Research Progress in the Roles of Influenza A H1N1 Virus and Its Vaccine in the Pathogenesis of Narcolepsy Type 1

Narcolepsy type 1(NT1) is a chronic sleep disorder caused by the specific depletion of hypocretin(HCRT) neurons.The pathogenesis of NT1 involves human leukocyte antigen(HLA)-related genes(most NT1 patients carry the HLA-DQB1*06∶02 allele) and environmental factors.In Europe,there was a notable increase in NT1 cases among children and adolescents following the H1N1 pandemic in 2009 and 2010,particularly associated with the Pandemrix vaccination.Similarly,in China,the surge in NT1 incidence has been linked to H1N1 virus infections.It has been postulated that H1N1 virus infection may be a predisposing factor for NT1 development.In susceptible individuals,the confluence of the immune response triggered by the Pandemrix vaccine and the H1N1 virus infection could instigate autoimmunity against HCRT,leading to the loss of HCRT neurons mediated by T cells.This paper examines the involvement of influenza A H1N1 virus and its vaccines in the pathogenesis of NT1.