstract
The alpha-herpes virus (pseudorabies, PRV) was used to observe central nervous system (CNS) pathways associated with the vestibulocerebellar system. Retrograde transneuronal migration of alpha-herpes virions from specific lobules of the gerbil and rat vestibulo-cerebellar cortex was detected immunohistochemically. Using a time series analysis, progression of infection along polyneuronal cerebellar afferent pathways was examined. Pressure injections of > 20 nanoliters of a 10(8) plaque forming units (pfu) per ml solution of virus were sufficient to initiate an infectious locus which resulted in labeled neurons in the inferior olivary subnuclei, vestibular nuclei, and their afferent cell groups in a progressive temporal fashion and in growing complexity with increasing incubation time. We show that climbing fibers and some other cerebellar afferent fibers transported the virus retrogradely from the cerebellum within 24 hours. One to three days after cerebellar infection discrete cell groups were labeled and appropriate laterality within crossed projections was preserved. Subsequent nuclei labeled with PRV after infection of the flocculus/paraflocculus, or nodulus/uvula, included the following: vestibular (e.g., z) and inferior olivary nuclei (e.g., dorsal cap), accessory oculomotor (e.g., Darkschewitsch n.) and accessory optic related nuclei, (e.g., the nucleus of the optic tract, and the medial terminal nucleus); noradrenergic, raphe, and reticular cell groups (e.g., locus coeruleus, dorsal raphe, raphe pontis, and the lateral reticular tract); other vestibulocerebellum sites, the periaqueductal gray, substantia nigra, hippocampus, thalamus and hypothalamus, amygdala, septal nuclei, and the frontal, cingulate, entorhinal, perirhinal, and insular cortices. However, there were differences in the resulting labeling between infection in either region. Double-labeling experiments revealed that vestibular efferent neurons are located adjacent to, but are not included among, flocculus-projecting supragenual neurons. PRV transport from the vestibular labyrinth and cervical muscles also resulted in CNS infections. Virus propagation in situ provides specific connectivity information based on the functional transport across synapses. The findings support and extend anatomical data regarding vestibulo-olivo-cerebellar pathways.
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Affiliation(s)
- G D Kaufman
- Department of Otolaryngology, University of Texas Medical Branch, Galveston 77555-1063, USA
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31
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Horii A, Takeda N, Yamatodani A, Kubo AT. Vestibular influences on the histaminergic and cholinergic systems in the rat brain. Ann N Y Acad Sci 1996; 781:633-4. [PMID: 8694460 DOI: 10.1111/j.1749-6632.1996.tb15743.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- A Horii
- Department of Otolaryngology, Faculty of Medicine, Osaka University, Japan
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32
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Abstract
The management of Menière's disease often provides a formidable clinical challenge largely because its precise aetiology is unknown. There is no known 'cure' once the condition is established, but drugs may be helpful in treating both the acute attacks of vertigo, and in more long-term management, particularly in the earlier fluctuant stage. These remedies are largely symptomatic and there are few if any properly controlled studies of their efficacy. Suppressant drugs may act centrally at neurotransmitter sites, or peripherally on the labyrinth. Conventional diuretics and osmotically acting agents have been given to reduce the endolymph fluid volume. Histamine analogues directly reduce inner ear fluid pressure mainly by increasing the cochlear blood flow, and are probably the treatment of choice. Otovestibulotoxic drugs given systemically to cause chemical labyrinthine ablation are frequently effective in abolishing attacks of vertigo but often resulted in disabling oscillopsia and ataxia. There is now evidence that local administration by intratympanic injection may well be more efficacious resulting in selective partial end organ ablation. To date innovative immune modifying regimes have not proved helpful.
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Affiliation(s)
- G B Brookes
- Royal National Throat, Nose and Ear Hospital, National Hospital for Neurology and Neurosurgery, London, UK
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33
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Wang JJ, Dutia MB. Effects of histamine and betahistine on rat medial vestibular nucleus neurones: possible mechanism of action of anti-histaminergic drugs in vertigo and motion sickness. Exp Brain Res 1995; 105:18-24. [PMID: 7589314 DOI: 10.1007/bf00242178] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The tonic discharge of 71 medial vestibular nucleus (MVN) neurones was recorded in slices of the dorsal brainstem of young adult rats. Bath application of histamine caused a dose-related excitation in 59 of the 71 cells (83%), the remaining 12 (17%) being unresponsive. Dimaprit, a selective H2 agonist, also caused excitation in all 20 cells tested. The histamine-induced excitation and the response to dimaprit were antagonised by the selective H2 antagonist ranitidine, confirming that the H2 subtype of histamine receptor is involved in mediating the effects of histamine on these cells. Triprolidine, a selective H1 antagonist, also antagonised the excitation caused by histamine, at a concentration (0.3 microM) which left the H2 receptor-mediated response to dimaprit unchanged. Thus the excitatory effects of histamine on MVN cells in the rat involve two components mediated through H1 and H2 receptor-linked mechanisms, respectively. Betahistine, a weak H1 agonist and H3 antagonist, had little excitatory action when applied on its own, but significantly reduced the excitation caused by histamine when the two drugs were applied together. The effects of betahistine were consistent with a partial-agonist action at H1 receptors on MVN cells, reducing the excitatory responses to histamine presumably by occupying these receptor sites in competition with the exogenously applied neurotransmitter. This partial-agonist action of betahistine may be an important part of its mechanism of action in the symptomatic treatment of vertigo and motion sickness, since it is likely to occur not only in the MVN but also in many brain regions, including the thalamus and cortex, which express H1 receptors and which are innervated by the hypothalamic histaminergic system. Thus the effectiveness of betahistine and other anti-H1 drugs against motion sickness may be explained by their action in reducing the effects of the excess histamine release induced in such conditions in various brain areas, including the MVN.
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Affiliation(s)
- J J Wang
- Department of Physiology, Medical School, Edinburgh, UK
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34
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Timmerman H. Pharmacotherapy of vertigo: any news to be expected? ACTA OTO-LARYNGOLOGICA. SUPPLEMENTUM 1994; 513:28-32. [PMID: 7910713 DOI: 10.3109/00016489409127323] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Despite the introduction of new medicinal agents for the treatment of vertigo, no new pharmacological entities have been established. For several years all "new" products have belonged to the well established pharmacological classes of antihistamines (H1-antagonists), calcium-entry inhibitors or vasodilators. In this article these pharmacological classes will be briefly reviewed, with special emphasis given to the pre-synaptic histamine receptor (H3), a recently established pharmacological function. Compounds interfering with this receptor, especially the antagonists, seem to offer new ways of treating vertigo and possibly also new ways of developing new therapeutic agents.
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Affiliation(s)
- H Timmerman
- Leiden/Amsterdam Center for Drug Research, Department of Pharmacochemistry, Vrije Universiteit, The Netherlands
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