1型和2型嗜睡症患者的高分辨率HLA测序和下视素受体2自身抗体。

IF 2.3 4区 医学 Q3 GENETICS & HEREDITY International Journal of Immunogenetics Pub Date : 2024-06-19 DOI:10.1111/iji.12688
Samia Hamdan, Pontus Wasling, Alexander Lind
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引用次数: 0

摘要

嗜睡症是一种睡眠障碍,是由于下丘脑外侧区域的奥曲肽/甲状腺素神经元明显退化,脑脊液中的奥曲肽/甲状腺素水平随之下降所致。嗜睡症分为 1 型(NT1)和 2 型(NT2)。虽然对人类白细胞抗原(HLA)区域的遗传关联和 NT1 的候选自身抗体进行了调查,以暗示自身免疫的起源,但对 NT2 的发病机制却知之甚少。研究对象包括26名NT1和15名NT2患者,以及24名特发性嗜睡症(IH)患者和778名普通人群对照组。通过高分辨率测序确定了 HLA-DRB3、-DRB4、-DRB5、-DRB1、-DQA1、-DQB1、-DPA1 和 -DPB1 的等位基因、扩展单倍型和基因型。放射结合试验用于确定针对降视素受体 2 的自身抗体(抗HCRTR2 自身抗体)。NT1与HLA-DRB5*01:01:01、-DRB1*15:01:01、-DQA1*01:02:01、-DQB1*06:02:01、-DRB5*01:01:01、-DRB1*15:01:01、-DQA1*01:02:01、-DQB1*06:02:01相关(几率比[OR]:9.15;P = 8.31 × 10-4)和 HLA-DRB5*01:01:01, -DRB1*15:01:01, -DQA1*01:02:01, -DQB1*06:02:01, -DRB4*01:03:01, -DRB1*04:01:01, -DQA1*03:02//03:03:01, -DQB1*03:01:01(OR:23.61;p = 1.58 × 10-4)基因型。据报道,NT2亚组(n = 5)的奥曲肽/视黄醇水平较低,这与扩展的HLA-DQB1*06:02:01单倍型有关(p = .001)。抗HCRTR2自身抗体水平在研究组之间没有差异(p = .8524)。我们证实了之前发现的 NT1 与 HLA-DQB1*06:02:01 扩展基因型的关联。我们还发现了一个 NT2 患者亚组,其奥曲肽/甲状腺素水平处于中间水平,且与 HLA-DQB1*06:02:01 相关,这表明 NT1 和 NT2 这两种不同的嗜睡症亚型之间可能存在重叠。抗HCRTR2自身抗体水平较低,表明这些受体在NT1和NT2中可能都不是自身免疫靶点。
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High-resolution HLA sequencing and hypocretin receptor 2 autoantibodies in narcolepsy type 1 and type 2

Narcolepsy is a sleep disorder caused by an apparent degeneration of orexin/hypocretin neurons in the lateral hypothalamic area and a subsequent decrease in orexin/hypocretin levels in the cerebrospinal fluid. Narcolepsy is classified into type 1 (NT1) and type 2 (NT2). While genetic associations in the human leukocyte antigen (HLA) region and candidate autoantibodies have been investigated in NT1 to imply an autoimmune origin, less is known about the pathogenesis in NT2. Twenty-six NT1 and 15 NT2 patients were included, together with control groups of 24 idiopathic hypersomnia (IH) patients and 778 general population participants. High-resolution sequencing was used to determine the alleles, the extended haplotypes, and the genotypes of HLA-DRB3, -DRB4, -DRB5, -DRB1, -DQA1, -DQB1, -DPA1, and -DPB1. Radiobinding assay was used to determine autoantibodies against hypocretin receptor 2 (anti-HCRTR2 autoantibodies). NT1 was associated with HLA-DRB5*01:01:01, -DRB1*15:01:01, -DQA1*01:02:01, -DQB1*06:02:01, -DRB5*01:01:01, -DRB1*15:01:01, -DQA1*01:02:01, -DQB1*06:02:01 (odds ratio [OR]: 9.15; p = 8.31 × 10−4) and HLA-DRB5*01:01:01, -DRB1*15:01:01, -DQA1*01:02:01, -DQB1*06:02:01, -DRB4*01:03:01, -DRB1*04:01:01, -DQA1*03:02//03:03:01, -DQB1*03:01:01 (OR: 23.61; p = 1.58 × 10−4) genotypes. Lower orexin/hypocretin levels were reported in the NT2 subgroup (n = 5) that was associated with the extended HLA-DQB1*06:02:01 haplotype (p = .001). Anti-HCRTR2 autoantibody levels were not different between study groups (p = .8524). We confirmed the previous association of NT1 with HLA-DQB1*06:02:01 extended genotypes. A subgroup of NT2 patients with intermediate orexin/hypocretin levels and association with HLA-DQB1*06:02:01 was identified, indicating a possible overlap between the two distinct narcolepsy subtypes, NT1 and NT2. Low anti-HCRTR2 autoantibody levels suggest that these receptors might not function as autoimmune targets in either NT1 or NT2.

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来源期刊
CiteScore
4.70
自引率
0.00%
发文量
48
审稿时长
6-12 weeks
期刊介绍: The International Journal of Immunogenetics (formerly European Journal of Immunogenetics) publishes original contributions on the genetic control of components of the immune system and their interactions in both humans and experimental animals. The term ''genetic'' is taken in its broadest sense to include studies at the evolutionary, molecular, chromosomal functional and population levels in both health and disease. Examples are: -studies of blood groups and other surface antigens- cell interactions and immune response- receptors, antibodies, complement components and cytokines- polymorphism- evolution of the organisation, control and function of immune system components- anthropology and disease associations- the genetics of immune-related disease: allergy, autoimmunity, immunodeficiency and other immune pathologies- All papers are seen by at least two independent referees and only papers of the highest quality are accepted.
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