A comparative study of vestibular improvement and gastrointestinal effect of betahistine and gastrodin in mice

Betahistine and gastrodin are the first-line medications for vestibular disorders in clinical practice, nevertheless, their amelioration effects on vestibular dysfunctions still lack direct comparison and their unexpected extra-vestibular effects remain elusive. Recent clinical studies have indicated that both of them may have effects on the gastrointestinal (GI) tract. Therefore, we purposed to systematically compare both vestibular and GI effects induced by betahistine and gastrodin and tried to elucidate the mechanisms underlying their GI effects. Our results showed that betahistine and gastrodin indeed had similar therapeutic effects on vestibular-associated motor dysfunction induced by unilateral labyrinthectomy. However, betahistine reduced total GI motility with gastric hypomotility and colonic hypermotility, whereas gastrodin did not influence total GI motility with only slight colonic hypermotility. In addition, betahistine, at normal dosages, induced a slight injury of gastric mucosa. These GI effects may be due to the different effects of betahistine and gastrodin on substance P and vasoactive intestinal peptide secretion in stomach and/or colon, and agonistic/anatgonistic effects of betahistine on histamine H1 and H3 receptors expressed in GI mucosal cells and H3 receptors distributed on nerves within the myenteric and submucosal plexuses. Furthermore, treatment of betahistine and gastrodin had potential effects on gut microbiota composition, which could lead to changes in host-microbiota homeostasis in turn. These results demonstrate that gastrodin has a consistent improvement effect on vestibular functions compared with betahistine but less effect on GI functions and gut microbiota, suggesting that gastrodin may be more suitable for vestibular disease patients with GI dysfunction.

Preventing olanzapine-induced weight gain using betahistine: a study in a rat model with chronic olanzapine treatment

Olanzapine is the one of first line antipsychotic drug for schizophrenia and other serious mental illness. However, it is associated with troublesome metabolic side-effects, particularly body weight gain and obesity. The antagonistic affinity to histamine H₁ receptors (H₁R) of antipsychotic drugs has been identified as one of the main contributors to weight gain/obesity side-effects. Our previous study showed that a short term (2 weeks) combination treatment of betahistine (an H₁R agonist and H₃R antagonist) and olanzapine (O+B) reduced (−45%) body weight gain induced by olanzapine in drug-naïve rats. A key issue is that clinical patients suffering with schizophrenia, bipolar disease and other mental disorders often face chronic, even life-time, antipsychotic treatment, in which they have often had previous antipsychotic exposure. Therefore, we investigated the effects of chronic O+B co-treatment in controlling body weight in female rats with chronic and repeated exposure of olanzapine. The results showed that co-administration of olanzapine (3 mg/kg, t.i.d.) and betahistine (9.6 mg/kg, t.i.d.) significantly reduced (−51.4%) weight gain induced by olanzapine. Co-treatment of O+B also led to a decrease in feeding efficiency, liver and fat mass. Consistently, the olanzapine-only treatment increased hypothalamic H₁R protein levels, as well as hypothalamic pAMPKα, AMPKα and NPY protein levels, while reducing the hypothalamic POMC, and UCP₁ and PGC-1α protein levels in brown adipose tissue (BAT). The olanzapine induced changes in hypothalamic H₁R, pAMPKα, BAT UCP₁ and PGC-1α could be reversed by co-treatment of O+B. These results supported further clinical trials to test the effectiveness of co-treatment of O+B for controlling weight gain/obesity side-effects in schizophrenia with chronic antipsychotic treatment.

[The effect of betahistine on histological changes in rabbit brain in model of whole body wide-frequency vibration]

In acute experiments in conscious rabbits was studied protective action of selective blocker of histamine H3-receptor betahistine (2mg/kg i/v) against histological changes in precentral and postcentral gyrus, as well as in temporal lobe of cerebral cortex, thalamus, hypothalamus, and cerebellum, arising in case of modeling of whole body wide-frequency vibration. Betahistine attenuates edematous and degenerative changes in neurons and reciprocal glial reaction, caused by vibration, but does not eliminate edema in perivascular spaces. This effect may be related to the improvement of blood supply as a result of of vasodilatory action and decrease of oxygen consumption via vestibuloprotective effect.

Betahistine exerts a dose-dependent effect on cochlear stria vascularis blood flow in guinea pigs in vivo

OBJECTIVE

Betahistine is a histamine H(1)-receptor agonist and H(3)-receptor antagonist that is administered to treat Menière's disease. Despite widespread use, its pharmacological mode of action has not been entirely elucidated. This study investigated the effect of betahistine on guinea pigs at dosages corresponding to clinically used doses for cochlear microcirculation.

METHODS

Thirty healthy Dunkin-Hartley guinea pigs were randomly assigned to five groups to receive betahistine dihydrochloride in a dose of 1,000 mg/kg b. w. (milligram per kilogram body weight), 0.100 mg/kg b. w., 0.010 mg/kg b. w., 0.001 mg/kg b. w. in NaCl 0.9% or NaCl 0.9% alone as placebo. Cochlear blood flow and mean arterial pressure were continuously monitored by intravital fluorescence microscopy and invasive blood pressure measurements 3 minutes before and 15 minutes after administration of betahistine.

RESULTS

When betahistine was administered in a dose of 1.000 mg/kg b. w. cochlear blood flow was increased to a peak value of 1.340 arbitrary units (SD: 0.246; range: 0.933-1.546 arb. units) compared to baseline (p<0.05; Two Way Repeated Measures ANOVA/Bonferroni t-test). The lowest dosage of 0.001 mg/kg b. w. betahistine or NaCl 0.9% had the same effect as placebo. Nonlinear regression revealed that there was a sigmoid correlation between increase in blood flow and dosages.

CONCLUSIONS

Betahistine has a dose-dependent effect on the increase of blood flow in cochlear capillaries. The effects of the dosage range of betahistine on cochlear microcirculation corresponded well to clinically used single dosages to treat Menière's disease. Our data suggest that the improved effects of higher doses of betahistine in the treatment of Menière's disease might be due to a corresponding increase of cochlear blood flow.

[Prospects for the use of histaminergic preparations for the purpose of noise otoprotection]

The objective of the present study was to experimentally evaluate the otoprotective effect of the histaminergic preparation betagistin dihydrochloride given at a dose of 32 mg to 10 healthy male volunteers aged from 18 to 22 (mean 19.4) years who were exposed to 85 dB "white" nose for 1 hour. The functional state of their auditory system was estimated from the results of investigations including determination of the tonal auditory threshold, delayed evoked otoacoustic emission and distortion-product frequency otoacoustic emission, short-latency evoked auditory potentials, and extratympanic electrocochleography. It was shown that betagistin dihydrochloride produced a well-apparent otoprotective effect over the entire range of tests comprehensively characterizing the functional state of the cochlea. It is concluded that betagistin dihydrochloride has good prospects for the application in a variety of production activities (to treat occupational noise-induced pathology) including aerospace medicine.

Histaminergic ligands improve vestibular compensation in the cat: behavioural, neurochemical and molecular evidence

This study analysed the effects of betahistine and thioperamide, two histamine H(3) receptor antagonists, on the recovery process after unilateral vestibular neurectomy (UVN) in the cat. In UVN animals untreated or treated with betahistine or thioperamide, recovery was evaluated by recording the horizontal spontaneous nystagmus and the postural and locomotor performances. The neurochemical effects of these drugs were determined by examining their impact on the histaminergic system. We quantified the mRNA coding for histidine decarboxylase (enzyme synthesizing histamine) by in situ hybridisation in the tuberomammillary nuclei, while binding density to histamine H(3) receptors was assessed using a histamine H(3) receptor agonist ([(3)H]N-alpha-methylhistamine) and autoradiography methods in the tuberomammillary and the vestibular nuclei. Relative to the UVN-untreated group, cats treated with betahistine or thioperamide showed strongly accelerated behavioural recovery. UVN-induced 1) an up-regulation of histidine decarboxylase mRNA in the tuberomammillary nuclei, strongly accentuated under betahistine and thioperamide, 2) a reduction of the binding to histamine H(3) receptors in the vestibular and tuberomammillary nuclei, also strongly enhanced in both groups of treated cats. This study demonstrates that betahistine and thioperamide strongly improve the recovery of vestibular functions in UVN cats by interacting with the histaminergic system.

Dose- and duration-dependent effects of betahistine dihydrochloride treatment on histamine turnover in the cat

Drugs interacting with the histaminergic system are currently used for vertigo treatment and it was shown in animal models that structural analogues of histamine like betahistine improved the recovery process after vestibular lesion. This study was aimed at determining the possible dose and duration effects of betahistine treatment on histamine turnover in normal adult cats, as judged by the level of messenger RNA for histidine decarboxylase (enzyme synthesizing histamine) in the tuberomammillary nuclei. Experiments were conducted on betahistine-treated cats receiving daily doses of 2, 5, 10, or 50 mg/kg during 1 week, 3 weeks, 2 months, or 3 months. The 1-week, 3-week, and 2- and 3-month treatments correspond to the acute, compensatory, and sustained compensatory stages of vestibular compensation, respectively. The lowest dose (2 mg/kg) given the longest time (3 months) was close to the dosage for vestibular defective patients. Data from the experimental groups were compared to control, untreated cats and to placebo-treated animals. The results clearly show that betahistine dihydrochloride administered orally in the normal cat interferes with histamine turnover by increasing the basal expression level of histidine decarboxylase mRNA of neurons located in the tuberomammillary nuclei of the posterior hypothalamus. The effects were both dose- and time-dependent. In conclusion, compensation of both static and dynamic deficits is subtended by long-term adaptive mechanisms that could be facilitated pharmacologically using betahistine dihydrochloride.

Effects of betahistine on the spatiotemporal response properties of vestibulospinal neurons to labyrinthine volleys

Betahistine, a drug used in the treatment of vestibular disorders, speeds-up the recovery from hemilabyrinthectomy in experimental animals, likely through the activation of histamine receptors. In order to better understand the mechanism of action of this drug we investigated, in adult, urethane anesthetized rats, whether betahistine modifies the spatial (directional) and temporal response properties of vestibular nuclear neurons to the labyrinthine input, as well as the convergence of different labyrinthine signals on single units. Extracellular single-unit activity was recorded from the caudal, spinal-projecting region of the vestibular nuclei during tilt of the animal, before and after i.p. injection of betahistine. The two orthogonal directions of maximal and minimal response to tilt, as well as the corresponding gains were determined for each neuron. Betahistine reduced the maximal response gain of units showing larger basal values of this parameter and increased it in neurons with smaller basal values, while the minimal response gain was on the average raised. These changes led to a significant decrease in the spatial specificity of the neurons, suggesting that betahistine affects the process of spatiotemporal convergence on vestibular units, likely through a rearrangement of the various inputs. This could be related to the effect of the drug on vestibular compensation.

The effect of betahistine, a histamine H1 receptor agonist/H3 antagonist, on olanzapine-induced weight gain in first-episode schizophrenia patients

Histamine antagonism has been implicated in antipsychotic drug-induced weight gain. Betahistine, a histamine enhancer with H1 agonistic/H3 antagonistic properties (48 mg t.i.d.), was coadministered with olanzapine (10 mg/day) in three first-episode schizophrenia patients for 6 weeks. Body weight was measured at baseline and weekly thereafter. Clinical rating scales were completed at baseline and at week 6. All participants gained weight (mean weight gain 3.1+/-0.9 kg) and a similar pattern of weight gain was observed: an increase during the first 2 weeks and no additional weight gain (two patients) or minor weight loss (one patient) from weeks 3 to 6. None gained 7% of baseline weight, which is the cut-off for clinically significant weight gain. Betahistine was safe and well tolerated and did not interfere with the antipsychotic effect of olanzapine. Our findings justify a placebo-controlled evaluation of the putative weight-attenuating effect of betahistine in olanzapine-induced weight gain.

Investigation of Betaserc in auditory and vestibular disturbances

Vestibular vertigo is a primary symptom in neurootological clinical practice and is common among cerebrovascular diseases. The aim of this investigation was to evaluate the effect of betahistine dihydrochloride (Betaserc), 8 and 16 mg, on patients who were transport system workers with vascular auditory and vestibular disturbances. We examined 50 patients, 30 of whom were treated with 16-mg doses and 20 of whom received 8-mg doses of Betaserc. The mean age of the patients was 37+/-2.3 years. The following evaluative methods were used: questionnaire including detailed neurootological history; ear, nose, and throat and neurological examinations; tonal threshold audiometry; and examination of the vestibular system (spontaneous and provoked reactions). On the basis of the investigations carried out, we recommend 16 mg Betaserc three times daily in the acute phase. The medication is very well tolerated, has no sedative effect and is suitable for long-term treatment.

[Betaserc treatment of psychogenic vertigo]

An effect of betaserc on the character and intensity of vertigo (V), psycho-autonomic state of patients, vestibular functions and oculomotor system, using computer stimulating programs, has been studied in 39 patients with V. After 4 weeks of the treatment, betaserc exerted a positive effect on patients; however, the optimal effect was shown in patients with psychogenic V (73%). In this group, betaserc reduced both V and other psycho-autonomic disturbances. After betaserc treatment, patients with psychogenic V demonstrated a normalization of the vestibular responsiveness parameters in 70% of the cases and of the parameters of spontaneous oculomotor activity and pursuit eye function in 40 to 90%.

Betahistine dihydrochloride interaction with the histaminergic system in the cat: neurochemical and molecular mechanisms

Drugs interfering with the histaminergic system facilitate behavioral recovery after vestibular lesion, likely by increasing histamine turnover and release. The effects of betahistine (structural analogue of histamine) on the histaminergic system were tested by quantifying messenger RNA for histidine decarboxylase (enzyme synthesizing histamine) by in situ hybridization and binding to histamine H(3) receptors (mediating, namely, histamine autoinhibition) using a histamine H(3) receptor agonist ([(3)H]N-alpha-methylhistamine) and radioautography methods. Experiments were done in brain sections of control cats (N=6) and cats treated with betahistine for 1 (N=6) or 3 (N=6) weeks. Betahistine treatment induced symmetrical changes with up-regulation of histidine decarboxylase mRNA in the tuberomammillary nucleus and reduction of [(3)H]N-alpha-methylhistamine labeling in both the tuberomammillary nucleus, the vestibular nuclei complex and nuclei of the inferior olive. These findings suggest that betahistine upregulates histamine turnover and release, very likely by blocking presynaptic histamine H(3) receptors, and induces histamine H(3) receptor downregulation. This action on the histaminergic system could explain the effectiveness of betahistine in the treatment of vertigo and vestibular disease.

Betahistine produces post-synaptic inhibition of the excitability of the primary afferent neurons in the vestibular endorgans

Betahistine has been used to treat several vestibular disorders of both central and peripheral origin. The objective of this work was to study the action of betahistine in the vestibular endorgans. Experiments were done in wild larval axolotl (Ambystoma tigrinum). Multiunit extracellular recordings were obtained from the semicircular canal nerve using a suction electrode. Betahistine (10 microM to 10 mM; n = 32) inhibited the basal spike discharge of the vestibular afferent neurons with an IC50 of 600 microM. To define the site of action of betahistine, its interactions with the nitric oxide synthase inhibitor NG-nitro-L-arginine (3 microM) and with the cholinergic antagonists atropine (10 microM; n = 3) and d-tubocurarine (10 microM; n = 3) were studied. The action of betahistine when co-administered with these drugs was the same as that in control experiments, indicating that its effects did not include nitric oxide production or the activation of cholinergic receptors. In contrast, 0.01-1 mM betahistine reduced the excitatory action of kainic acid (10 microM; n = 6) and quiscualic acid (1 microM; n = 13). These results indicate that the action of betahistine on the spike discharge of afferent neurons seems to be due to a post-synaptic inhibitory action on the primary afferent neuron response to the hair cell neurotransmitter.

Histamine and betahistine in the treatment of vertigo: elucidation of mechanisms of action

The aim of this review is to provide clinicians with a picture of the mechanisms by which: histamine and histaminergic agonists act on the vestibular system both peripherally and centrally; and histaminergic agonists and antagonists interfere with the recovery process after peripheral vestibular lesion. We have focused on betahistine, a structural analogue of histamine with weak histamine H(1) receptor agonist and more potent H(3) receptor antagonist properties, to review the currently available data on the role of the histaminergic system in the recovery process after peripheral vestibular deficits and the effects of histamine analogues in the clinical treatment of vertigo. This review provides new insights into the basic mechanisms by which betahistine improves vestibular compensation in animal models of unilateral vestibular dysfunction, and elucidates particularly the mechanisms of action of this substance at the level of the CNS. It is proposed that betahistine may reduce peripherally the asymmetric functioning of the sensory vestibular organs in addition to increasing vestibulocochlear blood flow by antagonising local H(3) heteroreceptors. Betahistine acts centrally by enhancing histamine synthesis within tuberomammillary nuclei of the posterior hypothalamus and histamine release within vestibular nuclei through antagonism of H(3) autoreceptors. This mechanism, together with less specific effects of betahistine on alertness regulation through cerebral H(1) receptors, should promote and facilitate central vestibular compensation. Elucidation of the mechanisms of action of betahistine is of particular interest for the treatment of vestibular and cochlear disorders and vertigo.

Betahistine inhibits food intake in rats

Betahistine, administered intraperitoneally, decreased, in a dose-dependent manner and in a statistically significant degree, total food intake in different experimental models in rats.

The effect of betahistine on vestibular habituation: comparison of rotatory and sway habituation training

This study was designed to investigate the effect of histaminergic agonists and antagonists on the acquisition of vestibular habituation. The experimental animals, pigeons, were subjected to unilateral rotatory and sway habituation training sessions. The habituation of postural reflexes and post-rotatory head nystagmus was assessed. Vestibular habituation in the control group was achieved by adopting the kinetic reflex posture after approximately 9 training sessions, and after 10 and 14 training sessions, respectively for 50% reduction of the total number of beats (TNB) and the duration of post-rotatory head nystagmus. In the sway adaptation test control pigeons needed nearly 15 training sessions while pigeons receiving betahistine adapted after approximately 8 sessions. Administration of histamine and, most notably, betahistine accelerated the process, while both H1 and H2 antagonists (clemastine, cimetidine) tended to retard it, indicating a less significant contribution of H2 receptors. The cholinergic agent physostigmine strongly retarded habituation while the anticholinergic agent scopolamine markedly accelerated it. In addition the adrenomimetic agent ephedrine also accelerated habituation while the adrenolytic agent droperidol retarded reduction of nystagmus beats. The results indicate that histaminergic receptors play a significant role in the vestibular habituation mechanism but are intricately involved with other types of receptors. Betahistine is clearly the agent of choice for attenuating vestibular effects.

The pharmacology of betahistine in the context of the vestibular system

The problem of deciding, which, of several drug actions is the 'true' mechanism of action is an ancient and difficult one in pharmacology. Sometimes the problem is that each investigator may see his described action as through a tunnel, his vision not encompassing other possibilities. To help with the process of deciding the 'true' mechanism of action, the pharmacologist Philip Seeman has offered some guidelines. A few of his guidelines apply in the case of betahistine (BH). One is--does the drug have access to the proposed site of action? A second is--are the concentrations at which the drug acts at the candidate mechanism achievable in the patient? The three candidate sites of BH action are vascular, central nervous system and inner ear. There is obvious evidence that a vascular site as well as a vestibular end organs site are possible. There is also evidence that BH gains access to the central nervous system albeit achieving lower concentrations there than in plasma. Whether BH crosses the blood-labyrinthine barrier is not known. Then there is the guideline of similarity of clinically-achievable and experimental concentrations. Implicit in this guideline, without data to the contrary, is the assumption that the plasma concentration of a drug is roughly the concentration at the active site. This may or may not be true.

Effects of betahistine and of its metabolites on vestibular sensory organs

Betahistine is widely used in the treatment of peripheral and central vestibular disorders. Till now the anti-vertigo effect of the drug was though to be mainly due to an action of betahistine on inner ear or cerebral microcirculation or on some structures of the CNS, chiefly the vestibular nuclei. Vertigo, however is, in most cases, of peripheral origin but it remains unknown whether betahistine, or some of its metabolities, may directly affect the vestibular system at peripheral level. Pharmacokinetic studies have in fact demonstrated that betahistine is transformed, mainly at the hepatic level, in aminoethylpyridine (M1), hydroxyethylpyridine (M2) and, finally, in pyridylacetic acid (M3) which is excreted with the urine. All these substances are therefore present in the body fluids of subjects treated with betahistine, and thus might have pharmacological effects. The goal of the present study was to investigate whether betahistine or some of its metabolites could exert any effect on vestibular receptors. To this end, the effects of the drugs (10(-7)-10(-2) M) have been examined on frog semicircular canals, an animal model well suited for this purpose. The effects of betahistine and of its metabolites have been evaluated by recording ampullar receptor activity both at rest and during mechanical stimulation of the sensory organ. The results demonstrated that both betahistine and one of its metabolites, the aminoethylpyridine (M1), exert effects quite similar on ampullar receptors; both these substances in fact could reduce greatly ampullar receptor resting discharge but had scanty effects on mechanically-evoked responses. This observation might justify betahistine and possibly M1 anti-vertigo effects. In fact vertigo is normally due to uncontrolled changes in vestibular receptor resting discharge. It is therefore probable that any factor able to reduce vestibular receptor resting firing rate and, in consequence, its variations, may have, as final effect, an anti-vertigo action. The observation that betahistine and M1 have similar effects might be of some clinical interest. In fact, on the basis of our data, the hypothesis may be put forward that the anti-vertigo action of betahistine is at first achieved by betahistine itself and then sustained and prolonged in time by M1.

Action mechanism of betahistine in the vestibular end organs

Betahistine has been used to treat several vestibular disorders of both central and peripheral origin. The objective of this work was to study the betahistine action mechanism at the vestibular end organs. Experiments were carried out in wild larval axolotl (Ambystoma tigrinum). Multiunit extracellular recordings were obtained from the semicircular canal nerve using a suction electrode. Betahistine (10 microM to 10 mM, n = 32) inhibited the basal spike discharge of the vestibular afferent neurons with an IC50 of 600 microM. To define the site of action of betahistine, its interactions with antagonists of nitric oxide sintethizing enzyme, cholinergic drugs, and excitatory amino acids were studied. Betahistine 1 mM (n = 5) was coadministered with NG-nitro-L-arginine 3 microM. The action of betahistine remained as in control experiments. Betahistine 1 mM reduced the excitatory action of carbachol (200 microM, n = 5) in a 30 +/- 3.4%. Cholinergic antagonists atropine (10 microM, n = 3) and d-tubocurarine (10 microM, n = 3) did not modify betahistine actions. Betahistine 1 mM also reduced kainic acid (10 microM, n = 4) excitatory action in 45.5 +/- 9.8%. These results corroborate that betahistine has a peripheral inhibitory action in the spike discharge of the afferent neurons in the vestibule. This action seems to involve neither NO production nor modifications in the release of acetylcholine from the efferent fibers. The inhibitory action of betahistine seems to be due to a postsynaptic binding site on the afferent neurons.

Betahistine, vestibular function and compensation: in vitro studies of vestibular function and plasticity

Histamine has an excitatory action on rat medial vestibular nucleus neurones in vitro, an effect that is mediated by histamine H1 and H2 receptors. Betahistine, which is a weak agonist at the H1 receptor and a moderate antagonist at the presynaptic H3 autoreceptor, weakly excites medial vestibular nucleus cells but antagonizes their responses to histamine. Experiments were carried out on rat medial vestibular nucleus cells in vitro using slices prepared from animals that had undergone unilateral labyrinthectomy (UL). There was a significant increase in the intrinsic excitability of medial vestibular nucleus cells in the rostral region of the ipsi-lesional nucleus within 4 h post-UL, which was sustained for the following week. These changes in intrinsic excitability of the medial vestibular nucleus neurones were abolished in animals that were not exposed to the secretion of stress hormones that normally occurs following UL. Histamine is also released in response to the stress associated with vestibular dysfunction. It is possible that the beneficial effects of betahistine on vestibular compensation are related to an interaction between histaminergic receptors activated by the parallel release of histamine and the activation of glucocorticoid receptors through the activation of the stress axis. Further study of the interactions between histamine receptors and the activation of the stress axis may be useful in understanding the effects of betahistine on vestibular plasticity.

Betahistine reduces the resting firing rate of vestibular receptors in the frog

Although betahistine is widely used in the treatment of vertigo, it remains unclear whether it directly affects the vestibular system at the peripheral level. The effects of betahistine were therefore assessed in an isolated preparation of frog semicircular canal. Betahistine was administered either in the endolymphatic or the perilymphatic fluid and the ampullar receptor potential and mass nerve discharge were recorded at rest and during mechanical stimulation. Endolymphatic administration was without effect. In contrast, perilymphatic administration resulted in a marked reduction in ampullar receptor resting discharge, although the mechanically evoked responses were only slightly affected. As vertigo is generally caused by sudden and uncontrolled changes in the resting discharge of vestibular receptors, the ability of betahistine to reduce the resting firing rate of vestibular receptors is thought to contribute to its anti-vertigo actions.

Betahistine effects on cochlear blood flow: from the laboratory to the clinic

The development of laser Doppler flowmetry techniques has contributed greatly to the study of cochlear blood flow (CBF). In animal models, intravenous betahistine dihydrochloride clearly increased CBF in a dose-dependent manner. This effect was greater in the cochlear vasculature than in the systemic vascular bed. The effects of betahistine were blocked by the alpha 2-antagonist idazoxan, thus suggesting an interaction between histaminergic and presynaptic adrenergic receptors. This was further supported by studies investigating the effects of electrical stimulation on CBF. Local (round window membrane) application of betahistine did not affect CBF, but had a non-specific effect on cochlear electrophysiology. This indicates that the receptors for betahistine vascular effects in the inner ear are most likely located in the modiolar artery. More recently, laser Doppler flowmetry techniques have been applied to human subjects. It has been shown that intratympanic application of adrenaline affects CBF and that this blood flow is under vigorous sympathetic control. Electrical stimulation has also been used to obtain measures of dynamic responsiveness in human subjects. This results in an increase in CBF, which is dependent on the intensity of the stimulation. Preliminary evidence indicates that this procedure can provide a standardized measure of the dynamic properties of CBF and may provide a means to differentially identify patients with compromised vasculature.

Vestibular compensation in the cat: the role of the histaminergic system

Histamine is thought to be involved in the recovery of vestibular function as histaminergic medications are effective in vestibular-related syndromes. We conducted studies in the cat to assess the effects of betahistine (a histamine-like substance) on the behavioural recovery process after unilateral vestibular neurectomy (UVN). We also investigated histamine immunoreactivity changes in the vestibular and tuberomammillary nuclei of betahistine-treated lesioned cats compared with untreated and unlesioned cats. Betahistine strongly accelerated the behavioural recovery process after UVN, with a time benefit of approximately 2 weeks for both static posture (support surface) and dynamic equilibrium function (locomotor balance) compared with untreated animals. A bilateral decrease in histamine immunoreactivity was seen in both acute and compensated UVN cats; this effect was strongly accentuated with betahistine treatment. In conclusion, the results indicate that vestibular lesion reduces histamine staining due to an increase in histamine release in the vestibular and tuberomammillary nuclei that promote vestibular recovery. Betahistine dihydrochloride should contribute to this process by acting on both the presynaptic histamine H3 and postsynaptic histamine H1 receptors.

Lack of substantial effect of the H(3)-antagonist thioperamide and of the non-selective mixed H(3)-antagonist/H(1)-agonist betahistine on amygdaloid kindled seizures

We investigated whether some histamine H(3)-antagonists would attenuate amygdaloid kindled seizures in rats. Thioperamide, a standard H(3)-antagonist, did not significantly reduce either seizure ranks or afterdischarge duration (ADD). Betahistine which has both H(3)-antagonistic activity and H(1)-agonistic activity significantly reduced ADD, albeit mild at a toxic dose, though seizure ranks were not affected. In addition, L-histidine, the precursor of histamine, affected neither seizure ranks, nor ADD. It was shown that H(3)-antagonists have no significant inhibitory action against amygdaloid kindled seizures, probably because released histamine was unable to inhibit those seizures.

The effect of blood flow promoting drugs on cochlear blood flow, perilymphatic pO(2) and auditory function in the normal and noise-damaged hypoxic and ischemic guinea pig inner ear

The effect of blood flow promoting drugs, such as hydroxyethyl starch (HES) either of low or high molecular weight (HES 70, HES 200), pentoxifylline, ginkgo biloba, naftidrofuryl and betahistine, and various combinations of the drugs was studied in unexposed and noise-exposed (broad-band noise, bandwidth 1-12 kHz, 106 dB SPL, 30 min) guinea pigs. The results were compared without therapy and placebo (isotonic saline, NaCl). The cochlear blood flow (CoBF) and the partial pressure of oxygen in the perilymph (PL-pO(2)) were continuously and simultaneously recorded over a period of 210 min. In addition, cochlear microphonics (CMs), compound action potentials of the auditory nerve (CAPs) and auditory brain stem responses (ABRs) were registered. Noise-induced hearing loss (NIHL) paralleled a decrease of PL-pO(2). Both were found to occur before evidence of reduced CoBF. PL-pO(2) and CoBF declined progressively post-exposure, while CMs, CAPs and ABRs showed no further deterioration or signs of recovery up to 180 min after cessation of noise. Treatment started 60 min post-exposure, respectively after 90 min, without manipulation in unexposed animals, and was then studied for a further 120 min. In unexposed animals, CoBF increased significantly during infusion of HES 70, HES 200, pentoxifylline and betahistine. NaCl, ginkgo biloba and naftidrofuryl did not alter CoBF. PL-pO(2) decreased significantly during infusion of all administered drugs and combinations, except for NaCl. CMs, CAPs and ABRs remained constant, with the exception of increased ABRs after infusion of HES 70 and HES 200. In noise-exposed animals, a sustained therapeutic effect on cochlear ischemia was achieved only by HES 200 and pentoxifylline. HES 70, betahistine and ginkgo biloba compensated cochlear ischemia only during infusion; however, 30-60 min after termination of therapy, no significant difference of values for CoBF was observed compared to the untreated noise-exposed groups. NaCl and naftidrofuryl showed no effect on CoBF. None of the applied drugs had a sustained compensatory effect on cochlear hypoxia. CMs, CAPs and ABRs improved significantly after HES 70, HES 200 and betahistine, resulting in partial recovery of CMs, and partial (betahistine) or even full (HES 70 and HES 200) recovery of CAPs and ABRs. In contrast, NaCl, pentoxifylline, ginkgo biloba and naftidrofuryl had no therapeutic effect on NIHL.

Effects of betahistine metabolites on frog ampullar receptors

Previous studies have demonstrated that betahistine, an histamine-like substance used widely as an anti-vertigo drug, can decrease ampullar receptor resting discharge without affecting their mechanically evoked responses. Pharmacokinetic studies have shown that this drug is transformed, mainly at the hepatic level, into aminoethylpyridine (M1), hydroxyethylpyridine (M2), then excreted with the urine as pyridylacetic acid (M3). The goal of the present study was to investigate whether betahistine metabolites are also able to affect vestibular receptor activity. Results demonstrated that, in the range tested (10(-7)-10(-2) M), M2 and M3 exerted no effect, whereas M1, at concentrations higher than 10(-6) M, was able to reduce the resting discharge of ampullar receptors without affecting the evoked responses. M1 therefore exerts effects similar to those of betahistine on ampullar receptors. This might be of some clinical interest. On the basis of our data, the hypothesis may be put forward that the anti-vertigo action of betahistine is at first achieved by betahistine itself and then sustained by M1.

Effect of the H1-histamine receptor agonist betahistine on drinking and eating behavior in pygmy goats

The effect of different doses of the H1-receptor agonist betahistine (0.9 and 2, 4 and 8 mg/kg b.wt.(0.75)) on water and food intake was investigated in 12 pygmy goats. Intraperitoneal (i.p.) injection of betahistine (2, 4, and 8 mg/kg b.wt.(0.75)) stimulated drinking in a dose-dependent manner. Food intake was decreased after the injection of 4 or 8 mg/kg b.wt.(0.75) betahistine, respectively. The increase in water intake was characterized by an increased draft size and decreased latency to drink. The decrease in food intake at the highest dose tested was characterized by an increased latency to eat and by a decreased meal frequency, and food intake associated to drinking was decreased. In line with previous studies, these results support the hypothesis that food-associated drinking is mediated by stimulation of H1-receptors of histamine in pygmy goats.

Pharmacological evaluation of an in vivo model of vestibular dysfunction in the rat

A unilateral microinjection of either histamine or kainic acid was made into the medial vestibular nucleus of rats, eliciting robust barrel rotations that were evaluated by an elevated body-rotation test. Systemic pretreatment with betahistine or GT-2016 significantly attenuated the kainic acid-induced barrel rotations. These data indicate that the animal model described herein may represent a new model to identify novel drugs with potential antivertigo properties.

Betahistine increases vestibular blood flow

Betahistine is used for treatment of several vestibular disorders. Despite the accepted use of this histamine-like substance, its mechanism of action is not well understood. The purpose of this study was to assess the possibility that one of the activities of betahistine is increasing blood flow in the peripheral vestibular end organs. Using a novel surgical approach, we identified the posterior semicircular canal ampulla of guinea pigs and placed a laser Doppler probe in position to obtain blood flow measurements from the posterior semicircular canal ampulla. Blood pressure, heart rate, and vestibular blood flow were continuously recorded. Concentration-response curves were obtained for betahistine (2.5, 5, 7.5, and 10 mg/kg) and control-vehicle (0.15 mol/L NaCl) infusions. A separate group of subjects was pretreated with the competitive selective H3 agonist, thioperimide maleate, before betahistine treatment. Increases in vestibular blood flow and decreases in blood pressure were observed in response to betahistine infusions. Pretreatment with thioperamide maleate abolished these changes at low doses of betahistine and attenuated the responses at higher doses of betahistine. These results show that betahistine administration induces increases in vestibular blood flow. These findings support the potential use of betahistine for treatment of vestibular disorders, which may be caused by compromised circulation.

[The effects of betahistine on the function of equilibrium system]

The authors present a pilot investigation of the effect of betahistine on vestibular disorders of peripheral and central origin. The evaluation of drug efficacy was based on subjective symptoms (vertigo, dizziness) and values of nystagmus parameters in ENG. and stability records made during posturographic tests, before and after drug administration. The regression or moderation of symptoms, such as vertigo and dizziness, was noted as well as the reduction of nystagmus slow phase velocity and the amplitude and the reduction of parameters during posturographic test. The reduction was observed during the treatment, especially during the studies after 4 hours following drug administration. After 6 months, values of the parameters, especially those made during posturographic tests, were close to initial values. The criteria, helpful for diagnosing subjective ailments were discussed with the emphasis placed on the significance of the processes responsible for equilibrium system function return. The review was made of the literature concerning the role of betahistine in the treatment of vestibular disorders.

Effects of betahistine on vestibular receptors of the frog

Betahistine is widely used in the symptomatic treatment of peripheral and central vestibular disorders. However, its remains unknown whether the drug can act directly on inner ear sensory organs. To this end, the effects of betahistine (10(-7)-10(-2) M) were examined on isolated preparations of frog semicircular canal mounted in a double-celled bath which allowed drug administration both in the endolymphatic and in the perilymphatic fluid. The effects of betahistine were evaluated by recording ampullar receptor potentials and nerve firing rate both at rest and during mechanical stimulation of the isolated preparation. The results demonstrated that endolymphatic administration of betahistine had no effect, whereas its perilymphatic administration could reduce greatly ampullar receptor resting discharge but had little effect on mechanically evoked responses. This observation may explain the anti-vertigo effects of betahistine. Vertigo is normally due to uncontrolled changes in vestibular receptor resting discharge. It is therefore probable that any factor able to reduce the resting firing rate of vestibular receptors and, in consequence, its variations, may have an anti-vertigo action.

The vascular mechanism of action of betahistine in the inner ear of the guinea pig

The aim of this study was to investigate the mechanism and site of action of betahistine dihydrochloride in the inner ear of the guinea pig. Betahistine-evoked increases in cochlear blood flow (CBF) have been presumed to be due to the drug effect on the later wall capillary bed or larger feeding vessels in the cochlea vascular system. As such, the mechanism of action could be due to inhibition of H3 receptors. Betahistine may also have a direct effect on postsynaptic H1/H2 receptors and/or an effect modulated by other autonomic receptors. Betahistine-evoked CBF responses were assessed by laser Doppler flowmetry in the presence of an H3 agonist (alpha N-methyl-histamine dihydrochloride), an H3 antagonist (thioperamide), an H2 antagonist (cimetidine) or an alpha 2 antagonist (idazoxan). The effects of betahistine on circulation in the anterior inferior cerebellar artery (AICA) and ipsilateral stria vascularis (SV) were assessed using intravital microscopy (IVM). Findings showed that betahistine increased CBF and reduced systemic blood pressure (BP). In contrast, alpha N-methylhistamine dihydrochloride had no effect on baseline CBF or BP and did not influence betahistine-induced increases in CBF. Thioperamide reversed the effects of betahistine on CBF, but had no effect on baseline CBF or BP. Cimetidine had no marked effect on baseline CBF or betahistine-induced increases in CBF Idazoxan had no consistent effects on baseline CBF, but abolished the effect of betahistine on CBF. The mean increase of red blood cell velocity in SV capillaries was 15% and occurred without a demonstrable change in capillary diameters. In contrast, the diameter of the AICA increased by 17-20%, indicating that betahistine-evoked increases in CBF resulted primarily from vasodilatation of the AICA. We suggest that this effect may be mediated via presynaptic H3 heteroreceptors and autonomic alpha 2 receptors.

Dose-dependent effect of betahistine on the vestibulo-ocular reflex: a double-blind, placebo controlled study in patients with paroxysmal vertigo

The effect of betahistine on the vestibulo-ocular reflex (VOR) was assessed in 12 patients suffering from paroxysmal vertigo. Only patients who responded to betahistine treatment were admitted to the study in order to increase the probability of quantifying the effect of the drug on vestibular function. Patients received placebo or 16, 32 or 64 mg betahistine orally under double-blind conditions. Vestibular function was tested a few minutes before intake, and 1, 2, 3, 4, 6 and 8 h after intake, by torsion swing stimulus in the dark, visuo-vestibular interaction upon simultaneous visual and vestibular stimulation and high frequency passive head shaking. Betahistine significantly affected the velocity gain of low and high frequency VOR. The reduction in gain was maximal about 4 h after administration of the 16 mg dose in the torsion swing experiment and the 32 mg dose in the head shaking experiment. Above these doses, the effect on velocity gain was less marked. Betahistine had no effect on visuo-vestibular interaction or nystagmus duration during low frequency torsion. These results suggest that betahistine has a complex action on H3 receptors and that the site of action may be in the vestibular nuclei.

Histamine immunoreactivity changes in vestibular-lesioned and histaminergic-treated cats

Histamine is likely involved in vestibular function recovery since histaminergic medications are effective in vestibular-related syndromes. We investigated the histamine immunoreactivity changes after unilateral vestibular neurectomy and the effects of betahistine (a partial histamine H1 receptor agonist and an histamine H3 receptor antagonist) and thioperamide (a pure histamine H3 receptor antagonist) treatment in cats. Histamine staining was analyzed in the tuberomammillary and vestibular nuclei through immunohistochemical methods and quantification techniques in light microscopy. Unilateral vestibular neurectomy induced a strong bilateral decrease in histamine immunoreactivity in the vestibular nuclei and a smaller reduction in the tuberomammillary nuclei in both acute (1 week) and compensated (3 weeks, 1 year) cats. One-week thioperamide or betahistine treatment led to a near-total lack of staining in these structures in both lesioned and control cats. One-month betahistine treatment had weaker effects in the compensated cats. We conclude that vestibular lesions reduce histamine staining because of an increase in histamine release in the vestibular and tuberomammillary nuclei, promoting vestibular functions recovery, and betahistine could contribute to this process by acting on both the presynaptic histamine H3 and postsynaptic histamine H1 receptors.

Non-specific effect of beettahistine on cochlear electrophysiology in guinea pig

Beettahistine hydrochloride (BH) is reported to be beneficial in the treatment of certain type of vestibulo-cochlear disorders. Experimentally is shown that BH inhibits vestibular firing rate and improves cochlear blood flow by dilatating the larger feeding vessels. Both these effects are weak, and hardly can explain the clinical benefits reported for the drug. We investigated the effect of BH on the organ of Corti electrophysiology in vivo. Two microliters of 1, 2, 5 and 10% saline solutions of BH was applied (in increasing order) to the round window (RW) membrane in an anesthetized guinea pig (n = 5). Summating potential (SP), action potential (AP), and cochlear microphonics (CM) were recorded at 16 kHz frequency using RW Ag wire electrode. The repeated applications of BH with increasing concentrations produced a dose-dependent threshold shift in CAP. The I/O function for 20, 30, 40, 50, 60, 70, and 80 dB at 16 kHz indicated that there was a saturation before complete blockade of the responsiveness in all measured parameters. SP and CM changes nearly followed CAP changes. The changes recover during 2 hours follow-up period. Our findings indicate that BH affects the organ of Corti electrophysiology. That the drug effect saturates before a complete blockade suggests non-specific effect of BH on the organ of Corti structures and cochlear nerve.

Physiopathology of H3-receptors and pharmacology of betahistine

This article reviews published research on the physiology of histamine H3-receptors. The function of this inhibitory autoreceptor, its localisation and influence on histaminergic neurones as well as histamine-controlled processes are presented together with the role of H3-receptors in the vestibular system. In addition to a summary of the properties of the main H3-agonists and -antagonists, the pharmacology of betahistine and its place in the treatment of vertigo are discussed.

Effects of betahistine, a histamine H1 agonist and H3 antagonist, in a light/dark test in mice

The effects of betahistine, a histamine H1 agonist and H3 antagonist, were investigated in a light/dark test measuring anxiety in mice. Betahistine significantly decreased the locomotion and rearing in the light and dark zones, shuttle crossing and time spent in the light zone in the light/dark test. These phenomena suggest that betahistine has anxiogenic effects and/or locomotor suppressive effects. Pyrilamine (6 mg/kg) and ketotifen (6 mg/kg), H1-receptor antagonists, antagonized the effects of betahistine (100 mg/kg) on all parameters in the light/dark test but zolantidine (6 mg/kg), an H2-receptor antagonist, augmented its effects on some parameters decreased by betahistine. Especially, it potentiated the decreases by betahistine in the parameters showing anxiety in this test. The decreases in the light/dark test induced by zolantidine (6 mg/kg) plus betahistine (200 mg/kg) were antagonized by pyrilamine (12 mg/kg) but antagonism of the decrease in the time spent in the light zone as a parameter showing anxiety was not significant. These results suggest that the effects via H1 receptors are involved in anxiety in the light/dark test in mice but the other factor may be simultaneously needed for induction of behaviorally detectable anxiogenic effects in this test.

Effects of histamine and betahistine on rat medial vestibular nucleus neurones: possible mechanism of action of anti-histaminergic drugs in vertigo and motion sickness

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.

Effect of histamine on haemorrhagic mucosal lesions is related to vascular permeability in rats: studies with histamine, H1-, H2- and H3-agonists and bradykinin

OBJECTIVE

To test the hypothesis that an early increase in vascular permeability is correlated with later gastric mucosal protection in the rat.

METHODS

Histamine, its agonists (H1, H2, H3) and bradykinin, were either given subcutaneously or intragastrically before the intragastric administration of ethanol. The extravasation of intravenously injected 99mTc-glucoheptonate into the gastric wall and into the gastric contents was used as an indicator of increased permeability. Gastric haemorrhagic lesions where measured by computerized planimetry and ethanol absorption was determined by an ACA Clinical Analyzer.

RESULTS

Histamine and bradykinin increased vascular permeability in the glandular stomach and provided significant gastroprotection, similar to H1-, H2- and H3-agonists, against ethanol-induced gastric haemorrhagic lesions. This gastroprotection was accompanied by low blood levels of ethanol, probably indicating decreased ethanol absorption and the creation of a histodilutional barrier in the stomach by histamine.

CONCLUSIONS

These data indicate that an increase in vascular permeability dissipates the concentration, and may delay the absorption, of ethanol in gastric mucosa by creating a perivascular histodilutional barrier. Vascular injury, which is an early pathogenetic factor in the development of ethanol-induced gastric haemorrhagic erosions, may thus be prevented.

Betahistine dihydrochloride treatment facilitates vestibular compensation in the cat

Unilateral lesion of the vestibular system induces posturo-locomotor deficits that are compensated for with time. Drug therapy is currently used to improve the recovery process and to facilitate vestibular compensation. Betahistine dihydrochloride is an histamine-like substance that has been employed in vestibular pathology; it was found effective in many forms of vertigo and in vestibular-related syndromes. Investigations performed in animal models have shown betahistine-induced neuronal modulations in the vestibular nuclei complex and interactions with the H1 and H3 histamine receptors. Potentially, this substance is therefore capable to interfere with some recovery mechanisms and to improve the behavioral adaptations. But there is at present a total lack of data concerning the influence of betahistine treatment on vestibular compensation in animal models. The aim of this study was to understand the pharmacological activity of betahistine in the restoration of posture and locomotor balance functions in unilateral vestibular neurectomized cats. Posture recovery was assessed by quantifying the surface reaction of the cat's support as measured while standing erect on its four legs, at rest. Locomotor balance recovery was determined using the rotating beam test, by measuring the maximal performance (max. P.) of the cat and its locomotion speed regulation during the postoperative time period. We have compared the recovery profile and time course of these static (posture) and dynamic (equilibrium) functions in three groups of cats. Two experimental groups were treated at daily doses of 50 mg/kg and 100 mg/kg, respectively. Betahistine dihydrochloride was given orally until complete recovery of posturolocomotor functions. One untreated control group served as the reference. Results showed that postoperative treatment strongly accelerated the recovery process in both treated groups, inducing a time benefit of around 2 weeks as compared to the controls. Maximum performance of the cats on the rotating beam as well as locomotion speed regulation were highly correlated to the postoperative development of the cat's support surface, indicating that compensation of the static vestibulospinal deficits conditioned the subsequent locomotor balance recovery. These behavioral data showed that betahistine dihydrochloride constitutes a useful drug therapy for the symptomatic treatment of central vestibular disorders in our animal model of unilateral vestibular lesion. Improvement of vestibular compensation under betahistine postoperative treatment, as evidenced here for the posture and locomotor balance functions, is discussed both in terms of aspecific effect (histamine-induced increase of the level of vigilance) or more direct action in the vestibular nuclei (histamine-induced rebalance of neuronal activity on both sides).

[Inner ear blood flow with betahistine--an animal experiment study]

The influence of the drug Betahistin on the cochlear blood flow (CBF) was checked on 15 guinea pigs (6 controls) (Charles River, BFA 350-450 g) by means of the hydrogen clearance method. The hydrogen clearance measurements were carried out under alpha-chloralose-ethylurethane anaesthesia, artificial respiration with simultaneous control of the electrocardiogram, arterial blood pressure and body temperature. The actual arterial pH-value was checked hourly. Indirect measurement of CBF was carried out in the perilymphatic space (basal turn) before and after intravenous application of Betahistin (vena jugularis externa) (dosage: 0.11 mg/kg/min). The mean arterial blood pressure remained within the 10% range during the experiments. Under Betahistin-treatment the CBF showed an significant increase (p = 0.05). Despite this favourable pharmacological efficiency of Betahistin it must be pointed out that the general application of vasoactive drugs, especially of vasodilative drugs, in the treatment of postulated inner ear blood flow disturbances is presently controversial.

Histamine receptors in the human nose

The aim of this study was to determine the role of histamine receptors in the nose. The effects of intranasal histamine challenge were compared with those of a specific H1-receptor agonist, betahistine and a specific H2-receptor agonist, impromidine, in 11 normal individuals and four with rhinitis. Sneezing, nasal irritation and hypersecretion were induced by histamine and the H1-receptor agonist, betahistine only. Nasal airway resistance (Rna) was measured by passive anterior rhinomanometry. Histamine, betahistine and impromidine all induced rises in Rna in both normal individuals and those with rhinitis but histamine had the most potent effect; the H2-receptor effect on Rna was predominant over that of the H1-receptor. The sensitivity to all three agonists was greater in the individuals with rhinitis.

Influence of histamine receptor antagonists on the dynamics of the cutaneous hypersensitivity reaction in patients infected with schistosoma haematobium

The biphasic cutaneous hypersensitivity response elicited by intradermal administration of S. haematobium antigen to patients with schistosomiasis may be used as a model for drug effects on cell dynamics. As the effects of H1- and H2-blockade, and the possible involvement of H3-receptors, have not been elucidated, we have examined the effects of combinations of cetirizine, cimetidine and betahistine on the response of patients with confirmed schistosomiasis. The skin blister technique was used. After intradermal administration of antigen, blister fluid containing inflammatory cells was collected on microscope slides at 6 and 24 h, and a differential cell count was done; and the area of induration was measured at 0.25, 1, 6 and 24 h. These baseline tests were repeated after 3 days of pretreatment with cetirizine 20 mg/d, after the addition of cimetidine 1200 mg/d for 3 further days, and finally after adding on betahistine 32 mg/d for 3 days. Simultaneous H1- and H2-blockade with cetirizine plus cimetidine caused a significantly greater reduction in induration than cetirizine (H1-blockade) alone; the reductions from the baseline value were 70%, 78%, 89%, 97%, and 33%, 53%, 43%, 30%, at times 0.25, 1, 6 and 24 h, respectively. The triple combination with the addition of betahistine (H1- and H2-agonist and H3-antagonist) resulted in reductions of 37%, 63%, 95% and 97% at the same times. The most striking changes in cellular dynamics were a significant increase in eosinophil (6 h) and neutrophil (6 h) vacuolation, and enhancement of monocyte (24 h) and basophil (6 h) accumulation, when the betahistine was added.(ABSTRACT TRUNCATED AT 250 WORDS)

Dimaprit, a histamine H2-agonist, inhibits anaphylactic histamine release from mast cells and the decreased release is restored by thioperamide (H3-antagonist), but not by cimetidine (H2-antagonist)

Whether anaphylactic histamine release from rat peritoneal mast cells is influenced by betahistine, a histamine H1-receptor agonist/H3-antagonist, and dimaprit, an H2-agonist, was examined. Treatment with dimaprit at 6 and 60 microM for 20 min significantly inhibited the anaphylactic histamine release, whereas betahistine at up to 80 microM under the same conditions did not affect it. Treatment with dimaprit at 6 and 60 microM for 1 to 20 min and for 5 to 20 min, respectively, caused a time-dependent inhibition of the release, but up to 30 min treatment with 8 and 80 microM betahistine had no effect. The decreased histamine release induced by dimaprit was recovered by neither mepyramine nor cimetidine. However, thioperamide, an H3-selective antagonist, dose-dependently restored the diminished release. From these results, the inhibition of anaphylactic histamine release by dimaprit is not produced by the stimulation of H2-receptors, but involves the stimulation of H3-like receptors or H3-subtype receptors, which are distinct from the H3-receptors located in brain, and suggests that the receptor plays an important role in the negative feedback regulation of histamine release.

Histamine increases cytosolic Ca2+ in dibutyryl-cAMP-differentiated HL-60 cells via H1 receptors and is an incomplete secretagogue

Human neutrophils and dibutyryl-cAMP (Bt2cAMP)-differentiated HL-60 cells possess receptors for the chemotactic peptide N-formyl-L-methionyl-L-leucyl-L-phenylalanine (fMet-Leu-Phe), which mediate activation of phospholipase C, with subsequent increase in cytosolic Ca2+ concentration ([Ca2+]i) and activation of specific cell functions. In many cell types, histamine, via H1 receptors, activates phospholipase C, but it is unknown whether neutrophilic cells possess functional H1 receptors. We compared the effects of histamine with those of fMet-Leu-Phe on activation of these cells. In Bt2cAMP-differentiated HL-60 cells, substances increased [Ca2+]i in the effectiveness order fMet-Leu-Phe greater than histamine greater than betahistine. Pertussis toxin diminished fMet-Leu-Phe-induced rises in [Ca2+]i to a greater extent than those induced by histamine. H1 but not H2 antagonists inhibited histamine- and betahistine-induced rises in [Ca2+]i. fMet-Leu-Phe and histamine activated phospholipase C and increased [Ca2+]i through release of Ca2+ from intracellular stores and sustained influx of Ca2+ from the extracellular space. The substances also induced Mn2+ influx. Ca2+ and Mn2+ influxes were inhibited by 1-(beta-[3-(4-methoxyphenyl)propoxyl]-4-methoxyphenethyl)-1H-imida zole hydrochloride (SK&F 96365). The stimulatory effects of histamine on [Ca2+]i were more sensitive to inhibition by 4 beta-phorbol 12-myristate 13-acetate than were those of fMet-Leu-Phe. Unlike fMet-Leu-Phe, histamine did not activate superoxide anion formation, release of beta-glucuronidase, and tyrosine phosphorylation. In neutrophils, histamine and betahistine did not induce rises in [Ca2+]i. Our data show that (i) in Bt2cAMP-differentiated HL-60 cells, histamine increases [Ca2+]i via H1 receptors coupled to pertussis toxin-sensitive and possibly, pertussis toxin-insensitive heterotrimeric regulatory guanine nucleotide-binding proteins, (ii) histamine activates nonselective cation channels, and (iii) unlike fMet-Leu-Phe, histamine is an incomplete secretagogue.

The effects of two anti-vertigo drugs (betahistine and prochlorperazine) on driving skills

1. The effects of betahistine 72 mg three times daily, prochlorperazine 5 mg three times daily and placebo taken for 3 days before testing were compared on two actual driving tasks (weaving and gap estimation) and two psychomotor tasks (reaction time and kinetic visual acuity) in normal subjects in a double-blind prospectively randomised cross-over study. 2. The psychomotor effects of betahistine could not be distinguished from those of placebo. 3. Prochlorperazine impaired driving performance causing increased carelessness and slowing on the weaving test. 4. There was little subjective appreciation of impairment whilst taking prochlorperazine.

Histamine in the treatment of vertigo

The vasodilating properties of histamine were the basis for histamine treatment of episodic vertigo and other inner ear dysfunctions. The successes obtained led to the development of betahistine: an orally active histamine analogue; its general pharmacology resembles that of histamine. Animal pharmacology experiments proved that betahistine increases cerebral blood flow and probably also affects vestibular neurons. From clinical studies, it appears that betahistine is an effective agent for the symptomatic treatment of Meniere's syndrome. Efficacy has also been shown in the treatment of patients suffering from paroxysmal vertigo.

Effects of anti-vertigo drugs on medial vestibular nucleus neurons activated by horizontal rotation

The effects of anti-vertigo drugs on medial vestibular nucleus (MVN) neurons were examined to assess the site and mode of action using cats anesthetized with alpha-chloralose. Single neuron activity in the MVN was extracellularly recorded using a silver wire microelectrode attached along a seven-barreled micropipette, each of which was filled with diphenhydramine, diphenidol, betahistine, glutamate or NaCl. Type I of the MVN neurons were identified according to the responses obtained when the animal placed on a turn-table was rotated sinusoidally. The effects of the drugs were examined on type I neurons which received impulses primarily from the labyrinth and sent them to the oculomotor nuclei. The microiontophoretic application of diphenhydramine, diphenidol and betahistine inhibited rotation-induced firing of type I MVN neurons. Diphenhydramine and diphenidol were more potent than betahistine. These results suggest that these drugs directly act on MVN neurons to reduce the responsiveness to rotatory stimulation.

Do H3-receptors participate in the effects of histamine on electrically-evoked contractions of rat vas deferens?

1. The specific effects of histamine were studied on rat vas deferens contractions induced by electrical field stimulation (0.1 Hz, 1 pulse, 1 msec duration, supramaximal voltage). 2. Histamine (5 x 10(-7)-10(-4) M) inhibited the electrically-evoked contractions (EEC). This effect was unchanged after the H1-receptor antagonist diphenhydramine (5 x 10(-6) M) and was decreased after the H2-receptor antagonist cimetidine (10(-5) M). 3. Betahistine, described as H1-agonist (in guinea pig ileum) and H3-autoreceptor antagonist (in rat cerebral cortex) slightly decreased the EEC, but competitively inhibited the histamine effect. 4. The results obtained suggest the existence of a specific third type presynaptic H-receptors in rat vas deferens, which are pharmacologically similar to the presynaptic H3-autoreceptors in rat cerebral cortex.

[The effects of ligustrazine, aspirin and beta-histine on platelet aggregation in patients with acute ischemic stroke]

With a auto-balanced terbidimeter, the effects of ligustrazine, aspirin and betahistine on platelet aggregation were studied in 45 patients with acute ischemic stroke. The adopted parameters were: 1) the maximal aggregation (Amax), 2) the maximal aggregation velocity (Vmax), 3) the effective disaggregation rate in 5 minutes (DA 5), 4) the inhibition rate of aggregation given by drugs (IR), and 5) the concentration causing 50% inhibition of aggregation (IC 50). The results indicated that these three drugs could inhibit platelet aggregation both in vivo and in vitro. Aspirin could promote the aggregated platelets disaggregation in vivo and ligustrazine, in vitro. Regarding the effects on inhibiting platelet aggregation in vitro, ligustrazine was the most noticeable among the 3 drugs and aspirin was more effective than betahistine. The IC50 of ligustrazine, aspirin and betahistine were 0.568 mg/ml, 1,286 mg/ml and 1.722 mg/ml respectively. The authors considered that all three drugs possessed anti-platelet effects but they showed some differences among them.