TY - JOUR
T1 - Narcolepsy as an autoimmune disease
T2 - the role of H1N1 infection and vaccination
AU - Partinen, Markku
AU - Kornum, Birgitte Rahbek
AU - Plazzi, Giuseppe
AU - Jennum, Poul
AU - Julkunen, Ilkka
AU - Vaarala, Outi
N1 - Copyright © 2014 Elsevier Ltd. All rights reserved.
PY - 2014/6
Y1 - 2014/6
N2 - Narcolepsy is a sleep disorder characterised by loss of hypothalamic hypocretin (orexin) neurons. The prevalence of narcolepsy is about 30 per 100 000 people, and typical age at onset is 12-16 years. Narcolepsy is strongly associated with the HLA-DQB1*06:02 genotype, and has been thought of as an immune-mediated disease. Other risk genes, such as T-cell-receptor α chain and purinergic receptor subtype 2Y11, are also implicated. Interest in narcolepsy has increased since the epidemiological observations that H1N1 infection and vaccination are potential triggering factors, and an increase in the incidence of narcolepsy after the pandemic AS03 adjuvanted H1N1 vaccination in 2010 from Sweden and Finland supports the immune-mediated pathogenesis. Epidemiological observations from studies in China also suggest a role for H1N1 virus infections as a trigger for narcolepsy. Although the pathological mechanisms are unknown, an H1N1 virus-derived antigen might be the trigger.
AB - Narcolepsy is a sleep disorder characterised by loss of hypothalamic hypocretin (orexin) neurons. The prevalence of narcolepsy is about 30 per 100 000 people, and typical age at onset is 12-16 years. Narcolepsy is strongly associated with the HLA-DQB1*06:02 genotype, and has been thought of as an immune-mediated disease. Other risk genes, such as T-cell-receptor α chain and purinergic receptor subtype 2Y11, are also implicated. Interest in narcolepsy has increased since the epidemiological observations that H1N1 infection and vaccination are potential triggering factors, and an increase in the incidence of narcolepsy after the pandemic AS03 adjuvanted H1N1 vaccination in 2010 from Sweden and Finland supports the immune-mediated pathogenesis. Epidemiological observations from studies in China also suggest a role for H1N1 virus infections as a trigger for narcolepsy. Although the pathological mechanisms are unknown, an H1N1 virus-derived antigen might be the trigger.
KW - Autoimmune Diseases of the Nervous System/epidemiology
KW - Humans
KW - Influenza A Virus, H1N1 Subtype/immunology
KW - Influenza, Human/complications
KW - Narcolepsy/epidemiology
KW - Vaccination/adverse effects
U2 - 10.1016/s1474-4422(14)70075-4
DO - 10.1016/s1474-4422(14)70075-4
M3 - Review
C2 - 24849861
SN - 1474-4422
VL - 13
SP - 600
EP - 613
JO - Lancet Neurology
JF - Lancet Neurology
IS - 6
ER -
