A new Stanford study could pave the way for a diagnostic blood test for narcolepsy. As reported in several other media outlets, Alberto De la Herrán-Arita and colleagues have “closed the loop” on the autoimmune basis of narcolepsy, showing that “in patients with cataplexy reactive CD4+ T cells are present in most patients but not in controls.”
A recent article by Dr. Emmanuel Mignot in the Huffington Post declares that the discovery has two consequences. “First, narcolepsy joins the club of diseases with an undisputable autoimmune basis,” writes Mignot. “Because of the relative simplicity of the HLA association, the small number of epitopes presented, and the relationship with a specific triggering antigen in the 2009 H1N1 flu, it is likely to be a major model to understand autoimmunity in the future.”
The study titled “CD4+ T Cell Autoimmunity to Hypocretin/Orexin and Cross-Reactivity to a 2009 H1N1 Influenza A Epitope in Narcolepsy” from the Stanford Center for Sleep Sciences and Medicine has prompted researchers predict that narcolepsy will become the prototype of several other diseases that affect neurons. “We believe these have been difficult to detect, as they likely primarily involve T cell rather than B cell immunity, a speculation we hope to discuss further in a future blog,” writes Mignot. “Second is the possibility of diagnosing narcolepsy with a blood test, a development that is rapidly implementable, and the object of this discussion.”
Researchers say the next step is to test patients and a population sample with unexplained sleepiness: narcolepsy without cataplexy, idiopathic hypersomnia, or sleep apnea patients who remain sleepy. It is suspected that some cases without cataplexy will have reactivity, the question is, how many?