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CD4+ T cell autoimmunity to hypocretin/orexin and cross-reactivity to a 2009 H1N1 influenza A epitope in narcolepsy

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Alberto K De la Herrán-Arita
  • Kornum, Birgitte Rahbek
  • Josh Mahlios
  • Wei Jiang
  • Ling Lin
  • Tieying Hou
  • Claudia Macaubas
  • Mali Einen
  • Giuseppe Plazzi
  • Catherine Crowe
  • Evan W Newell
  • Mark M Davis
  • Elizabeth D Mellins
  • Emmanuel Mignot

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.

OriginalsprogEngelsk
TidsskriftScience Translational Medicine
Vol/bind5
Udgave nummer216
Sider (fra-til)216ra176
ISSN1946-6234
DOI
StatusUdgivet - 18 dec. 2013

ID: 196168680