title: Relationship between CSF hypocretin levels and hypocretin neuronal loss.
abstract: The sleep disorder narcolepsy may now be considered a neurodegenerative disease, as there is a massive reduction in the number of neurons containing the neuropeptide, hypocretin (HCRT). Most narcoleptic patients have low to negligible levels of HCRT in the cerebrospinal fluid (CSF), and such measurements serve as an important diagnostic tool. However, the relationship between HCRT neurons and HCRT levels in CSF in human narcoleptics is not known and cannot be directly assessed. To identify this relationship in the present study, the neurotoxin, hypocretin-2-saporin (HCRT2-SAP), was administered to the lateral hypothalamus (LH) to lesion HCRT neurons. CSF was extracted at circadian times (ZT) 0 (time of lights-on) or ZT8 at various intervals (2, 4, 6, 12, 21, 36, 60 days) after neurotoxin administration. Compared to animals given saline in the LH, rats with an average loss of 73% of HCRT neurons had a 50% decline in CSF HCRT levels on day 60. The decline in HCRT levels was evident by day 6 and there was no recovery or further decrease. The decline in HCRT was correlated with increased REM sleep. Lesioned rats that were kept awake for 6 h were not able to release HCRT to match the output of saline rats. As most human narcoleptics have more than 80% reduction of CSF HCRT, the results from this study lead us to conclude that in these patients, virtually all of the HCRT neurons might be lost. In those narcoleptics where CSF levels are within the normal range, it is possible that not all of the HCRT neurons are lost and that the surviving HCRT neurons might be increasing output of CSF HCRT.
authors.affiliation: West Roxbury VA Medical Center and Harvard Medical School, West Roxbury, MA 02132, USA. dmitri_gerachtchenko@hms.harvard.edu
authors.forename: Dmitry
authors.initials: D
authors.lastname: Gerashchenko
authors.forename: Eric
authors.initials: E
authors.lastname: Murillo-Rodriguez
authors.forename: Ling
authors.initials: L
authors.lastname: Lin
authors.forename: Man
authors.initials: M
authors.lastname: Xu
authors.forename: Laura
authors.initials: L
authors.lastname: Hallett
authors.forename: Seiji
authors.initials: S
authors.lastname: Nishino
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mignot
authors.forename: Priyattam J
authors.initials: PJ
authors.lastname: Shiromani
mesh_terms: D000818:Animals; D002940:Circadian Rhythm / Q000502:physiology; D007031:Hypothalamus / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology*; D000922:Immunotoxins; D007276:Injections, Intraventricular; D047908:Intracellular Signaling Peptides and Proteins; D008297:Male; D009290:Narcolepsy / Q000139:chemically induced / Q000503:physiopathology*; D009410:Nerve Degeneration / Q000139:chemically induced / Q000503:physiopathology; D009419:Nerve Tissue Proteins; D009474:Neurons / Q000187:drug effects / Q000473:pathology / Q000502:physiology*; D009479:Neuropeptides / Q000008:administration & dosage / Q000134:cerebrospinal fluid* / Q000378:metabolism; D064446:Orexin Receptors; D000068797:Orexins; D010940:Plant Proteins; D011500:Protein Synthesis Inhibitors / Q000008:administration & dosage / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D043562:Receptors, G-Protein-Coupled; D018013:Receptors, Neuropeptide / Q000378:metabolism; D054789:Ribosome Inactivating Proteins, Type 1; D000076985:Saporins; D012892:Sleep Deprivation / Q000503:physiopathology; D012895:Sleep, REM / Q000187:drug effects / Q000502:physiology; D014118:Toxins, Biological
chemical_list: C000596229:HCRT protein, human; D000922:Immunotoxins; D047908:Intracellular Signaling Peptides and Proteins; D009419:Nerve Tissue Proteins; D009479:Neuropeptides; D064446:Orexin Receptors; D000068797:Orexins; D010940:Plant Proteins; D011500:Protein Synthesis Inhibitors; D043562:Receptors, G-Protein-Coupled; D018013:Receptors, Neuropeptide; D054789:Ribosome Inactivating Proteins, Type 1; D014118:Toxins, Biological; C435665:hypocretin-2-saporin conjugate; D000076985:Saporins