Re: 히스타민과 어지러움증, 멀미의 치료법에 대해서

[문형철]

beyond reason

히스타민 문제를 해결하면 어지러움증, 멀미를 해결할 수 있구나!!

히스타민과 어지러움증, 멀미

- 뇌에 있는 히스타민성 핵(tuberomammilay nucleus)은 인체의 균형을 유지하는 전정기관(vestibular neuclei), 소뇌와 연결되어 있음. 그래서 히스타민 자극으로 이런 핵들에 염증이 생기면 어지러움증과 멀미가 심해짐. 

참고) 근육검사 - yes

- 젊어서 이런 문제가 반복되는 사람들이 뇌간의 흑질에 루이소체가 침착되면서 파킨슨병으로 진행

- 만약 대뇌에 염증연쇄반응이 나타나면서 베타 아밀로이드가 축적되면 알츠하이머 치매로 진행

- 히스타민 증후군에서의 어지러움증은 메니에르병, 이석증과는 다름. 메니에르병은 전정기관의 림프순환이 안돼 부종에 의한 자극으로 발생함. 이석증은 전정기관 벽에 붙어 평형감각을 유지해주는 칼슘가루(이석)이 외부충격으로 떨어져 나오는 질병. 

- 히스타민은 위 모든 문제를 악화시킴. 

Vestibular Functions and Parkinson's Disease

Paul F. Smith^1,2*

• ¹Department of Pharmacology and Toxicology, School of Biomedical Sciences and The Brain Health Research Centre, University of Otago, Dunedin, New Zealand
• ²Brain Research New Zealand Centre of Research Excellence, Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, Auckland, New Zealand

For decades it has been speculated that Parkinson's Disease (PD) is associated with dysfunction of the vestibular system, especially given that postural instability is one of the major symptoms of the disorder. Nonetheless, clear evidence of such a connection has been slow to emerge. There are still relatively few studies of the vestibulo-ocular reflexes (VORs) in PD. However, substantial evidence of vestibulo-spinal reflex deficits, in the form of abnormal vestibular-evoked myogenic potentials (VEMPs), now exists. The evidence for abnormalities in the subjective visual vertical is less consistent. However, some studies suggest that the integration of visual and vestibular information may be abnormal in PD. In the last few years, a number of studies have been published which demonstrate that the neuropathology associated with PD, such as Lewy bodies, is present in the central vestibular system. Increasingly, stochastic or noisy galvanic vestibular stimulation (nGVS) is being investigated as a potential treatment for PD, and a number of studies have presented evidence in support of this idea. The aim of this review is to summarize and critically eval‎uate the human and animal evidence relating to the connection between the vestibular system and PD.

REVIEW

Management of peripheral vertigo with antihistamines: New options on the horizon

Jonas Dyhrfjeld‐Johnsen 

 

Pierre Attali

First published: 03 July 2019

 

https://doi.org/10.1111/bcp.14046

Abstract

Vertigo is associated with a wide range of vestibular pathologies. It increasingly affects the elderly, with a high cost to society. Solutions include vestibular suppressants and vestibular rehabilitation, which form the mainstay of therapy. Antihistamines represent the largest class of agents used to combat vestibular vertigo symptoms. Agents targeting the H1 and H3 receptors have been in clinical use for several decades as single agents. Nonetheless, effective management of vertigo proves elusive as many treatments largely address only associated symptoms, and with questionable efficacy. Additionally, the primary and limiting side effect of sedation is counterproductive to normal functioning and the natural recovery process occurring via central compensation. To address these issues, the timing of administration of betahistine, the mainstay H3 antihistamine, can be fine‐tuned, while bioavailability is also being improved. Other approaches include antihistamine combination studies, devices, physical therapy and behavioural interventions. Recently demonstrated expression‎ of H4 receptors in the peripheral vestibular system represents a new potential drug target for treating vestibular disorders. A number of novel selective H4 antagonists are active in vestibular models in vivo. The preclinical potential of SENS‐111 (Seliforant), an oral first‐in‐class selective H4antagonist is the only such molecule to date to be translated into the clinical setting. With an excellent safety profile and notable absence of sedation, encouraging outcomes in an induced vertigo model in healthy volunteers have led to ongoing clinical studies in acute unilateral vestibulopathy, with the hope that H4 antagonists will offer new effective therapeutic options to patients suffering from vertigo.