CSF Histamine Contents in Narcolepsy, Idiopathic Hypersomnia and Obstructive Sleep Apnea Syndrome
CSF Histamine Contents in Narcolepsy, Idiopathic Hypersomnia and Obstructive Sleep Apnea Syndrome
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DOI：
10.1093/sleep/32.2.181
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发表时间：
2009-02-01
期刊：
影响因子：
5.6
通讯作者：
Nishino, Seiji
中科院分区：
文献类型：
--
作者：
Kanbayashi, Takashi;Kodama, Tohru;Nishino, Seiji
研究目的：为了（1）在不同的样本人群中复制我们先前关于发作性睡病患者脑脊液（CSF）组胺水平低的结果，并（2）评估组胺含量是否在伴有和不伴有下丘脑泌素缺乏的其他类型的嗜睡症中改变。设计：横断面研究。纳入67例发作性睡病受试者、26例特发性睡眠过度（IHS）受试者、16例阻塞性睡眠呼吸暂停综合征（OSAS）受试者和73例神经系统对照者。所有患者均为日本人。结果：下丘脑泌素缺乏型发作性睡病伴猝倒症患者脑脊液组胺水平明显降低（平均值+/- SEM; 176.0 +/- 25.8 pg/mL），下丘脑泌素非缺乏型发作性睡病伴紧张症（97.8 +/- 38.4 pg/mL），下丘脑泌素非缺乏型发作性睡病，不伴癫痫发作（113.6 +/- 16.4 pg/mL）和特发性嗜睡（161.0 +/- 29.3 pg/mL）; OSAS患者的水平（259.3 +/- 46.6 pg/mL）与对照组（333.8 +/- 22.0 pg/mL）无统计学差异。CSF组胺水平低主要见于未用药患者;组胺水平显著降低见于未用药的下丘脑泌素缺乏性发作性睡病伴cataeprazole患者（112.1 ± 16.3 pg/mL）和特发性嗜睡（143.3 +/- 28.8 pg/mL），而服药患者的水平在正常范围内。该研究证实了下丘脑泌素缺乏性发作性睡病伴卡他汀的CSF组胺水平降低。在下丘脑泌素非缺陷型发作性睡病和特发性嗜睡中也观察到类似程度的减少，而在OSAS（非中枢神经系统嗜睡）中没有改变。这些受试者中组胺的降低在未用药受试者中更特异性地观察到，表明CSF组胺是反映中枢性睡眠过度程度的生物标志物。
Study Objective: To (1) replicate our prior result of low cerebrospinal fluid (CSF) histamine levels in human narcolepsy in a different sample population and to (2) evaluate if histamine contents are altered in other types of hypersomnia with and without hypocretin deficiency.Design: Cross sectional studies.Setting and Patients: Sixty-seven narcolepsy subjects, 26 idiopathic hypersomnia (IHS) subjects, 16 obstructive sleep apnea syndrome (OSAS) subjects, and 73 neurological controls were included. All patients were Japanese. Diagnoses were made according to ICSD-2.Results: We found significant reductions in CSF histamine levels in hypocretin deficient narcolepsy with cataplexy (mean +/- SEM; 176.0 +/- 25.8 pg/mL), hypocretin non-deficient narcolepsy with cataplexy (97.8 +/- 38.4 pg/mL), hypocretin non-deficient narcolepsy without cataplexy (113.6 +/- 16.4 pg/mL), and idiopathic hypersomnia (161.0 +/- 29.3 pg/mL); the levels in OSAS (259.3 +/- 46.6 pg/mL) did not statistically differ from those in the controls (333.8 +/- 22.0 pg/mL). Low CSF histamine levels were mostly observed in non-medicated patients; significant reductions in histamine levels were evident in non-medicated patients with hypocretin deficient narcolepsy with cataplexy (112.1 +/- 16.3 pg/mL) and idiopathic hypersomnia (143.3 +/- 28.8 pg/mL), while the levels in the medicated patients were in the normal range.Conclusion: The study confirmed reduced CSF histamine levels in hypocretin-deficient narcolepsy with cataplexy. Similar degrees of reduction were also observed in hypocretin non-deficient narcolepsy and in idiopathic hypersomnia, while those in OSAS (non central nervous system hypersomnia) were not altered. The decrease in histamine in these subjects were more specifically observed in non-medicated subjects, suggesting CSF histamine is a biomarker reflecting the degree of hypersomnia of central origin.