Elevated Anti-Streptococcal Antibodies in Patients with Recent Narcolepsy Onset

Aran, Adi; Lin, Ling; Nevšímalová, Soňa; Plazzi, Giuseppe; Hong, Seung Chul; Weiner, Karin; Zeitzer, Jamie M.; Mignot, Emmanuel

doi:10.1093/sleep/32.8.979

Cited by 328 publications

(220 citation statements)

References 25 publications

(26 reference statements)

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“…Narcolepsy occurs almost exclusively in patients whose HLA is DQA1*01:02 and DQB1*06:02 [81,82]. Strong correlations between the onset of narcolepsy with Streptococcus pyogenes [83] and influenza A virus infections have been reported, with epitope redundancy suspected to play a major role in triggering the autoimmune reaction. A 6-9 fold increase in the risk of developing narcolepsy was observed following 2009-2010 H1N1 influenza pandemics in Europe [84,85] and China [86].…”

Section:  Narcolepsymentioning

confidence: 99%

T cell epitope redundancy: cross-conservation of the TCR face between pathogens and self and its implications for vaccines and autoimmunity

Moise

Beseme

Tassone

et al. 2016

Expert Review of Vaccines

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SummaryT cells are extensively trained on 'self' in the thymus and then move to the periphery, where they seek out and destroy infections and regulate immune response to self-antigens. T cell receptors (TCR) on T cells' surface recognize T cell epitopes, short linear strings of amino acids presented by antigen-presenting cells. Some of these epitopes activate T effectors, while others activate regulatory T cells. It was recently discovered that T cell epitopes that are highly conserved on their TCR face with human genome sequences are often associated with T cells that regulate immune response. These TCR-cross-conserved or 'redundant epitopes' are more common in proteins found in pathogens that have co-evolved with humans than in other noncommensal pathogens. Epitope redundancy might be the link between pathogens and autoimmune disease. This article reviews recently published data and addresses epitope redundancy, the "elephant in the room" for vaccine developers and T cell immunologists.

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Section:  Narcolepsymentioning

confidence: 99%

T cell epitope redundancy: cross-conservation of the TCR face between pathogens and self and its implications for vaccines and autoimmunity

Moise

Beseme

Tassone

et al. 2016

Expert Review of Vaccines

View full text Add to dashboard Cite

show abstract

“…4 In recent onset NC, elevated ASO are found. 5 Beta-amyloid decrease in CSF could indicate its involvement in (post-infectious) immunological processes in narcolepsy.…”

Section: Post H1n1 Narcolepsymentioning

confidence: 99%

Post H1N1 vaccination narcolepsy–cataplexy with decreased CSF beta-amyloid

et al. 2012

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“…The recent classification of narcolepsy into type 1 and type 2 (based on the presence of cataplexy or the absence of HCRT1) may eventually be further expanded to reflect an etiology based on response to an infectious environmental challenge. Although streptococcal infection has been strongly linked to narcolepsy onset (19), the paucity of evidence for autoantibodies against HCRT-related targets after such infections (20) …”

Section: Etiological Implicationsmentioning

confidence: 99%