Astemizole, a Second-Generation Histamine H1-Receptor Antagonist, Did Not Attenuate the Aggregation Process of α-Synuclein In Vitro.

The antihistamine astemizole has shown disease-modifying effects in several preclinical disease models of Parkinson's disease (PD). Astemizole also interacts with an anomalous aggregation of Alzheimer's disease-related amyloid-ß (Aß) peptide and has inhibitory activity on the human prion protein PrPSc. We hypothesized that the proposed preclinical benefits of astemizole on PD can be associated with the attenuation of pathological α-synuclein (α-syn) aggregation. We tested the effects of astemizole on the fibrillation processes of amyloid peptides using thioflavin T aggregation monitoring, Congo red spectral analysis, cell viability study, and transmission electron microscopic imaging. We found that astemizole did not inhibit α-syn aggregation in vitro even at a high molar ratio but inhibited the assembly of Aß aggregates. Our results suggest that the inhibitory effect of astemizole on amyloid formation is target-protein selective, and the proposed beneficial effects of this compound observed in translational PD models might not be due to its ameliorating effects on α-syn aggregation.

Clinical and Polysomnographic Characteristics of Adult Patients with Suspected Obstructive Sleep Apnea from Different Sleep Clinics at a Single Tertiary Center.

INTRODUCTION: The characteristics of patients across different sleep clinics may vary because they selectively visit specific specialists on the basis of their primary symptoms. This study aimed to compare the clinical and polysomnography (PSG) features of patients with suspected obstructive sleep apnea (OSA) at three sleep specialty clinics (otolaryngology [ENT], neurology [NR], and psychiatry [PSY]). METHODS: We retrospectively analyzed the medical records and PSG reports of adult patients who underwent full-night PSG between January 2022 and June 2023 at a tertiary medical center. The demographic, questionnaire, and PSG variables were compared. RESULTS: Of the 407 patients, 83.0% exhibited sleep-disordered breathing (apnea-hypopnea index ≥ 5) with varying severity among the specialty pathways. Patients in the ENT group (n = 231) were the youngest and had the shortest sleep latency and most severe OSA markers with the highest positive airway pressure (PAP) acceptance, while those in the NR group (n = 79) had similar OSA-related PSG parameters to those in the ENT group but were older and had more OSA-related comorbidities, although their PAP acceptance was relatively low. The PSY group (n = 97) included a significant proportion of patients with normal or mild OSA, a female majority, high levels of depression, and subjective sleep distress. CONCLUSION: Our results highlight the multidisciplinary aspects of sleep medicine and diverse patients, and specialist needs for diagnosing sleep disorders and PAP acceptance. Exploring the potential differences in prognosis and treatment responses across various sleep specialty clinics would facilitate the development of personalized strategies.