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Narcolepsy is a chronic sleep disorder characterized by pervasive, uncontrolled sleepiness and other sleep disturbances. One of its hallmark symptoms is an abrupt transition to REM sleep upon falling asleep, which causes symptoms typically associated with this phase to occur unexpectedly during wakefulness. These include the following symptoms, which typically last from a minute or two to half an hour.
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Narcolepsy Associated with Pandemrix Vaccine.

Tomi Sarkanen1,2, Anniina Alakuijala2,3, Ilkka Julkunen4

  • 1Department of Neurology, Tampere University Hospital, Tampere, Finland.

Current Neurology and Neuroscience Reports
|June 2, 2018
PubMed
Summary

The Pandemrix vaccine significantly increased narcolepsy risk, particularly in young people. Research indicates narcolepsy is an autoimmune disease, though specific triggers remain unclear.

Keywords:
H1N1 vaccinationHypocretinNarcolepsyOrexinPandemrixVaccines

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Area of Science:

  • Neurology
  • Immunology
  • Vaccinology

Background:

  • The AS03-adjuvanted pandemic H1N1 vaccine, Pandemrix, was linked to narcolepsy in 2010.
  • Narcolepsy research intensified following the recognition of this association.

Purpose of the Study:

  • To review current concepts and recent findings on Pandemrix-associated narcolepsy.
  • To provide an overview of the epidemiological and etiological aspects of vaccine-induced narcolepsy.

Main Methods:

  • Review of observational studies and genetic research.
  • Analysis of epidemiological data on narcolepsy incidence post-vaccination.
  • Investigation of genetic predispositions and autoantibody findings.

Main Results:

  • Pandemrix vaccination increased narcolepsy risk 5-14 fold in children/adolescents and 2-7 fold in adults.
  • Increased risk persisted for up to two years post-vaccination.
  • All vaccine-associated cases were narcolepsy type 1, characterized by hypocretin deficiency and HLA-DQB1*06:02 positivity.

Conclusions:

  • Narcolepsy is likely an autoimmune disease, with Pandemrix acting as a potential trigger in genetically susceptible individuals.
  • While genetic factors and autoantibodies are implicated, specific autoantigens remain unidentified.
  • The disease phenotype in vaccine-associated narcolepsy is indistinguishable from idiopathic narcolepsy type 1.