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Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
Published on: September 12, 2016
Narcolepsy as an immune-mediated disease.
Alberto K De la Herrán-Arita1, Fabio García-García2
1Stanford Center for Sleep Sciences and Medicine, Stanford University School of Medicine, 3165 Porter Drive, Palo Alto, CA 94304, USA.
Narcolepsy is a neurological disorder caused by the loss of hypocretin-producing neurons. An autoimmune process, potentially triggered by H1N1 influenza or vaccination, is strongly suspected.
Area of Science:
- Neurology
- Immunology
Background:
- Narcolepsy is a neurological disorder characterized by excessive daytime sleepiness and other symptoms.
- It results from the loss of hypothalamic hypocretin (orexin)-producing neurons.
Purpose of the Study:
- To explore the autoimmune basis of narcolepsy.
- Investigate the role of human leukocyte antigen (HLA) and T cell receptor (TCR) polymorphisms.
- Examine the potential link between H1N1 influenza, vaccination, and narcolepsy.
Main Methods:
- Review of genetic associations (DQB1∗06:02, HLA, TCR).
- Analysis of narcolepsy surge following H1N1 pandemic and vaccination.
- Consideration of autoimmune mechanisms like molecular mimicry and bystander activation.
Main Results:
- Strong association between narcolepsy and DQB1∗06:02 marker supports autoimmune hypothesis.
- Narcolepsy cases linked to HLA and TCR polymorphisms suggest specific autoimmune targets.
- Increased childhood narcolepsy post-2009 H1N1 pandemic and Pandemrix vaccination observed.
Conclusions:
- Autoimmune processes targeting hypocretin neurons are implicated in narcolepsy.
- Molecular mimicry or bystander activation may trigger narcolepsy following H1N1 infection or vaccination.
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