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Ollila HM, Sharon E, Lin L, Sinnott-Armstrong N, Ambati A, Yogeshwar SM, Hillary RP, Jolanki O, Faraco J, Einen M, Luo G, Zhang J, Han F, Yan H, Dong XS, Li J, Zhang J, Hong SC, Kim TW, Dauvilliers Y, Barateau L, Lammers GJ, Fronczek R, Mayer G, Santamaria J, Arnulf I, Knudsen-Heier S, Bredahl MKL, Thorsby PM, Plazzi G, Pizza F, Moresco M, Crowe C, Van den Eeden SK, Lecendreux M, Bourgin P, Kanbayashi T, Martínez-Orozco FJ, Peraita-Adrados R, Benetó A, Montplaisir J, Desautels A, Huang YS, Jennum P, Nevsimalova S, Kemlink D, Iranzo A, Overeem S, Wierzbicka A, Geisler P, Sonka K, Honda M, Högl B, Stefani A, Coelho FM, Mantovani V, Feketeova E, Wadelius M, Eriksson N, Smedje H, Hallberg P, Hesla PE, Rye D, Pelin Z, Ferini-Strambi L, Bassetti CL, Mathis J, Khatami R, Aran A, Nampoothiri S, Olsson T, Kockum I, Partinen M, Perola M, Kornum BR, Rueger S, Winkelmann J, Miyagawa T, Toyoda H, Khor SS, Shimada M, Tokunaga K, Rivas M, Pritchard JK, Risch N, Kutalik Z, O'Hara R, Hallmayer J, Ye CJ, Mignot EJ. Narcolepsy risk loci outline role of T cell autoimmunity and infectious triggers in narcolepsy. Nat Commun 2023; 14:2709. [PMID: 37188663 DOI: 10.1038/s41467-023-36120-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/17/2023] [Indexed: 05/17/2023] Open
Abstract
Narcolepsy type 1 (NT1) is caused by a loss of hypocretin/orexin transmission. Risk factors include pandemic 2009 H1N1 influenza A infection and immunization with Pandemrix®. Here, we dissect disease mechanisms and interactions with environmental triggers in a multi-ethnic sample of 6,073 cases and 84,856 controls. We fine-mapped GWAS signals within HLA (DQ0602, DQB1*03:01 and DPB1*04:02) and discovered seven novel associations (CD207, NAB1, IKZF4-ERBB3, CTSC, DENND1B, SIRPG, PRF1). Significant signals at TRA and DQB1*06:02 loci were found in 245 vaccination-related cases, who also shared polygenic risk. T cell receptor associations in NT1 modulated TRAJ*24, TRAJ*28 and TRBV*4-2 chain-usage. Partitioned heritability and immune cell enrichment analyses found genetic signals to be driven by dendritic and helper T cells. Lastly comorbidity analysis using data from FinnGen, suggests shared effects between NT1 and other autoimmune diseases. NT1 genetic variants shape autoimmunity and response to environmental triggers, including influenza A infection and immunization with Pandemrix®.
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Affiliation(s)
- Hanna M Ollila
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
- Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Eilon Sharon
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
- Department of Biology, Stanford University, Stanford, CA, 94305, USA
| | - Ling Lin
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Nasa Sinnott-Armstrong
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
- Department of Biology, Stanford University, Stanford, CA, 94305, USA
| | - Aditya Ambati
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Selina M Yogeshwar
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
- Department of Neurology, Charité-Universitätsmedizin, 10117, Berlin, Germany
- Charité-Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, 10117, Berlin, Germany
| | - Ryan P Hillary
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Otto Jolanki
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | - Juliette Faraco
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Mali Einen
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Guo Luo
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Jing Zhang
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA
| | - Fang Han
- Division of Sleep Medicine, The Peking University People's Hospital, Beijing, China
| | - Han Yan
- Division of Sleep Medicine, The Peking University People's Hospital, Beijing, China
| | - Xiao Song Dong
- Division of Sleep Medicine, The Peking University People's Hospital, Beijing, China
| | - Jing Li
- Division of Sleep Medicine, The Peking University People's Hospital, Beijing, China
| | - Jun Zhang
- Department of Neurology, The Peking University People's Hospital, Beijing, China
| | - Seung-Chul Hong
- Department of Psychiatry, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Tae Won Kim
- Department of Psychiatry, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
| | - Yves Dauvilliers
- Sleep-Wake Disorders Center, National Reference Network for Narcolepsy, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier; Institute for Neurosciences of Montpellier (INM), INSERM, Université Montpellier 1, Montpellier, France
| | - Lucie Barateau
- Sleep-Wake Disorders Center, National Reference Network for Narcolepsy, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier; Institute for Neurosciences of Montpellier (INM), INSERM, Université Montpellier 1, Montpellier, France
| | - Gert Jan Lammers
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Stichting Epilepsie Instellingen Nederland (SEIN), Sleep-Wake Centre, Heemstede, The Netherlands
| | - Rolf Fronczek
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Stichting Epilepsie Instellingen Nederland (SEIN), Sleep-Wake Centre, Heemstede, The Netherlands
| | - Geert Mayer
- Hephata Klinik, Schimmelpfengstr. 6, 34613, Schwalmstadt, Germany
- Philipps Universität Marburg, Baldinger Str., 35043, Marburg, Germany
| | - Joan Santamaria
- Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Isabelle Arnulf
- Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Assistance Publique-Hopitaux de Paris, 75013, Paris, France
| | - Stine Knudsen-Heier
- Norwegian Centre of Expertise for Neurodevelopment Disorders and Hypersomnias (NevSom), Department of Rare Disorders, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - May Kristin Lyamouri Bredahl
- Norwegian Centre of Expertise for Neurodevelopment Disorders and Hypersomnias (NevSom), Department of Rare Disorders, Oslo University Hospital and University of Oslo, Oslo, Norway
- Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Per Medbøe Thorsby
- Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123, Bologna, Italy
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123, Bologna, Italy
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Monica Moresco
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123, Bologna, Italy
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | | | | | - Michel Lecendreux
- Pediatric Sleep Center and National Reference Center for Narcolepsy and Idiopathic Hypersomnia Hospital Robert Debre, Paris, France
| | - Patrice Bourgin
- Department of Sleep Medicine, Strasbourg University Hospital, Strasbourg University, Strasbourg, France
| | - Takashi Kanbayashi
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
| | - Francisco J Martínez-Orozco
- Sleep Unit. Clinical Neurophysiology Service. San Carlos University Hospital. University Complutense of Madrid, Madrid, Spain
| | - Rosa Peraita-Adrados
- Sleep and Epilepsy Unit, Clinical Neurophysiology Service, Gregorio Marañón University General Hospital and Research Institute, University Complutense of Madrid (UCM), Madrid, Spain
| | | | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur and Department of Neurosciences, University of Montréal, Montréal, QC, Canada
| | - Alex Desautels
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur and Department of Neurosciences, University of Montréal, Montréal, QC, Canada
| | - Yu-Shu Huang
- Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital and University, Taoyuan, Taiwan
| | - Poul Jennum
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark
| | - Sona Nevsimalova
- Department of Neurology and Centre of Clinical Neurosciences, First Faculty of Medicine, Charles University and General University Hosptal, Prague, Czech Republic
| | - David Kemlink
- Department of Neurology and Centre of Clinical Neurosciences, First Faculty of Medicine, Charles University and General University Hosptal, Prague, Czech Republic
| | - Alex Iranzo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Neurology, Barcelona, Spain
- Multidisciplinary Sleep Disorders Unit, Barcelona, Spain
| | - Sebastiaan Overeem
- Sleep Medicine Center Kempenhaeghe, P.O. Box 61, 5590 AB, Heeze, The Netherlands
- Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Aleksandra Wierzbicka
- Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Peter Geisler
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Karel Sonka
- Department of Neurology and Centre of Clinical Neurosciences, First Faculty of Medicine, Charles University and General University Hosptal, Prague, Czech Republic
| | - Makoto Honda
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Seiwa Hospital, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Birgit Högl
- Department of Neurology, Medical University Innsbruck (MUI), Innsbruck, Austria
| | - Ambra Stefani
- Department of Neurology, Medical University Innsbruck (MUI), Innsbruck, Austria
| | | | - Vilma Mantovani
- Center for Applied Biomedical Research (CRBA), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Eva Feketeova
- Neurology Department, Medical Faculty of P. J. Safarik University, University Hospital of L. Pasteur Kosice, Kosice, Slovak Republic
| | - Mia Wadelius
- Department of Medical Sciences and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Niclas Eriksson
- Department of Medical Sciences and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Uppsala Clinical Research Center, Uppsala, Sweden
| | - Hans Smedje
- Division of Child and Adolescent Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Pär Hallberg
- Department of Medical Sciences and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | | | - David Rye
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Zerrin Pelin
- Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Luigi Ferini-Strambi
- Sleep Disorders Center, Division of Neuroscience, Ospedale San Raffaele, Università Vita-Salute, Milan, Italy
| | - Claudio L Bassetti
- Neurology Department, EOC, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Johannes Mathis
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Ramin Khatami
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
- Center for Sleep Medicine and Sleep Research, Clinic Barmelweid AG, Barmelweid, Switzerland
| | - Adi Aran
- Shaare Zedek Medical Center, Jerusalem, Israel
| | - Sheela Nampoothiri
- Department of Pediatric Genetics, Amrita Institute of Medical Sciences & Research Centre, Kerala, India
| | - Tomas Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Kockum
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Markku Partinen
- Helsinki Sleep Clinic, Vitalmed Research Centre, Helsinki, Finland
- Department of Clinical Neurosciences, University of Helsinki, Helsinki, Finland
| | - Markus Perola
- University of Helsinki, Institute for Molecular Medicine, Finland (FIMM) and Diabetes and Obesity Research Program. University of Tartu, Estonian Genome Center, Tartu, Estonia
| | - Birgitte R Kornum
- Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark
| | - Sina Rueger
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Juliane Winkelmann
- Institute of Neurogenomics, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Neurologische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - Taku Miyagawa
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiromi Toyoda
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Seik-Soon Khor
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mihoko Shimada
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Manuel Rivas
- Department of Biomedical Data Science-Administration, Stanford University, Palo Alto, CA, USA
| | | | - Neil Risch
- Dept. Epidemiology and Biostatistics, UCSF, 513 Parnassus Avenue, San Francisco, CA, 94117, USA
| | - Zoltan Kutalik
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
- University Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland, Lausanne, 1010, Switzerland
| | - Ruth O'Hara
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
- Mental Illness Research Education Clinical Centers (MIRECC), VA Palo Alto, Palo Alto, CA, USA
| | - Joachim Hallmayer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
- Mental Illness Research Education Clinical Centers (MIRECC), VA Palo Alto, Palo Alto, CA, USA
| | - Chun Jimmie Ye
- Department of Epidemiology & Biostatistics, Institute for Human Genetics, University of California San Francisco, San Francisco, CA, USA
| | - Emmanuel J Mignot
- Stanford University, Center for Sleep Sciences and Medicine, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, 94304, USA.
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Hillary RP, Ollila HM, Faraco J, Lin L, Dauvilliers Y, Han F, Huang H, Arnulf I, Mignot E. 0026 GENETIC LOCI IN PERIODIC HYPERSOMNIA/KLEINE-LEVIN SYNDROME TYPE. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Goldberg S, Ollila HM, Lin L, Sharifi H, Rico T, Andlauer O, Aran A, Bloomrosen E, Faraco J, Fang H, Mignot E. Analysis of Hypoxic and Hypercapnic Ventilatory Response in Healthy Volunteers. PLoS One 2017; 12:e0168930. [PMID: 28045995 PMCID: PMC5207520 DOI: 10.1371/journal.pone.0168930] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 12/08/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction A previous study has suggested that the Human Leukocyte Antigen (HLA) allele DQB1*06:02 affects hypoxic ventilatory response (HVR) but not hypercapnic ventilatory response (HCVR) in an Asian population. The current study evaluated the relationship in Caucasians and Asians. In addition we assessed whether gender or polymorphisms in genes participating in the control of breathing affect HVR and HCVR. Methods A re-breathing system was used to measure HVR and HCVR in 551 young adults (56.8% Caucasians, 30% Asians). HLA-DQB1*06:02 and tagged polymorphisms and coding variants in genes participating in breathing (PHOX2B, GPR4 and TASK2/KCNK5) were analyzed. The associations between HVR/HCVR and HLA-DQB1*06:02, genetic polymorphisms, and gender were evaluated using ANOVA or frequentist association testing with SNPTEST. Results HVR and gender are strongly correlated. HCVR and gender are not. Mean HVR in women was 0.276±0.168 (liter/minute/%SpO2) compared to 0.429±0.266 (liter/minute/%SpO2) in men, p<0.001 (55.4% higher HVR in men). Women had lower baseline minute ventilation (8.08±2.36 l/m vs. 10.00±3.43l/m, p<0.001), higher SpO2 (98.0±1.3% vs. 96.6±1.7%, p<0.001), and lower EtCO2 (4.65±0.68% vs. 4.82±1.02%, p = 0.025). One hundred and two (18.5%) of the participants had HLA-DQB1*06:02. No association was seen between HLA-DQB1*06:02 and HVR or HCVR. Genetic analysis revealed point wise, uncorrected significant associations between two TASK2/KCNK5 variants (rs2815118 and rs150380866) and HCVR. Conclusions This is the largest study to date reporting the relationship between gender and HVR/ HCVR and the first study assessing the association between genetic polymorphisms in humans and HVR/HCVR. The data suggest that gender has a large effect on hypoxic breathing response.
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Affiliation(s)
- Shmuel Goldberg
- Pediatric Pulmonology Unit, Shaare Zedek Medical Center, Hebrew University, School of Medicine, Jerusalem, Israel
| | - Hanna Maria Ollila
- Stanford University Center for Sleep Sciences, Palo Alto, CA, United States of America
| | - Ling Lin
- Stanford University Center for Sleep Sciences, Palo Alto, CA, United States of America
| | - Husham Sharifi
- Stanford University Center for Sleep Sciences, Palo Alto, CA, United States of America
| | - Tom Rico
- Stanford University Center for Sleep Sciences, Palo Alto, CA, United States of America
| | - Olivier Andlauer
- East London NHS Foundation Trust, Newham Centre for Mental Health, London, United Kingdom
| | - Adi Aran
- Neuropediatric unit, Shaare Zedek Medical Center, Hebrew University, School of Medicine, Jerusalem, Israel
| | - Efrat Bloomrosen
- Department of Family Medicine, Hebrew University and Clalit Health Services, Jerusalem, Israel
| | - Juliette Faraco
- Stanford University Center for Sleep Sciences, Palo Alto, CA, United States of America
| | - Han Fang
- Department of Pulmonary Medicine, Peking University People's Hospital, Beijing, China
| | - Emmanuel Mignot
- Stanford University Center for Sleep Sciences, Palo Alto, CA, United States of America
- * E-mail:
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Ollila H, Ravel JM, Han F, Faraco J, Lin L, Zheng X, Plazzi G, Dauvilliers Y, Pizza F, Hong SC, Jennum P, Knudsen S, Kornum B, Dong X, Yan H, Hong H, Coquillard C, Mahlios J, Jolanki O, Einen M, Arnulf I, Högl B, Frauscher B, Crowe C, Partinen M, Huang Y, Bourgin P, Vaarala O, Désautels A, Montplaisir J, Mack S, Mindrinos M, Fernandez-Vina M, Mignot E. HLA-DPB1 and HLA Class I Confer Risk of and Protection from Narcolepsy. Am J Hum Genet 2015. [DOI: 10.1016/j.ajhg.2015.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Holm A, Lin L, Faraco J, Mostafavi S, Battle A, Zhu X, Levinson DF, Han F, Gammeltoft S, Jennum P, Mignot E, Kornum BR. EIF3G is associated with narcolepsy across ethnicities. Eur J Hum Genet 2015; 23:1573-80. [PMID: 25669430 DOI: 10.1038/ejhg.2015.4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 10/28/2014] [Accepted: 12/09/2014] [Indexed: 01/06/2023] Open
Abstract
Type 1 narcolepsy, an autoimmune disease affecting hypocretin (orexin) neurons, is strongly associated with HLA-DQB1*06:02. Among polymorphisms associated with the disease is single-nucleotide polymorphism rs2305795 (c.*638G>A) located within the P2RY11 gene. P2RY11 is in a region of synteny conserved in mammals and zebrafish containing PPAN, EIF3G and DNMT1 (DNA methyltransferase 1). As mutations in DNMT1 cause a rare dominant form of narcolepsy in association with deafness, cerebellar ataxia and dementia, we questioned whether the association with P2RY11 in sporadic narcolepsy could be secondary to linkage disequilibrium with DNMT1. Based on genome-wide association data from two cohorts of European and Chinese ancestry, we found that the narcolepsy association signal drops sharply between P2RY11/EIF3G and DNMT1, suggesting that the association with narcolepsy does not extend into the DNMT1 gene region. Interestingly, using transethnic mapping, we identified a novel single-nucleotide polymorphism rs3826784 (c.596-260A>G) in the EIF3G gene also associated with narcolepsy. The disease-associated allele increases EIF3G mRNA expression. EIF3G is located in the narcolepsy risk locus and EIF3G expression correlates with PPAN and P2RY11 expression. This suggests shared regulatory mechanisms that might be affected by the polymorphism and are of relevance to narcolepsy.
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Affiliation(s)
- Anja Holm
- Molecular Sleep Laboratory, Department of Diagnostics, Glostrup University Hospital, Glostrup, Denmark.,Danish Center for Sleep Medicine, Department of Neurophysiology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark
| | - Ling Lin
- Center for Sleep Sciences in Medicine and Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Juliette Faraco
- Center for Sleep Sciences in Medicine and Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Sara Mostafavi
- Department of Computer Science, Stanford University, Palo Alto, CA, USA
| | - Alexis Battle
- Department of Computer Science, Stanford University, Palo Alto, CA, USA
| | - Xiaowei Zhu
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Douglas F Levinson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Fang Han
- Department of Pulmonary, Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Steen Gammeltoft
- Molecular Sleep Laboratory, Department of Diagnostics, Glostrup University Hospital, Glostrup, Denmark
| | - Poul Jennum
- Danish Center for Sleep Medicine, Department of Neurophysiology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark
| | - Emmanuel Mignot
- Center for Sleep Sciences in Medicine and Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Birgitte R Kornum
- Molecular Sleep Laboratory, Department of Diagnostics, Glostrup University Hospital, Glostrup, Denmark
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Ollila H, Ravel JM, Han F, Faraco J, Lin L, Zheng X, Plazzi G, Dauvilliers Y, Pizza F, Hong SC, Jennum P, Knudsen S, Kornum B, Dong X, Yan H, Hong H, Coquillard C, Mahlios J, Jolanki O, Einen M, Arnulf I, Högl B, Frauscher B, Crowe C, Partinen M, Huang Y, Bourgin P, Vaarala O, Désautels A, Montplaisir J, Mack S, Mindrinos M, Fernandez-Vina M, Mignot E, Mignot E. HLA-DPB1 and HLA class I confer risk of and protection from narcolepsy. Am J Hum Genet 2015; 96:136-46. [PMID: 25574827 DOI: 10.1016/j.ajhg.2014.12.010] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 12/08/2014] [Indexed: 01/29/2023] Open
Abstract
Type 1 narcolepsy, a disorder caused by a lack of hypocretin (orexin), is so strongly associated with human leukocyte antigen (HLA) class II HLA-DQA1(∗)01:02-DQB1(∗)06:02 (DQ0602) that very few non-DQ0602 cases have been reported. A known triggering factor for narcolepsy is pandemic 2009 influenza H1N1, suggesting autoimmunity triggered by upper-airway infections. Additional effects of other HLA-DQ alleles have been reported consistently across multiple ethnic groups. Using over 3,000 case and 10,000 control individuals of European and Chinese background, we examined the effects of other HLA loci. After careful matching of HLA-DR and HLA-DQ in case and control individuals, we found strong protective effects of HLA-DPA1(∗)01:03-DPB1(∗)04:02 (DP0402; odds ratio [OR] = 0.51 [0.38-0.67], p = 1.01 × 10(-6)) and HLA-DPA1(∗)01:03-DPB1(∗)04:01 (DP0401; OR = 0.61 [0.47-0.80], p = 2.07 × 10(-4)) and predisposing effects of HLA-DPB1(∗)05:01 in Asians (OR = 1.76 [1.34-2.31], p = 4.71 × 10(-05)). Similar effects were found by conditional analysis controlling for HLA-DR and HLA-DQ with DP0402 (OR = 0.45 [0.38-0.55] p = 8.99 × 10(-17)) and DP0501 (OR = 1.38 [1.18-1.61], p = 7.11 × 10(-5)). HLA-class-II-independent associations with HLA-A(∗)11:01 (OR = 1.32 [1.13-1.54], p = 4.92 × 10(-4)), HLA-B(∗)35:03 (OR = 1.96 [1.41-2.70], p = 5.14 × 10(-5)), and HLA-B(∗)51:01 (OR = 1.49 [1.25-1.78], p = 1.09 × 10(-5)) were also seen across ethnic groups in the HLA class I region. These effects might reflect modulation of autoimmunity or indirect effects of HLA class I and HLA-DP alleles on response to viral infections such as that of influenza.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Emmanuel Mignot
- Stanford University Center for Sleep Sciences, Palo Alto, CA 94304, USA.
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Canellas F, Lin L, Julià MR, Clemente A, Vives-Bauza C, Ollila HM, Hong SC, Arboleya SM, Einen MA, Faraco J, Fernandez-Vina M, Mignot E. Dual cases of type 1 narcolepsy with schizophrenia and other psychotic disorders. J Clin Sleep Med 2014; 10:1011-8. [PMID: 25142772 DOI: 10.5664/jcsm.4040] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Cases of narcolepsy in association with psychotic features have been reported but never fully characterized. These patients present diagnostic and treatment challenges and may shed new light on immune associations in schizophrenia. METHOD Our case series was gathered at two narcolepsy specialty centers over a 9-year period. A questionnaire was created to improve diagnosis of schizophrenia or another psychotic disorder in patients with narcolepsy. Pathophysiological investigations included full HLA Class I and II typing, testing for known systemic and intracellular/synaptic neuronal antibodies, recently described neuronal surface antibodies, and immunocytochemistry on brain sections to detect new antigens. RESULTS Ten cases were identified, one with schizoaffective disorder, one with delusional disorder, two with schizophreniform disorder, and 6 with schizophrenia. In all cases, narcolepsy manifested first in childhood or adolescence, followed by psychotic symptoms after a variable interval. These patients had auditory hallucinations, which was the most differentiating clinical feature in comparison to narcolepsy patients without psychosis. Narcolepsy therapy may have played a role in triggering psychotic symptoms but these did not reverse with changes in narcolepsy medications. Response to antipsychotic treatment was variable. Pathophysiological studies did not reveal any known autoantibodies or unusual brain immunostaining pattern. No strong HLA association outside of HLA DQB1*06:02 was found, although increased DRB3*03 and DPA1*02:01 was notable. CONCLUSION Narcolepsy can occur in association with schizophrenia, with significant diagnostic and therapeutic challenges. Dual cases maybe under diagnosed, as onset is unusually early, often in childhood. Narcolepsy and psychosis may share an autoimmune pathology; thus, further investigations in larger samples are warranted.
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Han F, Faraco J, Dong XS, Ollila HM, Lin L, Li J, An P, Wang S, Jiang KW, Gao ZC, Zhao L, Yan H, Liu YN, Li QH, Zhang XZ, Hu Y, Wang JY, Lu YH, Lu CJ, Zhou W, Hallmayer J, Huang YS, Strohl KP, Pollmächer T, Mignot E. Genome wide analysis of narcolepsy in China implicates novel immune loci and reveals changes in association prior to versus after the 2009 H1N1 influenza pandemic. PLoS Genet 2013; 9:e1003880. [PMID: 24204295 PMCID: PMC3814311 DOI: 10.1371/journal.pgen.1003880] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 08/29/2013] [Indexed: 11/25/2022] Open
Abstract
Previous studies in narcolepsy, an autoimmune disorder affecting hypocretin (orexin) neurons and recently associated with H1N1 influenza, have demonstrated significant associations with five loci. Using a well-characterized Chinese cohort, we refined known associations in TRA@ and P2RY11-DNMT1 and identified new associations in the TCR beta (TRB@; rs9648789 max P = 3.7×10−9 OR 0.77), ZNF365 (rs10995245 max P = 1.2×10−11 OR 1.23), and IL10RB-IFNAR1 loci (rs2252931 max P = 2.2×10−9 OR 0.75). Variants in the Human Leukocyte Antigen (HLA)- DQ region were associated with age of onset (rs7744020 P = 7.9×10−9 beta −1.9 years) and varied significantly among cases with onset after the 2009 H1N1 influenza pandemic compared to previous years (rs9271117 P = 7.8×10−10 OR 0.57). These reflected an association of DQB1*03:01 with earlier onset and decreased DQB1*06:02 homozygosity following 2009. Our results illustrate how genetic association can change in the presence of new environmental challenges and suggest that the monitoring of genetic architecture over time may help reveal the appearance of novel triggers for autoimmune diseases. Narcolepsy-hypocretin deficiency results from a highly specific autoimmune attack on hypocretin cells. Recent studies have established antigen presentation by specific class II proteins encoded by (HLA DQB1*06:02 and DQA1*01:02) to the cognate T cell receptor as the main disease pathway, with a role for H1N1 influenza in the triggering process. Here, we have used a large and well-characterized cohort of Chinese narcolepsy cases to examine genetic architecture not observed in European samples. We confirmed previously implicated susceptibility genes (T cell receptor alpha, P2RY11), and identify new loci (ZNF365, IL10RB-IFNAR1), most notably, variants at the beta chain of the T cell receptor. We found that one HLA variant, (DQB1*03:01), is associated with dramatically earlier disease onset (nearly 2 years). We also identified differences in HLA haplotype frequencies among cases with onset following the 2009 H1N1 influenza pandemic as compared to before the outbreak, with fewer HLA DQB1*06:02 homozygotes. This may be the first demonstration of such an effect, and suggests that the study of changes in GWAS signals over time could help identify environmental factors in other autoimmune diseases.
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Affiliation(s)
- Fang Han
- Department of Pulmonary, Critical Care Medicine, Peking University People's Hospital, Beijing, China
- * E-mail: (FH); (EM)
| | - Juliette Faraco
- Stanford University Center for Sleep Sciences, Palo Alto, California, United States
| | - Xiao Song Dong
- Department of Pulmonary, Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Hanna M. Ollila
- Stanford University Center for Sleep Sciences, Palo Alto, California, United States
| | - Ling Lin
- Stanford University Center for Sleep Sciences, Palo Alto, California, United States
| | - Jing Li
- Department of Pulmonary, Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Pei An
- Department of Pulmonary, Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Shan Wang
- Department of Surgery, Peking University People's Hospital, Beijing, China
| | - Ke Wei Jiang
- Department of Surgery, Peking University People's Hospital, Beijing, China
| | - Zhan Cheng Gao
- Department of Pulmonary, Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Long Zhao
- Department of Pulmonary, Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Han Yan
- Department of Pulmonary, Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Ya Nan Liu
- Department of Pulmonary, Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Qing Hua Li
- Department of Pulmonary, Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Xiao Zhe Zhang
- Department of Pulmonary, Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Yan Hu
- Department of Pulmonary, Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Jing Yu Wang
- Department of Pulmonary Medicine, Bin Zhou Medical University, Shandong, China
| | - Yun Hui Lu
- Department of Pulmonary Medicine, Yun Nan Province Hospital, Yun Nan, China
| | - Chang Jun Lu
- Department of Pulmonary Medicine, Bin Zhou Medical University, Shandong, China
| | - Wei Zhou
- Department of Pulmonary, Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Joachim Hallmayer
- Stanford University Center for Sleep Sciences, Palo Alto, California, United States
| | | | - Kingman P. Strohl
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Case Western Reserve University, and Cleveland Louis Stokes VA Medical Center, Cleveland, Ohio, United States
| | - Thomas Pollmächer
- Center of Mental Health, Ingolstadt, Klinikum Ingolstadt, Krumenauerstrasse, Ingolstadt, Germany
| | - Emmanuel Mignot
- Stanford University Center for Sleep Sciences, Palo Alto, California, United States
- * E-mail: (FH); (EM)
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Khor SS, Miyagawa T, Toyoda H, Yamasaki M, Kawamura Y, Tanii H, Okazaki Y, Sasaki T, Lin L, Faraco J, Rico T, Honda Y, Honda M, Mignot E, Tokunaga K. Genome-wide association study of HLA-DQB1*06:02 negative essential hypersomnia. PeerJ 2013; 1:e66. [PMID: 23646285 PMCID: PMC3642778 DOI: 10.7717/peerj.66] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 03/20/2013] [Indexed: 12/23/2022] Open
Abstract
Essential hypersomnia (EHS), a sleep disorder characterized by excessive daytime sleepiness, can be divided into two broad classes based on the presence or absence of the HLA-DQB1*06:02 allele. HLA-DQB1*06:02-positive EHS and narcolepsy with cataplexy are associated with the same susceptibility genes. In contrast, there are fewer studies of HLA-DQB1*06:02 negative EHS which, we hypothesized, involves a different pathophysiological pathway than does narcolepsy with cataplexy. In order to identify susceptibility genes associated with HLA-DQB1*06:02 negative EHS, we conducted a genome-wide association study (GWAS) of 125 unrelated Japanese EHS patients lacking the HLA-DQB1*06:02 allele and 562 Japanese healthy controls. A comparative study was also performed on 268 HLA-DQB1*06:02 negative Caucasian hypersomnia patients and 1761 HLA-DQB1*06:02 negative Caucasian healthy controls. We identified three SNPs that each represented a unique locus— rs16826005 (P = 1.02E-07; NCKAP5), rs11854769 (P = 6.69E-07; SPRED1), and rs10988217 (P = 3.43E-06; CRAT) that were associated with an increased risk of EHS in this Japanese population. Interestingly, rs10988217 showed a similar tendency in its association with both HLA-DQB1*06:02 negative EHS and narcolepsy with cataplexy in both Japanese and Caucasian populations. This is the first GWAS of HLA-DQB1*06:02 negative EHS, and the identification of these three new susceptibility loci should provide additional insights to the pathophysiological pathway of this condition.
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Affiliation(s)
- Seik-Soon Khor
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
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Faraco J, Lin L, Kornum BR, Kenny EE, Trynka G, Einen M, Rico TJ, Lichtner P, Dauvilliers Y, Arnulf I, Lecendreux M, Javidi S, Geisler P, Mayer G, Pizza F, Poli F, Plazzi G, Overeem S, Lammers GJ, Kemlink D, Sonka K, Nevsimalova S, Rouleau G, Desautels A, Montplaisir J, Frauscher B, Ehrmann L, Högl B, Jennum P, Bourgin P, Peraita-Adrados R, Iranzo A, Bassetti C, Chen WM, Concannon P, Thompson SD, Damotte V, Fontaine B, Breban M, Gieger C, Klopp N, Deloukas P, Wijmenga C, Hallmayer J, Onengut-Gumuscu S, Rich SS, Winkelmann J, Mignot E. ImmunoChip study implicates antigen presentation to T cells in narcolepsy. PLoS Genet 2013; 9:e1003270. [PMID: 23459209 PMCID: PMC3573113 DOI: 10.1371/journal.pgen.1003270] [Citation(s) in RCA: 163] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 11/19/2012] [Indexed: 11/21/2022] Open
Abstract
Recent advances in the identification of susceptibility genes and environmental exposures provide broad support for a post-infectious autoimmune basis for narcolepsy/hypocretin (orexin) deficiency. We genotyped loci associated with other autoimmune and inflammatory diseases in 1,886 individuals with hypocretin-deficient narcolepsy and 10,421 controls, all of European ancestry, using a custom genotyping array (ImmunoChip). Three loci located outside the Human Leukocyte Antigen (HLA) region on chromosome 6 were significantly associated with disease risk. In addition to a strong signal in the T cell receptor alpha (TRA@), variants in two additional narcolepsy loci, Cathepsin H (CTSH) and Tumor necrosis factor (ligand) superfamily member 4 (TNFSF4, also called OX40L), attained genome-wide significance. These findings underline the importance of antigen presentation by HLA Class II to T cells in the pathophysiology of this autoimmune disease. While there is now broad consensus that narcolepsy-hypocretin deficiency results from a highly specific autoimmune attack on hypocretin cells, little is understood regarding the initiation and progression of the underlying autoimmune process. We have taken advantage of a unique high-density genotyping platform (the ImmunoChip) designed to study variants in genes known to be important to autoimmune and inflammatory diseases. Our study of nearly 2000 narcolepsy cases compared to 10,000 controls underscored important roles for HLA DQB1*06:02 and the T cell receptor alpha genes and implicated two additional genes, Cathepsin H and TNFSF4/OX40L, in disease pathogenesis. These findings are particularly important, as these encoded proteins have key roles in antigen processing, presentation, and T cell response, and they suggest that specific interactions at the immunological synapse constitute the pathway to the disease. Further studies of these genes and encoded proteins may therefore reveal the mechanism leading to this highly selective and unique autoimmune disease.
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Affiliation(s)
- Juliette Faraco
- Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, California, United States of America
| | - Ling Lin
- Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, California, United States of America
| | - Birgitte Rahbek Kornum
- Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, California, United States of America
- Center for Sleep Medicine, Department of Clinical Neurophysiology, Faculty of Health Sciences, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark
| | - Eimear E. Kenny
- Department of Genetics, Stanford University, Palo Alto, California, United States of America
| | - Gosia Trynka
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Mali Einen
- Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, California, United States of America
| | - Tom J. Rico
- Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, California, United States of America
| | - Peter Lichtner
- Institute of Human Genetics, Helmholtz Zentrum München–German Research Center for Environmental Health, Munich, Germany
| | - Yves Dauvilliers
- National Reference Network for Orphan Diseases (Narcolepsy and Idiopathic Hypersomnia), Paris, France
- Sleep Unit, Gui-de-Chauliac Hospital, INSERM-1061, Montpellier, France
| | - Isabelle Arnulf
- National Reference Network for Orphan Diseases (Narcolepsy and Idiopathic Hypersomnia), Paris, France
- Sleep Disorders Unit, Hospital Pitié-Salpêtrière, Pierre and Marie Curie University, Paris, France
| | - Michel Lecendreux
- National Reference Network for Orphan Diseases (Narcolepsy and Idiopathic Hypersomnia), Paris, France
- Centre Pédiatrique des Pathologies du Sommeil, Hôpital Robert Debré, Paris, France
| | - Sirous Javidi
- Hephata-Klinik, Schwalmstadt-Treysa, Germany
- Department of Neurology, Philipps University of Marburg, Marburg, Germany
| | - Peter Geisler
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Geert Mayer
- Hephata-Klinik, Schwalmstadt-Treysa, Germany
- Department of Neurology, Philipps University of Marburg, Marburg, Germany
| | - Fabio Pizza
- Department of Neurological Sciences, University of Bologna/IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Francesca Poli
- Department of Neurological Sciences, University of Bologna/IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Giuseppe Plazzi
- Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, California, United States of America
- Department of Neurological Sciences, University of Bologna/IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | | | - Gert Jan Lammers
- Leiden University Medical Center, Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - David Kemlink
- Department of Neurology, Charles University, 1st Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic
| | - Karel Sonka
- Department of Neurology, Charles University, 1st Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic
| | - Sona Nevsimalova
- Department of Neurology, Charles University, 1st Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic
| | - Guy Rouleau
- CHU Ste-Justine Research Centre, Centre of Excellence in Neuromics, Université de Montréal (CENUM), Montreal, Quebec, Canada
| | - Alex Desautels
- Neurology Service, Hôpital du Sacré-Coeur, Université de Montréal, Montréal, Quebec, Canada
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur, Université de Montréal, Montréal, Québec, Canada
| | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur, Université de Montréal, Montréal, Québec, Canada
| | - Birgit Frauscher
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Laura Ehrmann
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Birgit Högl
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Poul Jennum
- Center for Sleep Medicine, Department of Clinical Neurophysiology, Faculty of Health Sciences, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark
| | - Patrice Bourgin
- University Sleep Clinic and CNRS UPR3212, Strasbourg University Hospital, Strasbourg University, Strasbourg, France
| | - Rosa Peraita-Adrados
- Sleep and Epilepsy Unit-Clinical Neurophysiology Service, University Hospital Gregorio Marañón, Madrid, Spain
| | - Alex Iranzo
- Neurology Service and Multisciplinary Sleep Unit, Hospital Clínic, CIBERNED, IDIBAPS, Barcelona, Spain
| | - Claudio Bassetti
- Department of Neurology, Inselspital Universitatsspital, Bern, Swizerland
| | - Wei-Min Chen
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Patrick Concannon
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Susan D. Thompson
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Vincent Damotte
- Inserm, U975, CRICM, Paris, France
- Pierre Marie Curie University, UMR-S975, Paris, France
| | - Bertrand Fontaine
- Inserm, U975, CRICM, Paris, France
- Pierre Marie Curie University, UMR-S975, Paris, France
- Assistance Publique-Hôpitaux de Paris, Department of Neurology, Hospital Pitié-Salpêtrière, Paris, France
| | - Maxime Breban
- Cochin Institute, INSERM U1016/CNRS UMR 8104/Paris Descartes University, Paris, France
- Department of Rheumatology, Ambroise Paré Hospital AP-HP, Boulogne-Billancourt, France
- Université Versailles Saint Quentin en Yvelines (UVSQ), Boulogne-Billancourt, France
| | - Christian Gieger
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, Munich, Germany
| | - Norman Klopp
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, Munich, Germany
| | - Panos Deloukas
- Wellcome Trust Sanger Institute, Hinxton, United Kingdom
| | - Cisca Wijmenga
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | - Joachim Hallmayer
- Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, California, United States of America
- Department of Psychiatry, Stanford University School of Medicine, Palo Alto, California, United States of America
| | - Suna Onengut-Gumuscu
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Juliane Winkelmann
- Institute of Human Genetics, Helmholtz Zentrum München–German Research Center for Environmental Health, Munich, Germany
- Institute for Human Genetics, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Neurology Clinic, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Emmanuel Mignot
- Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, California, United States of America
- * E-mail:
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Han F, Lin L, Li J, Dong SX, An P, Zhao L, Liu NY, Li QY, Yan H, Gao ZC, Faraco J, Strohl KP, Liu X, Miyadera H, Mignot E. HLA-DQ association and allele competition in Chinese narcolepsy. ACTA ACUST UNITED AC 2012; 80:328-35. [PMID: 22862152 DOI: 10.1111/j.1399-0039.2012.01948.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 07/09/2012] [Accepted: 07/16/2012] [Indexed: 12/17/2022]
Abstract
In Japanese, Koreans and Caucasians, narcolepsy/hypocretin deficiency is tightly associated with the DRB1*15:01-DQA1*01:02-DQB1*06:02 haplotype. Studies in African-Americans suggest a primary effect of DQB1*06:02, but this observation has been difficult to confirm in other populations because of high linkage disequilibrium between DRB1*15:01/3 and DQB1*06:02 in most populations. In this study, we studied human leucocyte antigen (HLA) class II in 202 Chinese narcolepsy patients (11% from South China) and found all patients to be DQB1*06:02 positive. Comparing cases with 103 unselected controls, and 110 and 79 controls selected for the presence of DQB1*06:02 and DRB1*15:01, we found that the presence of DQB1*06:02 and not DRB1*15:01 was associated with narcolepsy. In particular, Southern Chinese haplotypes such as the DRB1*15:01-DQA1*01:02-DQB1*06:01 and DRB1*15:01-DQA1*01:02-DQB1*05 were not associated with narcolepsy. As reported in Japanese, Koreans, African-Americans and Caucasians, additional protective effects of DQA1*01 (non-DQA1*01:02) and susceptibility effects of DQB1*03:01 were observed. These results illustrate the extraordinary conservation of HLA class II effects in narcolepsy across populations and show that DRB1*15:01 has no effect on narcolepsy susceptibility in the absence of DQB1*06:02. The results are also in line with a previously proposed 'HLA-DQ allelic competition model' that involves competition between non-DQA1*01:02, non-DQB1*06:02 'competent' (able to dimerize together) DQ1 alleles and the major DQα*01:02/ DQβ*06:02 narcolepsy heterodimer to reduce susceptibility.
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Affiliation(s)
- F Han
- Department of Pulmonary Medicine, Beijing University People's Hospital, Beijing, China.
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Winkelmann J, Lin L, Schormair B, Kornum BR, Faraco J, Plazzi G, Melberg A, Cornelio F, Urban AE, Pizza F, Poli F, Grubert F, Wieland T, Graf E, Hallmayer J, Strom TM, Mignot E. Mutations in DNMT1 cause autosomal dominant cerebellar ataxia, deafness and narcolepsy. Hum Mol Genet 2012; 21:2205-10. [PMID: 22328086 DOI: 10.1093/hmg/dds035] [Citation(s) in RCA: 165] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Autosomal dominant cerebellar ataxia, deafness and narcolepsy (ADCA-DN) is characterized by late onset (30-40 years old) cerebellar ataxia, sensory neuronal deafness, narcolepsy-cataplexy and dementia. We performed exome sequencing in five individuals from three ADCA-DN kindreds and identified DNMT1 as the only gene with mutations found in all five affected individuals. Sanger sequencing confirmed the de novo mutation p.Ala570Val in one family, and showed co-segregation of p.Val606Phe and p.Ala570Val, with the ADCA-DN phenotype, in two other kindreds. An additional ADCA-DN kindred with a p.GLY605Ala mutation was subsequently identified. Narcolepsy and deafness were the first symptoms to appear in all pedigrees, followed by ataxia. DNMT1 is a widely expressed DNA methyltransferase maintaining methylation patterns in development, and mediating transcriptional repression by direct binding to HDAC2. It is also highly expressed in immune cells and required for the differentiation of CD4+ into T regulatory cells. Mutations in exon 20 of this gene were recently reported to cause hereditary sensory neuropathy with dementia and hearing loss (HSAN1). Our mutations are all located in exon 21 and in very close spatial proximity, suggesting distinct phenotypes depending on mutation location within this gene.
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Affiliation(s)
- Juliane Winkelmann
- Institute of Human Genetics, Technische Universität München, Munich 81675, Germany
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Han F, Lin L, Warby SC, Faraco J, Li J, Dong SX, An P, Zhao L, Wang LH, Li QY, Yan H, Gao ZC, Yuan Y, Strohl KP, Mignot E. Narcolepsy onset is seasonal and increased following the 2009 H1N1 pandemic in China. Ann Neurol 2011; 70:410-7. [PMID: 21866560 DOI: 10.1002/ana.22587] [Citation(s) in RCA: 325] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Revised: 07/31/2011] [Accepted: 08/02/2011] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Narcolepsy is caused by the loss of hypocretin/orexin neurons in the hypothalamus, which is likely the result of an autoimmune process. Recently, concern has been raised over reports of narcolepsy in northern Europe following H1N1 vaccination. METHODS The study is a retrospective analysis of narcolepsy onset in subjects diagnosed in Beijing, China (1998-2010). Self-reported month and year of onset were collected from 629 patients (86% children). Graphical presentation, autocorrelations, chi-square, and Fourier analysis were used to assess monthly variation in onset. Finally, 182 patients having developed narcolepsy after October 2009 were asked for vaccination history. RESULTS The occurrence of narcolepsy onset was seasonal, significantly influenced by month and calendar year. Onset was least frequent in November and most frequent in April, with a 6.7-fold increase from trough to peak. Studying year-to-year variation, we found a 3-fold increase in narcolepsy onset following the 2009 H1N1 winter influenza pandemic. The increase is unlikely to be explained by increased vaccination, as only 8 of 142 (5.6%) patients recalled receiving an H1N1 vaccination. Cross-correlation indicated a significant 5- to 7-month delay between the seasonal peak in influenza/cold or H1N1 infections and peak in narcolepsy onset occurrences. INTERPRETATION In China, narcolepsy onset is highly correlated with seasonal and annual patterns of upper airway infections, including H1N1 influenza. In 2010, the peak seasonal onset of narcolepsy was phase delayed by 6 months relative to winter H1N1 infections, and the correlation was independent of H1N1 vaccination in the majority of the sample.
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Affiliation(s)
- Fang Han
- Department of Pulmonary Medicine, Beijing University People's Hospital, Beijing, China.
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Mignot E, Lin L, Faraco J, Kornum B, Steinman L, Hallmayer J. HLA and T cell receptor associations in narcolepsy, a disorder associated with the selective loss of hypocretin neurons (47.17). The Journal of Immunology 2011. [DOI: 10.4049/jimmunol.186.supp.47.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Narcolepsy is a life long disorder characterized by severe sleepiness and cataplexy. It affects 1 in 2,000 individuals and is caused by the selective loss of the hypocretin producing neurons in hypothalamus. This cell loss is likely to be autoimmune and recent findings are closing in on some of the key genetic and environmental effects involved. At the genetic level, the disorder is very tightly associated with DQA1*01:02/DQB1*06:02. In addition to the established role of HLA-DQ, a specific T Cell Receptor Alpha J segment polymorphism has been identified as another susceptibility factor. We are currently sequencing the T-cell TCR@ repertoire to explore this further in recent onset narcolepsy cases. At the level of environmental triggers, winter related upper airway infections are believed to be involved, e.g. we have reported an increased presence of antistreptolysin-O antibody, implicating a role for streptococcal infections. In China, studies of disease onset seasonality indicate a 16 fold increase in onset occurrence around spring when compared to early winter. We anticipate that the cause of narcolepsy will likely involve a specific antigen presentation by DQA1*01:02/DQB1*06:02 to a restricted number of pathogenic T-cell subtypes. As immune involvement is increasingly being recognized in neurodegenerative and neuropsychiatric disorders, understanding why the hypocretin neurons in narcolepsy die is likely to increase understanding of these other disorders as well.
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Affiliation(s)
- Emmanuel Mignot
- 1Center for Sleep Sciences, Stanford University, Palo Alto, CA
| | - Ling Lin
- 1Center for Sleep Sciences, Stanford University, Palo Alto, CA
| | - Juliette Faraco
- 1Center for Sleep Sciences, Stanford University, Palo Alto, CA
| | - Birgitte Kornum
- 1Center for Sleep Sciences, Stanford University, Palo Alto, CA
| | - Lawrence Steinman
- 2Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA
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Weiner-Lachmi K, Faraco J, R Kornum B, Lin L, Steinman L, Mignot E. The role of CTSH in narcolepsy susceptibility and autoimmunity (47.16). The Journal of Immunology 2011. [DOI: 10.4049/jimmunol.186.supp.47.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Narcolepsy, a disease associated with HLA-DQB1*0602, is caused by the selective autoimmune destruction of 70,000 hypocretin neurons in the brain. Recently we identified Cathepsin-H as a novel Narcolepsy susceptibility locus. SNP rs3825932 was associated with Narcolepsy in our set of 807 Caucasian cases vs. 1074 controls (p= 0.002 OR 1.24). The same SNP marker, was previously reported to be associated Type 1 Diabetes in two studies. Cathepsin H is a member of the papain-like family, and participates in intracellular protein degradation. CTSH have also been suggested to be involved in apoptosis and neurodegeneration. CTSH expression levels in peripheral white blood cells are strongly correlated with CTSH genotype at rs1036938 (p<0.0001). Presence of the disease associated C allele is correlated with a lower expression of the CTSH, in a dose dependent manner, in CD8 (T lymphocytes, NK) and CD4 (TH, regulatory, monocytes, macrophages, dendritic) cells, but not in other peripheral blood mononuclear cell types. The low expression variant is also associated with lower CTSH specific activity levels (p=0.029). The genetic association, and results from expression and activity studies strongly suggest a role for CTSH in the development of Narcolepsy. CTSH is implicated in at least two highly selective autoimmune diseases, therefore understanding the role of CTSH in Narcolepsy susceptibility may yield important insights into the development of that and other autoimmune diseases.
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Affiliation(s)
- Karin Weiner-Lachmi
- 1Center for Sleep Sciences, Stanford University, Palo Alto, CA
- 2Immunology Department, Stanford University, Palo Alto, CA
| | - Juliette Faraco
- 1Center for Sleep Sciences, Stanford University, Palo Alto, CA
| | | | - Ling Lin
- 1Center for Sleep Sciences, Stanford University, Palo Alto, CA
| | - Lawrence Steinman
- 3Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA
| | - Emmanuel Mignot
- 1Center for Sleep Sciences, Stanford University, Palo Alto, CA
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Vardeny O, Finn LA, Faraco J, Mignot E, Hla KM, Young T, Peppard PE. ß2 ADRENERGIC RECEPTOR POLYMORPHISMS AND NOCTURNAL BLOOD PRESSURE DIPPING STATUS IN THE WISCONSIN SLEEP COHORT STUDY. J Am Coll Cardiol 2011. [DOI: 10.1016/s0735-1097(11)61296-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Yokogawa T, Marin W, Faraco J, Pézeron G, Appelbaum L, Zhang J, Rosa F, Mourrain P, Mignot E. Characterization of sleep in zebrafish and insomnia in hypocretin receptor mutants. PLoS Biol 2008; 5:e277. [PMID: 17941721 PMCID: PMC2020497 DOI: 10.1371/journal.pbio.0050277] [Citation(s) in RCA: 248] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2007] [Accepted: 08/24/2007] [Indexed: 11/30/2022] Open
Abstract
Sleep is a fundamental biological process conserved across the animal kingdom. The study of how sleep regulatory networks are conserved is needed to better understand sleep across evolution. We present a detailed description of a sleep state in adult zebrafish characterized by reversible periods of immobility, increased arousal threshold, and place preference. Rest deprivation using gentle electrical stimulation is followed by a sleep rebound, indicating homeostatic regulation. In contrast to mammals and similarly to birds, light suppresses sleep in zebrafish, with no evidence for a sleep rebound. We also identify a null mutation in the sole receptor for the wake-promoting neuropeptide hypocretin (orexin) in zebrafish. Fish lacking this receptor demonstrate short and fragmented sleep in the dark, in striking contrast to the excessive sleepiness and cataplexy of narcolepsy in mammals. Consistent with this observation, we find that the hypocretin receptor does not colocalize with known major wake-promoting monoaminergic and cholinergic cell groups in the zebrafish. Instead, it colocalizes with large populations of GABAergic neurons, including a subpopulation of Adra2a-positive GABAergic cells in the anterior hypothalamic area, neurons that could assume a sleep modulatory role. Our study validates the use of zebrafish for the study of sleep and indicates molecular diversity in sleep regulatory networks across vertebrates. Sleep disorders are common and poorly understood. Further, how and why the brain generates sleep is the object of intense speculations. In this study, we demonstrate that a bony fish used for genetic studies sleeps and that a molecule, hypocretin, involved in causing narcolepsy, is conserved. In humans, narcolepsy is a sleep disorder associated with sleepiness, abnormal dreaming, and paralysis and insomnia. We generated a mutant fish in which the hypocretin system was disrupted. Intriguingly, this fish sleep mutant does not display sleepiness or paralysis but has a 30% reduction of its sleep time at night and a 60% decrease in sleep bout length compared with non-mutant fish. We also studied the relationships between the hypocretin system and other sleep regulatory brain systems in zebrafish and found differences in expression patterns in the brain that may explain the differences in behavior. Our study illustrates how a sleep regulatory system may have evolved across vertebrate phylogeny. Zebrafish, a powerful genetic model that has the advantage of transparency to study neuronal networks in vivo, can be used to study sleep. Zebrafish sleep, and have the receptor for the wake-inducing molecule hypocretin. While mutation in this receptor causes narcolepsy in mammals, in fish, sleep is fragmented, demonstrating differences in sleep control in vertebrates.
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Affiliation(s)
- Tohei Yokogawa
- Howard Hughes Medical Institute, Stanford University, Palo Alto, California, United States of America
| | - Wilfredo Marin
- Howard Hughes Medical Institute, Stanford University, Palo Alto, California, United States of America
| | - Juliette Faraco
- Stanford Center for Narcolepsy, Stanford University, Palo Alto, California, United States of America
| | - Guillaume Pézeron
- Ecole Normale Supérieure, Paris, France
- INSERM Unité 784, Paris, France
| | - Lior Appelbaum
- Howard Hughes Medical Institute, Stanford University, Palo Alto, California, United States of America
| | - Jian Zhang
- Stanford Center for Narcolepsy, Stanford University, Palo Alto, California, United States of America
| | - Frédéric Rosa
- Ecole Normale Supérieure, Paris, France
- INSERM Unité 784, Paris, France
| | - Philippe Mourrain
- Stanford Center for Narcolepsy, Stanford University, Palo Alto, California, United States of America
| | - Emmanuel Mignot
- Howard Hughes Medical Institute, Stanford University, Palo Alto, California, United States of America
- Stanford Center for Narcolepsy, Stanford University, Palo Alto, California, United States of America
- * To whom correspondence should be addressed. E-mail:
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Abstract
We have sequenced a segment of 150,102 nucleotides of canine major histocompatibility complex (MHC) DNA, corresponding to the junction of the class I and class III regions. The distal portion contained five class III genes including two tumor necrosis factor genes and the proximal portion contained five genes or pseudogenes belonging to the class I region. The order of the class III region genes was conserved as in the porcine and human MHC regions. The order of the class Ib loci from the proximal side outwards was DLA-53, DLA-12a, DLA-64, stress-induced phosphoprotein-1, followed by DLA-12. Only DLA-64 and DLA-12 display an overall predicted protein sequence compatible with the expression of membrane-anchored glycoproteins. The other class 1b loci do not appear to be functional by sequence analysis. In all, these 10 genes spanned 24% of the total sequence. The remaining 76% comprised of a number of non-coding and repetitive DNA elements including long interspersed nuclear element (LINE) fragments, short interspersed nuclear elements (SINE), and microsatellites.
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Affiliation(s)
- J L Wagner
- Blood and Marrow Transplant Program, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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Crocker A, España RA, Papadopoulou M, Saper CB, Faraco J, Sakurai T, Honda M, Mignot E, Scammell TE. Concomitant loss of dynorphin, NARP, and orexin in narcolepsy. Neurology 2005; 65:1184-8. [PMID: 16247044 PMCID: PMC2254145 DOI: 10.1212/01.wnl.0000168173.71940.ab] [Citation(s) in RCA: 212] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Narcolepsy with cataplexy is associated with a loss of orexin/hypocretin. It is speculated that an autoimmune process kills the orexin-producing neurons, but these cells may survive yet fail to produce orexin. OBJECTIVE To examine whether other markers of the orexin neurons are lost in narcolepsy with cataplexy. METHODS We used immunohistochemistry and in situ hybridization to examine the expression of orexin, neuronal activity-regulated pentraxin (NARP), and prodynorphin in hypothalami from five control and two narcoleptic individuals. RESULTS In the control hypothalami, at least 80% of the orexin-producing neurons also contained prodynorphin mRNA and NARP. In the patients with narcolepsy, the number of cells producing these markers was reduced to about 5 to 10% of normal. CONCLUSIONS Narcolepsy with cataplexy is likely caused by a loss of the orexin-producing neurons. In addition, loss of dynorphin and neuronal activity-regulated pentraxin may contribute to the symptoms of narcolepsy.
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Affiliation(s)
- A Crocker
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Nevsímalová S, Vanková J, Sonka K, Faraco J, Rogers W, Overeem S, Mignot E. [Hypocretin (orexin) deficiency in narcolepsy-cataplexy]. Sb Lek 2002; 101:381-6. [PMID: 11702580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
A mutation in the HCRT locus was proved in 18-yrs old male suffering from narcolepsy-cataplexy. He has demonstrated cataplectic attacks (brief spells of head dropping provoked by laughter) as well as imperative sleep in spells of several minutes up to one hour since the age of six months. He has suffered from severe bulimia since five years; later hypnagogic hallucinations, sleep paralysis and unquiet nocturnal sleep accompanied by periodic limb movements appeared. Symptoms are partially controlled with methylphenidate and either imipramine, clomipramine or fluoxetine. Periodic leg movements poorly responded to L-DOPA and clonazepam treatment. He is HLA-DQB1*0602 negative. Repeated MSLT (over 16 years followed-up period) showed extremely short latency with predominant SOREMPs and also nocturnal PSG recordings revealed fragmented sleep with SOREMPs. This case report demonstrates that hypocretin (orexin) mutations in human can produce the full narcolepsy phenotype and validates data recently reported in dog and mouse models suggesting a role for hypocretin (orexin) in the pathophysiology of narcolepsy and the regulation of REM sleep.
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Affiliation(s)
- S Nevsímalová
- Neurologická klinika 1. lékarské fakulty, Univerzity Karlovy a Vseobecné fakultní nemocnice, Katerinská 30, 120 00 Praha 2, Czech Republic.
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Peyron C, Faraco J, Rogers W, Ripley B, Overeem S, Charnay Y, Nevsimalova S, Aldrich M, Reynolds D, Albin R, Li R, Hungs M, Pedrazzoli M, Padigaru M, Kucherlapati M, Fan J, Maki R, Lammers GJ, Bouras C, Kucherlapati R, Nishino S, Mignot E. A mutation in a case of early onset narcolepsy and a generalized absence of hypocretin peptides in human narcoleptic brains. Nat Med 2000; 6:991-7. [PMID: 10973318 DOI: 10.1038/79690] [Citation(s) in RCA: 1370] [Impact Index Per Article: 57.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We explored the role of hypocretins in human narcolepsy through histopathology of six narcolepsy brains and mutation screening of Hcrt, Hcrtr1 and Hcrtr2 in 74 patients of various human leukocyte antigen and family history status. One Hcrt mutation, impairing peptide trafficking and processing, was found in a single case with early onset narcolepsy. In situ hybridization of the perifornical area and peptide radioimmunoassays indicated global loss of hypocretins, without gliosis or signs of inflammation in all human cases examined. Although hypocretin loci do not contribute significantly to genetic predisposition, most cases of human narcolepsy are associated with a deficient hypocretin system.
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Affiliation(s)
- C Peyron
- Center for Narcolepsy, Stanford University Medical School 1201 Welch Road, Stanford, California 94305-5485, USA
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Lin L, Faraco J, Li R, Kadotani H, Rogers W, Lin X, Qiu X, de Jong PJ, Nishino S, Mignot E. The sleep disorder canine narcolepsy is caused by a mutation in the hypocretin (orexin) receptor 2 gene. Cell 1999; 98:365-76. [PMID: 10458611 DOI: 10.1016/s0092-8674(00)81965-0] [Citation(s) in RCA: 1716] [Impact Index Per Article: 68.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Narcolepsy is a disabling sleep disorder affecting humans and animals. It is characterized by daytime sleepiness, cataplexy, and striking transitions from wakefulness into rapid eye movement (REM) sleep. In this study, we used positional cloning to identify an autosomal recessive mutation responsible for this sleep disorder in a well-established canine model. We have determined that canine narcolepsy is caused by disruption of the hypocretin (orexin) receptor 2 gene (Hcrtr2). This result identifies hypocretins as major sleep-modulating neurotransmitters and opens novel potential therapeutic approaches for narcoleptic patients.
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Affiliation(s)
- L Lin
- Center for Narcolepsy, Department of Psychiatry, Stanford University School of Medicine, California 94305-5485, USA
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Li R, Mignot E, Faraco J, Kadotani H, Cantanese J, Zhao B, Lin X, Hinton L, Ostrander EA, Patterson DF, de Jong PJ. Construction and characterization of an eightfold redundant dog genomic bacterial artificial chromosome library. Genomics 1999; 58:9-17. [PMID: 10331940 DOI: 10.1006/geno.1999.5772] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A large insert canine genomic bacterial artificial chromosome (BAC) library was built from a Doberman pinscher. Approximately 166,000 clones were gridded on nine high-density hybridization filters. Insert analysis of randomly selected clones indicated a mean insert size of 155 kb and predicted 8.1 coverage of the canine genome. Two percent of the clones were nonrecombinant. Chromosomal fluorescence in situ hybridization studies of 60 BAC clones indicated no chimerism. The library was hybridized with dog PCR products representing eight genes (ADA, TNFA, GCA, MYB, HOXA, GUSB, THY1, and TOP1). The resulting positive clones were characterized and shown to be compatible with an eightfold redundant library.
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Affiliation(s)
- R Li
- Stanford Center For Narcolepsy Research, 1201 Welch Road, Room P-112, Stanford, California 94305-5485, USA
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Abstract
Narcolepsy is a disabling sleep disorder characterized by excessive daytime sleepiness and abnormal manifestations of rapid eye movement (REM) sleep including cataplexy, sleep paralysis, and hypnagogic hallucinations. It is known to be a complex disorder, with both genetic predisposition and environmental factors playing a role. In humans, susceptibility to narcolepsy is tightly associated with a specific HLA allele, DQB1*0602. In humans and canines, most cases are sporadic. In Doberman pinschers and Labrador retrievers, however, the disease is transmitted as an autosomal recessive gene canarc-1 with full penetrance. This gene is not linked with the dog leukocyte antigen complex, but is tightly linked with a marker with high homology to the human mu-switch immunoglobulin gene. We have isolated several genomic clones encompassing the canarc-1 marker and the variable heavy chain immunoglobulin region in canines. These have been partially sequenced and have been mapped onto specific dog chromosomes by fluorescence in situ hybridization (FISH). Our results indicate that the mu-switch-like marker is not part of the canine immunoglobulin machinery. We are continuing to extend the genomic contig using a newly developed canine BAC library and attempting to identify the corresponding human region of conserved synteny.
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Affiliation(s)
- J Faraco
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California, USA
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27
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Abstract
Narcolepsy is a chronic neurologic disorder characterized by excessive daytime sleepiness and abnormal manifestations of REM sleep including cataplexy, sleep paralysis, and hypnagogic hallucinations. Narcolepsy is both a significant medical problem and a unique disease model for the study of sleep. Research in human narcolepsy has led to the identification of specific HLA alleles (DQB1*0602 and DQA1*0102) that predispose to the disorder. This has suggested the possibility that narcolepsy may be an autoimmune disorder, a hypothesis that has not been confirmed to date. Genetic factors other than HLA are also likely to be involved. In a canine model of narcolepsy, the disorder is transmitted as a non-MHC single autosomal recessive trait with full penetrance (canarc-1). A tightly linked marker for canarc-1 has been identified, and positional cloning studies are under way to isolate canarc-1 from a newly developed canine genomic BAC library. The molecular cloning of this gene may lead to a better understanding of sleep mechanisms, as has been the case for circadian rhythms following the cloning of frq, per, and Clock.
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Affiliation(s)
- H Kadotani
- Center for Narcolepsy, Stanford University School of Medicine, Stanford, California 94305, USA
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Liu W, Faraco J, Qian C, Francke U. The gene for microfibril-associated protein-1 (MFAP1) is located several megabases centromeric to FBN1 and is not mutated in Marfan syndrome. Hum Genet 1997; 99:578-84. [PMID: 9150721 DOI: 10.1007/s004390050409] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Linkage studies have mapped the Marfan syndrome (MFS) locus to chromosome region 15q15-q21 with no convincing evidence of genetic heterogeneity. The fibrillin-1 (FBN1) gene, located at 15q21.1, that encodes the major component of the defective microfibrils, has been identified as the gene for MFS. However, extensive mutation screening in many laboratories has detected FBN1 mutations in only a fraction of MFS probands studied, leading to the hypothesis that the missing mutations could involve another microfibril gene located in the same region. Recently, the gene for microfibril-associated protein-1 (MFAP1, also called AMP) has been isolated and mapped to the 15q15-q21 region that overlaps the location of the FBN1 gene. Here we report that the two loci are physically close, making MFAP1 an alternative positional candidate gene for MFS. We have carried out MFAP1 mutation screening and gene expression analysis in 48 probands with MFS or related phenotypes who were selected for this study because their fibroblast cultures synthesized fibrillin at normal levels. No MFAP1 mutations were identified, and transcription occurred equally from both alleles. We conclude that the MFAP1 locus is not a reservoir for the hidden MFS mutations.
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Affiliation(s)
- W Liu
- Howard Hughes Medical Institute, Beckmann Center, Stanford University Medical Center, CA 94305-5428, USA
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Faraco J, Bashir M, Rosenbloom J, Francke U. Characterization of the human gene for microfibril-associated glycoprotein (MFAP2), assignment to chromosome 1p36.1-p35, and linkage to D1S170. Genomics 1995; 25:630-7. [PMID: 7759096 DOI: 10.1016/0888-7543(95)80004-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Microfibril-associated glycoprotein, MAGP (gene symbol MFAP2), is a component of connective tissue microfibrils and a candidate for involvement in the etiology of inherited connective tissue diseases. We have cloned a human MAGP cDNA that is highly homologous to the previously characterized bovine and murine genes. Like the bovine and murine loci, the human gene has eight coding exons, but it contains two alternatively used 5' untranslated exons, whereas only one untranslated exon was described in the bovine and murine Magp genes. By using rodent x human somatic cell hybrid panels and fluorescence chromosomal in situ hybridization, we have assigned the locus to human chromosome 1p36.1-p35. An insertion/deletion polymorphism has been identified within intron 7. Linkage analysis between this polymorphism and markers on distal chromosome 1 revealed that MAGP is tightly linked to the anonymous marker D1S170. Physical mapping revealed a distance of < 100 kb between the two markers. This information can be used to screen for linkage in families with microfibrillar abnormalities that are not linked to the fibrillin genes on chromosomes 15 or 5.
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Affiliation(s)
- J Faraco
- Department of Genetics, Stanford University School of Medicine, California, USA
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Chen Y, Faraco J, Yin W, Germiller J, Francke U, Bonadio J. Structure, chromosomal localization, and expression pattern of the murine Magp gene. J Biol Chem 1993; 268:27381-9. [PMID: 8262979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The microfibril-associated glycoprotein (MAGP) was recently established as a discrete constituent of 10-nm microfibrils. We have characterized the primary structure of the mouse transcript, the structure and chromosomal localization of the murine gene, and the developmental pattern of gene expression. The transcript consists of 1,037 base pairs as determined by cDNA cloning, Northern blot analysis, S1 nuclease mapping, and primer extension mapping. Using a cDNA fragment as a probe, we isolated a single genomic clone that contained the entire mouse gene. Analysis of this clone indicated that Magp is fragmented into 9 exons, with the initiator Met codon located in exon 2. As determined by analysis of somatic cell hybrid lines and by fluorescence in situ hybridization, the mouse gene was mapped to chromosome 4 at a location corresponding to region D3-E1. Genomic sequence immediately upstream of the transcription start site was found to be GC-rich but lacked TATA or CCAAT boxes as well as other cis-acting motifs known to regulate transcription. Promoters of this type are usually found in genes that exhibit broad temporal and spatial patterns of expression. Consistent with this idea, the Magp transcript appeared to be the widespread product of mesenchymal/connective tissue cells throughout mouse development. This study presents the first comprehensive evaluation of microfibril gene expression during mammalian development.
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Affiliation(s)
- Y Chen
- Department of Pathology, University of Michigan, Ann Arbor 48109-0650
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