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Narcolepsy confirmed as autoimmune disease

Bob

Senior Member
Messages
16,455
Location
England (south coast)
Narcolepsy confirmed as autoimmune disease
Results also partly explain why the 2009 swine flu virus, and a vaccine against it, led to spikes in the sleep disorder.

Ed Yong
Nature
18 December 2013
http://www.nature.com/news/narcolepsy-confirmed-as-autoimmune-disease-1.14413?WT.ec_id=NEWS-20131224

As the H1N1 swine flu pandemic swept the world in 2009, China saw a spike in cases of narcolepsy — a mysterious disorder that involves sudden, uncontrollable sleepiness. Meanwhile, in Europe, around 1 in 15,000 children who were given Pandemrix — a now-defunct flu vaccine that contained fragments of the pandemic virus — also developed narcolepsy, a chronic disease.


The Study:
CD4+ T Cell Autoimmunity to Hypocretin/Orexin and Cross-Reactivity to a 2009 H1N1 Influenza A Epitope in Narcolepsy.
De la Herrán-Arita AK, Kornum BR, Mahlios J, Jiang W, Lin L, Hou T, Macaubas C, Einen M, Plazzi G, Crowe C, Newell EW, Davis MM, Mellins ED, Mignot E.
Sci Transl Med. 2013 Dec 18;5(216):216ra176.
doi: 10.1126/scitranslmed.3007762
http://stm.sciencemag.org/content/5/216/216ra176

Abstract
Narcolepsy, a disorder strongly associated with human leukocyte antigen (HLA)-DQA1*01:02/DQB1*06:02 (DQ0602), is characterized by excessive daytime sleepiness, cataplexy, and rapid eye movement sleep abnormalities. It is caused by the loss of ~70,000 posterior hypothalamic neurons that produce the wake-promoting neuropeptide hypocretin (HCRT) (orexin). We identified two DQ0602-binding HCRT epitopes, HCRT56-68 and HCRT87-99, that activated a subpopulation of CD4(+) T cells in narcolepsy patients but not in DQ0602-positive healthy control subjects. Because of the established association of narcolepsy with the 2009 H1N1 influenza A strain (pH1N1), we administered a seasonal influenza vaccine (containing pH1N1) to patients with narcolepsy and found an increased frequency of circulating HCRT56-68- and HCRT87-99-reactive T cells. We also identified a hemagglutinin (HA) pHA1 epitope specific to the 2009 H1N1 strain, pHA1275-287, with homology to HCRT56-68 and HCRT87-99. In vitro stimulation of narcolepsy CD4(+) T cells with pH1N1 proteins or pHA1275-287 increased the frequency of HCRT56-68- and HCRT87-99-reactive T cells. Our data indicate the presence of CD4(+) T cells that are reactive to HCRT in narcolepsy patients and possible molecular mimicry between HCRT and a similar epitope in influenza pH1N1, pHA1275-287.
 

xchocoholic

Senior Member
Messages
2,947
Location
Florida
I'm pretty sure that I had narcolepsy but it went away 7-10 days post gf diet. I'm not sure if this is common or not.

My sleep disorder test was negative BUT I have myoclonic jerks that stop me from entering REM. If I'd entered REM, I was told I would've been positive. There was
no chance of me entering REM back then.

I take Klonopin for myoclonus so I can sleep.

Tc ... x
 

out2lunch

Senior Member
Messages
204
I'm pretty sure that I had narcolepsy but it went away 7-10 days post gf diet. I'm not sure if this is common or not.

My sleep disorder test was negative BUT I have myoclonic jerks that stop me from entering REM. If I'd entered REM, I was told I would've been positive. There was
no chance of me entering REM back then.

I take Klonopin for myoclonus so I can sleep.

Tc ... x
I realize this post has aged a bit, but this addresses my issue with narcolepsy/cataplexy symptoms I've had for decades. (BTW… my symptoms did not go away with GF diet.)

My MLST was also negative; quick sleep onset but no REM. And I've been told lack of REM means I don't have narcolepsy/cataplexy. (Even though I have the gene, narcolepsy runs in my mom's family, and my symptoms are classic.)

What bothers me about the diagnosis is that it's based on lack of REM during the daytime naps. What if you don't produce REM at anytime? Does that mean you absolutely can't have narcolepsy or cataplexy?

My PSG done the night before the MSLT showed hardly any REM the entire night. Less than 3 minutes of REM during 4.5 hours of sleep. So how would I have had REM intrusion during the daytime naps if I didn't have REM at night?

I don't experience myoclonic jerks or restless legs, etc, so who knows why REM is absent in me. Other than mild to moderate apnea that is very well treated with Auto PAP, I don't have other sleep issues like insomnia, waking hallucinations, et. al. Just the FMS typical lack of deep sleep and REM.

There is no explanation for the lack of REM other than ME/CFS/FMS. And my cataplexy symptoms have always been more pronounced than the narcolepsy symptoms; I often don't get any sleepiness when my body turns to a rag doll. Which baffles my Stanford sleep neurologist, who said cataplexy and narcolepsy go hand-in-hand 99% of the time.

I've had other autoimmune diseases in my life, so having narcolepsy would make sense. I just don't understand why narcolepsy must be tied to REM. Why aren't variants a possibility in people without REM, like me? I don't get this.