A study of T CD4, CD8 and B lymphocytes in narcoleptic patients.
Narcolepsy is characterized by excessive daytime sleep and cataplexy. Little is known about the possible difference in pathophysiology between patients with or without cataplexy.


OBJECTIVE
To quantify T CD4, T CD8 and B lymphocytes in subgroups of patients with narcolepsy and the presence or absence of the HLA-DQB1*0602 allele between groups.


METHODS
Our study was prospective and controlled (transversal) with 22 narcoleptic patients and 23 health control subjects. Patients underwent an all-night polysomnographic recording (PSG) and a multiple sleep latency Test (MSLT). The histocompatibility antigen allele (HLA-DQB1*0602), T CD4, CD8 and B lymphocytes were quantified in control subjects and in narcoleptics.


RESULTS
The HLA-DQB1*0602 allele was identified in 10 (62.5%) of our 16 cataplexic subjects and in 2 (33.3%) of the 6 patients without cataplexy (p=0.24). In control subjects, HLA-DQB1*0602 allele was identified in 5 (20%). A significant decrease in T CD4 and B lymphocytes was found in narcoleptic patients with recurrent cataplexy when compared with our patients without cataplexy.


CONCLUSIONS
Autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis were associated with a decrease in sub-group of T CD4 and B lymphocytes. A drop in B lymphocytes count in reumathoid arthritis might, it is posited, be correlated to the presence of HLA-DRB1 allele along with an overall worsened outcome of the affliction. The theory of an increase in consumption of B lymphocytes over the maturation phase has likewise been put forward. Our study reinforces the view that narcolepsy should be considered from an immunological perspective.
Coelho
Fernando Morgadinho Santos
FM
Sleep Disorders Institute, EPM, UNIFESP, São Paulo, SP, Brazil. fernandomorgadinho@hotmail.com
Pradella-Hallinan
Márcia
M
Alves
Gabriela Rodrigues
GR
Bittencourt
Lia Rita Azeredo
LR
Pedrazzoli Neto
Mário
M
Moreira
Fábio
F
Tufik
Sérgio
S
D000328:Adult; D000483:Alleles; D001402:B-Lymphocytes / Q000276:immunology*; D016516:CD4-CD8 Ratio; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005819:Genetic Markers; D006683:HLA-DQ Antigens / Q000235:genetics* / Q000276:immunology; D059866:HLA-DQ beta-Chains; D006801:Humans; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000235:genetics / Q000276:immunology*; D011446:Prospective Studies; D012894:Sleep Stages / Q000502:physiology; D013997:Time Factors; D014851:Wakefulness / Q000502:physiology
D005819:Genetic Markers; D006683:HLA-DQ Antigens; D059866:HLA-DQ beta-Chains; C069051:HLA-DQB1 antigen