title: Cerebrospinal fluid cytokine levels in type 1 narcolepsy patients very close to onset.
abstract: Type 1 narcolepsy is caused by a loss of hypocretin (orexin) signaling in the brain. Genetic data suggests the disorder is caused by an autoimmune attack on hypocretin producing neurons in hypothalamus. This hypothesis has however not yet been confirmed by consistent findings of autoreactive antibodies or T-cells in patient samples. One explanation for these negative results may be that the autoimmune process is no longer active when patients present to the clinic. With increasing awareness in recent years, more and more patients have been diagnosed closer and closer to disease onset. In this study, we tested whether an active immune process in the brain could be detected in these patients, as reflected by increased cytokine levels in the cerebrospinal fluid (CSF). Using multiplex analysis, we measured the levels of 51 cytokines and chemokines in the CSF of 40 type 1 narcolepsy patients having varying disease duration. For comparison, we used samples from 9 healthy controls and 9 patients with other central hypersomnia. Cytokine levels did not differ significantly between controls and patients, even in 5 patients with disease onset less than a month prior to CSF sampling.
authors.affiliation: Center for Sleep Sciences and Medicine, Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA, USA; Molecular Sleep Laboratory, Department of Diagnostics, Rigshospitalet, Glostrup, Denmark; Danish Center for Sleep Medicine, Department of Neurophysiology, University of Copenhagen, Rigshospitalet, Glostrup, Denmark. Electronic address: Birgitte.kornum@regionh.dk.
authors.forename: Birgitte Rahbek
authors.initials: BR
authors.lastname: Kornum
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, AUSL di Bologna, Bologna, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Pizza
authors.affiliation: Danish Center for Sleep Medicine, Department of Neurophysiology, University of Copenhagen, Rigshospitalet, Glostrup, Denmark; Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias, Oslo University Hospital, Ullevål, Norway.
authors.forename: Stine
authors.initials: S
authors.lastname: Knudsen
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, AUSL di Bologna, Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Plazzi
authors.affiliation: Danish Center for Sleep Medicine, Department of Neurophysiology, University of Copenhagen, Rigshospitalet, Glostrup, Denmark.
authors.forename: Poul
authors.initials: P
authors.lastname: Jennum
authors.affiliation: Center for Sleep Sciences and Medicine, Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mignot
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001921:Brain / Q000276:immunology*; D002648:Child; D016207:Cytokines / Q000134:cerebrospinal fluid* / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000134:cerebrospinal fluid* / Q000276:immunology*; D006377:T-Lymphocytes, Helper-Inducer / Q000378:metabolism; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016207:Cytokines
keywords: Autoimmunity; Cataplexy; Cerebrospinal fluid; Chemokines; Cytokines; Hypocretin; Narcolepsy