Repurposing Histaminergic Drugs in Multiple Sclerosis

Int J Mol Sci. 2022 Jun 6;23(11):6347. doi: 10.3390/ijms23116347.

Abstract

Multiple sclerosis is an autoimmune disease with a strong neuroinflammatory component that contributes to severe demyelination, neurodegeneration and lesions formation in white and grey matter of the spinal cord and brain. Increasing attention is being paid to the signaling of the biogenic amine histamine in the context of several pathological conditions. In multiple sclerosis, histamine regulates the differentiation of oligodendrocyte precursors, reduces demyelination, and improves the remyelination process. However, the concomitant activation of histamine H1-H4 receptors can sustain either damaging or favorable effects, depending on the specifically activated receptor subtype/s, the timing of receptor engagement, and the central versus peripheral target district. Conventional drug development has failed so far to identify curative drugs for multiple sclerosis, thus causing a severe delay in therapeutic options available to patients. In this perspective, drug repurposing offers an exciting and complementary alternative for rapidly approving some medicines already approved for other indications. In the present work, we have adopted a new network-medicine-based algorithm for drug repurposing called SAveRUNNER, for quantifying the interplay between multiple sclerosis-associated genes and drug targets in the human interactome. We have identified new histamine drug-disease associations and predicted off-label novel use of the histaminergic drugs amodiaquine, rupatadine, and diphenhydramine among others, for multiple sclerosis. Our work suggests that selected histamine-related molecules might get to the root causes of multiple sclerosis and emerge as new potential therapeutic strategies for the disease.

Keywords: H1 receptor; amodiaquine; diphenhydramine; histamine N-methyltransferase; multiple sclerosis; network medicine; rupatadine.

MeSH terms

  • Drug Repositioning
  • Histamine
  • Histamine Agents* / therapeutic use
  • Humans
  • Multiple Sclerosis* / drug therapy
  • Multiple Sclerosis* / pathology
  • Receptors, Histamine H4
  • Remyelination*

Substances

  • Histamine Agents
  • Receptors, Histamine H4
  • Histamine

Grants and funding

This work was supported by Italian Ministry of Health Ricerca Corrente 2021- Fondazione Santa Lucia IRCCS, by PRIN 2017-Settore ERC LS2-Codice Progetto 20178L3P38, by the BiBiNet project (grant H35F21000430002) within the POR-Lazio FESR 2014–2020, and by Sapienza University of Rome grant entitled “Sviluppo di un algoritmo basato sulla teoria delle reti per il riposizionamento dei farmaci e la sua applicazione al COVID-19” (grant number: RM12117A34663A2C). The funding body played no role in the design of the study and collection, analysis, interpretation of data, and in writing the manuscript.