Anti-Tribbles homolog 2 (TRIB2) autoantibodies in narcolepsy are associated with recent onset of cataplexy

Minae Kawashima, Ling Lin, Susumu Tanaka, Poul Jennum, Stine Knudsen, Sona Nevsimalova, Giuseppe Plazzi, Emmanuel Mignot

101 Citations (Scopus)

Abstract

Study Objective: Recent studies have found increased autoantibodies against Tribbles homolog 2 (anti-TRIB2) and anti-streptolysin O (ASO) in narcolepsy. In this study, we replicated this finding with a primary focus on recent onset cases. Participants and Methods: Participants included (1) 90 cases with cataplexy, (2) 57 cases without cataplexy, and (3) 156 age-sex matched controls, including 73 human leukocyte antigen (HLA)-DQB1*0602 allele carriers. A radioligand binding assay was used to detect anti-TRIB2 antibodies. Results: Anti-TRIB2 antibodies were prevalent in HLA-DQB1*0602 positive cases with cataplexy (25.0% of 76) and rare in cases without cataplexy (3.5% of 57, OR = 9.2, 95% CI = 2.5 - 33.5, P = 6.0 × 10-4) or controls (4.5% of 156, OR = 7.1, 95% CI = 3.1 - 16.2, P = 9.3 × 10-6). Anti-TRIB2 positivity in controls was not associated with DQB1*0602. In DQB1*0602 narcolepsy-cataplexy cases, the presence of anti-TRIB2 was associated with short disease duration (2.3 years from cataplexy onset), with 41.0% positive in this group (OR = 7.4 versus cases with onset > 2.3 years, 95% CI = 1.9 - 28.5, P = 9.0 × 10-4). Anti-TRIB2 positivity in 39 DQB1*0602 positive recent onset cases was associated with increased ASO antibody (> 200 IU) (OR = 6.2, 95% CI = 1.6 - 24.6, P = 0.01), but did not correlate with age, gender, or body mass index. Conclusion: Anti-TRIB2 autoantibodies are strongly associated with narcolepsy close to cataplexy onset (≤ 2.3 years). Anti-TRIB2 was rarely found in cases without cataplexy or with distant onset.

Original languageEnglish
JournalSleep
Volume33
Issue number7
Pages (from-to)869-74
Number of pages6
ISSN0161-8105
Publication statusPublished - 1 Jul 2010

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