While parents of newborns may sometimes claim to have narcolepsy, this mysterious disease has presented a challenge to medical researchers for some time. Individuals with narcolepsy experience the frequent and sudden episodes of sleep during daytime hours. While sleep deprived parents of newborns know why they are falling asleep, those with narcolepsy and their doctors have been left in the dark. Recent research by University of Copenhagen scientists sheds some light into the mechanisms underlying the disease. Autoreactive CD8+ T cells appear to be activated against the nerves which control our sleep wake cycle.
By comparing blood from normal individuals without narcolepsy with blood from those with narcolepsy, they discovered that the narcolepsy participants had immune system cells called CD8+ cytotoxic T cells which had been activated against the very cells that control our sleep wake cycle. Past research had uncovered CD4+ T cells activated against the same nerve cells, but this further confirmed that narcolepsy is likely another form of autoimmunity. The CD8+ T cells are immune cells whose normal function is to kill virus infected cells and prevent further viral spread. In narcolepsy, they appear to be killing nerve cells that produce a hormone called hypocretin, our main sleep-wake regulator.
Those doctors who treat mold toxicity are not surprised by this finding. Why not? We are reminded on a regular basis, as we do HLA genetic testing on our mold toxic patients, that certain HLA genotypes are more prone to develop narcolepsy. The HLA genes refer to genes which help our immune systems recognize and respond to foreign invaders. As a genomic aware physician, I am also accustomed to various gene SNPs (single nucleotide polymorphisms) increasing the risk of various diseases. For narcolepsy, I occasionally inform a patient of the predisposition to narcolepsy and they respond by telling me about 1 or 2 other family members who already have narcolepsy. Always fascinating and rewarding to help my patients understand not just their own health but that of their other family members.
Despite causing great disruptions in their lives, narcolepsy sufferers only had a few symptom-based therapies that sometimes helped and sometimes did not. Root cause therapy was not available. The Copenhagen researchers only speculate on potential therapies at this time, but are hopeful that this knowledge of the actual disease process can lead to therapies that modulate the immune system or address the initial autoimmune trigger. While we wait for further research, functional MD’s like myself will continue to search out triggers for autoimmune and remove them while using many natural therapies to modulate our patient’s immune systems. Triggers may include mold toxins, heavy metals, chronic viral infections, or even every day foods. Natural therapies may include curcumin and other NrF2 enhancers or NfKappaB inhibitors. Until further light is provide, we will keep pressing towards healthier more abundant lives for our patients.
Natasja Wulff Pedersen, Anja Holm, Nikolaj Pagh Kristensen, Anne-Mette Bjerregaard, Amalie Kai Bentzen, Andrea Marion Marquard, Tripti Tamhane, Kristoffer Sølvsten Burgdorf, Henrik Ullum, Poul Jennum, Stine Knudsen, Sine Reker Hadrup, Birgitte Rahbek Kornum. CD8 T cells from patients with narcolepsy and healthy controls recognize hypocretin neuron-specific antigens. Nature Communications, 2019; 10 (1) DOI: 10.1038/s41467-019-08774-1