Tags

Type your tag names separated by a space and hit enter

Narcolepsy and H1N1 vaccination: a link?
Curr Opin Pulm Med. 2013 Nov; 19(6):587-93.CO

Abstract

PURPOSE OF REVIEW

A number of European countries have reported a dramatic increase in the rates of childhood narcolepsy with cataplexy in children immunized with a split-virion adjuvanted swine flu vaccine. Here, we review the strengths and weaknesses of these epidemiological studies and possible neuroimmunological mechanisms.

RECENT FINDINGS

Initial concerns of a 13-fold increased relative risk of narcolepsy were raised by the Scandinavian health protection agencies in 2010. Subsequent retrospective studies support these findings in Canada, France, Ireland, England and Denmark. The cases are predominantly young children who present with severe and rapid onset of cataplexy as well as narcolepsy often within a few weeks of vaccination. The proposed mechanism for postvaccination narcolepsy is one in which an environmental trigger causes or enhances an antibody-mediated autoimmune response in patients with a preexisting genetic susceptibility. However, there have not yet been any reports of specific autoimmunity, either antibody or T-cell-mediated.

SUMMARY

There is a strong association between narcolepsy and H1N1 vaccination. However, whether this reflects a true increase in affected individuals or a hastening of disease onset in individuals who would otherwise have developed narcolepsy later will become clear in the coming years. The pathological explanation of this association and narcolepsy is likely to be autoimmune, although supportive evidence is lacking.Video abstract available: See the Video Supplementary Digital Content 1 (http://links.lww.com/COPM/A9).

Authors+Show Affiliations

aNeuroimmunology Group, Nuffield Department of Clinical Neurosciences, Oxford University, Oxford bPaediatric Sleep Medicine Department, Evelina London and Kings College London, London, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

24048081

Citation

Thebault, Simon, et al. "Narcolepsy and H1N1 Vaccination: a Link?" Current Opinion in Pulmonary Medicine, vol. 19, no. 6, 2013, pp. 587-93.
Thebault S, Vincent A, Gringras P. Narcolepsy and H1N1 vaccination: a link? Curr Opin Pulm Med. 2013;19(6):587-93.
Thebault, S., Vincent, A., & Gringras, P. (2013). Narcolepsy and H1N1 vaccination: a link? Current Opinion in Pulmonary Medicine, 19(6), 587-93. https://doi.org/10.1097/MCP.0b013e328365af97
Thebault S, Vincent A, Gringras P. Narcolepsy and H1N1 Vaccination: a Link. Curr Opin Pulm Med. 2013;19(6):587-93. PubMed PMID: 24048081.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Narcolepsy and H1N1 vaccination: a link? AU - Thebault,Simon, AU - Vincent,Angela, AU - Gringras,Paul, PY - 2013/9/20/entrez PY - 2013/9/21/pubmed PY - 2014/6/4/medline SP - 587 EP - 93 JF - Current opinion in pulmonary medicine JO - Curr Opin Pulm Med VL - 19 IS - 6 N2 - PURPOSE OF REVIEW: A number of European countries have reported a dramatic increase in the rates of childhood narcolepsy with cataplexy in children immunized with a split-virion adjuvanted swine flu vaccine. Here, we review the strengths and weaknesses of these epidemiological studies and possible neuroimmunological mechanisms. RECENT FINDINGS: Initial concerns of a 13-fold increased relative risk of narcolepsy were raised by the Scandinavian health protection agencies in 2010. Subsequent retrospective studies support these findings in Canada, France, Ireland, England and Denmark. The cases are predominantly young children who present with severe and rapid onset of cataplexy as well as narcolepsy often within a few weeks of vaccination. The proposed mechanism for postvaccination narcolepsy is one in which an environmental trigger causes or enhances an antibody-mediated autoimmune response in patients with a preexisting genetic susceptibility. However, there have not yet been any reports of specific autoimmunity, either antibody or T-cell-mediated. SUMMARY: There is a strong association between narcolepsy and H1N1 vaccination. However, whether this reflects a true increase in affected individuals or a hastening of disease onset in individuals who would otherwise have developed narcolepsy later will become clear in the coming years. The pathological explanation of this association and narcolepsy is likely to be autoimmune, although supportive evidence is lacking.Video abstract available: See the Video Supplementary Digital Content 1 (http://links.lww.com/COPM/A9). SN - 1531-6971 UR - https://www.unboundmedicine.com/medline/citation/24048081/Narcolepsy_and_H1N1_vaccination:_a_link L2 - https://doi.org/10.1097/MCP.0b013e328365af97 DB - PRIME DP - Unbound Medicine ER -