Narcolepsy Associated with Pandemrix Vaccine

Show full item record



Permalink

http://hdl.handle.net/10138/302445

Citation

Sarkanen , T , Alakuijala , A , Julkunen , I & Partinen , M 2018 , ' Narcolepsy Associated with Pandemrix Vaccine ' , Current neurology and neuroscience reports , vol. 18 , no. 7 , 43 . https://doi.org/10.1007/s11910-018-0851-5

Title: Narcolepsy Associated with Pandemrix Vaccine
Author: Sarkanen, Tomi; Alakuijala, Anniina; Julkunen, Ilkka; Partinen, Markku
Contributor: University of Helsinki, Department of Neurosciences
University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2018-07
Language: eng
Number of pages: 10
Belongs to series: Current neurology and neuroscience reports
ISSN: 1528-4042
URI: http://hdl.handle.net/10138/302445
Abstract: After the connection between AS03-adjuvanted pandemic H1N1 vaccine Pandemrix and narcolepsy was recognized in 2010, research on narcolepsy has been more intensive than ever before. The purpose of this review is to provide the reader with current concepts and recent findings on the Pandemrix-associated narcolepsy. After the Pandemrix vaccination campaign in 2009-2010, the risk of narcolepsy was increased 5- to 14-fold in children and adolescents and 2- to 7-fold in adults. According to observational studies, the risk of narcolepsy was elevated for 2 years after the Pandemrix vaccination. Some confounding factors and potential diagnostic biases may influence the observed narcolepsy risk in some studies, but it is unlikely that they would explain the clearly increased incidence in all the countries where Pandemrix was used. An increased risk of narcolepsy after natural H1N1 infection was reported from China, where pandemic influenza vaccination was not used. There is more and more evidence that narcolepsy is an autoimmune disease. All Pandemrix-associated narcolepsy cases have been positive for HLA class II DQB1*06:02 and novel predisposing genetic factors directly linking to the immune system have been identified. Even though recent studies have identified autoantibodies against multiple neuronal structures and other host proteins and peptides, no specific autoantigens that would explain the disease mechanism in narcolepsy have been identified thus far. There was a marked increase in the incidence of narcolepsy after Pandemrix vaccination, especially in adolescents, but also in young adults and younger children. All vaccine-related cases were of narcolepsy type 1 characterized by hypocretin deficiency in the central nervous system. The disease phenotype and the severity of symptoms varied considerably in children and adolescents suffering from Pandemrix-associated narcolepsy, but they were indistinguishable from the symptoms of idiopathic narcolepsy. Narcolepsy type 1 is most likely an autoimmune disease, but the mechanisms have remained elusive.
Subject: Narcolepsy
H1N1 vaccination
Vaccines
Pandemrix
Hypocretin
Orexin
2009 INFLUENZA VACCINE
TRIB2 AUTOANTIBODIES
H1N1 VACCINATION
CONFER RISK
CATAPLEXY
ANTIBODIES
ONSET
CHILDREN
ANTIGANGLIOSIDE
PROTECTION
3112 Neurosciences
3124 Neurology and psychiatry
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
10.1007_s11910_018_0851_5.pdf 765.3Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record