The Immune Basis of Narcolepsy: What Is the Evidence?

Narcolepsy is a chronic neurologic sleep disorder. Type 1 narcolepsy (narcolepsy-cataplexy) is associated with the destruction of lateral hypothalamic hypocretin neurons. It is thought that the loss of hypocretin neurons is autoimmune mediated. This is because of the close relationship between type 1 narcolepsy and HLA DQB1∗0602 and the onset of narcolepsy at a young age. Evidence suggests that streptococcal and H1N1 influenza infections (and H1N1 vaccination) may be involved in the pathogenesis of narcolepsy. There are suggestions from genetic and immune studies that the immune system plays a key role in narcolepsy.