image: The autoimmune concept of H1N1 influenza-related narcolepsy involves four stages. (A) Stage I: In genetically susceptible individuals, anti-H1N1 vaccination triggers formation of antibodies that bind to the viral nucleoprotein and hypocretin receptor 2. (B) Stage II: After perforation of the blood-brain barrier, the antibodies leak into the brain tissue. (C) Stage III: Antibodies bind to the hypocretin receptor 2 on the surface of neurons and disrupt signaling either by direct blockade or by secondary depletion of hypocretin formation. (D) Stage IV: Disrupted hypocretin signaling results in clinical narcolepsy. This material relates to a paper that appeared in the July 1, 2015 issue of Science Translational Medicine, published by AAAS. The paper, by S. Sohail Ahmed at Novartis Vaccines Srl in Siena, Italy, and colleagues was titled, "Antibodies to influenza nucleoprotein cross-react with human hypocretin receptor 2." view more
Credit: [Credit: H. McDonald / <i>Science Translational Medicine </i>]