A study of T CD4, CD8 and B lymphocytes in narcoleptic patients

A study of T CD4, CD8 and B lymphocytes in narcoleptic patients

Alternative title Estudo dos linfócitos T CD4, CD8 e B em pacientes com narcolepsia
Author Coelho, Fernando Morgadinho Santos Autor UNIFESP Google Scholar
Pradella-Hallinan, Márcia Lurdes de Cássia Autor UNIFESP Google Scholar
Alves, Gabriela Rodrigues Autor UNIFESP Google Scholar
Bittencourt, Lia Rita Azeredo Autor UNIFESP Google Scholar
Pedrazzoli, Mario Autor UNIFESP Google Scholar
Moreira, Fábio Autor UNIFESP Google Scholar
Tufik, Sergio Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Narcolepsy is characterized by excessive daytime sleep and cataplexy. Little is known about the possible difference in pathophysiology between patients with or without cataplexy. OBJECTIVE: To quantify T CD4, T CD8 and B lymphocytes in subgroups of patients with narcolepsy and the presence or absence of the HLA-DQB1*0602 allele between groups. METHOD: Our study was prospective and controlled (transversal) with 22 narcoleptic patients and 23 health control subjects. Patients underwent an all-night polysomnographic recording (PSG) and a multiple sleep latency Test (MSLT). The histocompatibility antigen allele (HLA-DQB1*0602), T CD4, CD8 and B lymphocytes were quantified in control subjects and in narcoleptics. RESULTS: The HLA-DQB1*0602 allele was identified in 10 (62.5%) of our 16 cataplexic subjects and in 2 (33.3%) of the 6 patients without cataplexy (p=0.24). In control subjects, HLA-DQB1*0602 allele was identified in 5 (20%). A significant decrease in T CD4 and B lymphocytes was found in narcoleptic patients with recurrent cataplexy when compared with our patients without cataplexy. CONCLUSION: Autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis were associated with a decrease in sub-group of T CD4 and B lymphocytes. A drop in B lymphocytes count in reumathoid arthritis might, it is posited, be correlated to the presence of HLA-DRB1 allele along with an overall worsened outcome of the affliction. The theory of an increase in consumption of B lymphocytes over the maturation phase has likewise been put forward. Our study reinforces the view that narcolepsy should be considered from an immunological perspective.

A narcolepsia é caracterizada por sonolência excessiva diurna e cataplexia. Pouco se sabe sobre as diferenças fisiopatológicas entre pacientes com e sem cataplexia. OBJETIVO: Quantificar os linfócitos T CD4, T CD8 e B e a presença do alelo HLA-DQB1*0602 nos subgrupos de pacientes com narcolepsia. MÉTODO: O estudo foi prospectivo e controlado (transversal) com 22 pacientes portadores de narcolepsia e 23 sujeitos controle. Os pacientes realizaram polissonografia (PSG) de noite inteira e teste de múltiplas latências do sono (TMLS). O alelo do antígeno de histocompatibilidade (HLA-DQB1*0602) e os linfócitos T CD4, T CD8 e B foram quantificados nos pacientes e sujeitos controle. RESULTADOS: O alelo HLA-DQB1*0602 foi encontrado em 10 (62,5%) dos 16 pacientes com cataplexia e em 2 (33,3%) dos 6 pacientes sem cataplexia (p=0,24). Nos sujeitos controle, o alelo HLA-DQB1*0602 foi encontrado em 5 sujeitos (20%). Um aumento significativo de linfócitos T CD4 e uma diminuição de linfócitos B foi observado no grupo de pacientes com cataplexia freqüente quando comparado ao grupo de pacientes sem cataplexia. CONCLUSÃO: Doenças auto-imunes como lupus eritematoso sistêmico e artrite reumatóide têm sido associadas com diminuição de linfócitos T CD4 e B. Na artrite reumatóide, diminuição de linfócitos B e presença do alelo HLA-DRB1 tem sido associada a pior evolução. Para essa doença, a teoria de um maior consumo de linfócitos B em suas fases de maturação tem sido aventada. Os achados do nosso estudo reforçam a teoria imunológica da narcolepsia.
Keywords narcolepsy
HLA-DQB1*0602 allele
alelo HLA-DQB1*0602
Language English
Date 2007-06-01
Published in Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 65, n. 2b, p. 423-427, 2007.
ISSN 0004-282X (Sherpa/Romeo)
Publisher Academia Brasileira de Neurologia - ABNEURO
Extent 423-427
Origin http://dx.doi.org/10.1590/S0004-282X2007000300011
Access rights Open access Open Access
Type Article
SciELO ID S0004-282X2007000300011 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/3718

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