# Project 5

> **NIH NIH P01** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2020 · $446,672

## Abstract

Abstract/ Summary: Project 5
OSA is a common and debilitating condition that currently has no effective pharmacotherapy. In the previous
PPG, we identified a drug combination (atomoxetine + oxybutynin) that lowered the apnea-hypopnea index by
74% and raised the nadir oxygen saturation from 84% to 94%. Despite these encouraging results, some
patients experienced antimuscarinic side effects from oxybutynin. Furthermore, subsequent mechanistic
studies revealed that oxybutynin was acting primarily as a sedative (counteracting atomoxetine), rather than a
pharyngeal muscle stimulant. Therefore, the goal of the current grant is to find a better sedative than
oxybutynin to add to atomoxetine. This will be accomplished by first testing common, non-myorelaxing
sedatives (Aim 1). Then, in Aim 2 we will test sedatives identified from Projects 1-4 that specifically block CO2-
mediated arousals (but not CO2-mediated respiratory/pharyngeal muscle responses). As described in the
other grants accompanying this PPG, Projects 2 and 4 are expected to identify serotonin subreceptors on
parabrachial CGRP neurons (PBCGRP) that can be antagonized to prevent EEG arousal in response to elevated
CO2. Additionally, Projects 3 and 4 will focus on identifying serotonin subreceptors on a separate group of
parabrachial neurons (PBFoxP2) that could be manipulated pharmacologically to augment upper airway dilator
tone. Of note, preliminary studies suggest that PBCGRP neurons are activated by a different subset of serotonin
receptors than the PBFoxP2 neurons, thus allowing us to potentially target these two parabrachial regions
independently. Therefore, Aim 2 will test specific serotonin agonists/antagonists, with or without atomoxetine
(as necessary), to activate airway muscles without inducing arousals. Finally, in Aim 3 a one-month clinical trial
will be performed on the most effective drugs emerging from Aims 1 and 2 (if no such drugs are found, then the
original atomoxetine + oxybutynin combination will be studied). As the human component to this PPG, Project
5 will utilize the information gleaned from the animal experiments to build upon the exciting results of the
previous PPG and move the field closer towards a potential pharmacotherapy for OSA.

## Key facts

- **NIH application ID:** 9854436
- **Project number:** 1P01HL149630-01
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** DAVID ANDREW WELLMAN
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $446,672
- **Award type:** 1
- **Project period:** — → —

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9854436

## Citation

> US National Institutes of Health, RePORTER application 9854436, Project 5 (1P01HL149630-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9854436. Licensed CC0.

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