Tafti M, Nishino S, Aldrich M S, Liao W, Dement W C, Mignot E
Sleep Disorders Center, Department of Psychiatry, Stanford University, Palo Alto, California 94304, USA.
J Neurosci. 1996 Aug 1;16(15):4588-95. doi: 10.1523/JNEUROSCI.16-15-04588.1996.
Human narcolepsy is a neurological disorder known to be closely associated with HLA-DR2 and DQB1*0602. Because most autoimmune diseases are HLA-associated, a similar mechanism has been proposed for narcolepsy. However, neither systemic nor CNS evidence of an autoimmune abnormality has ever been reported. In this study, major histocompatibility (MHC) class I and class II expression was studied in the CNS of human and canine narcoleptics using immunohistochemistry and Northern analysis. Results indicated that canine narcolepsy is associated with a significant increase of MHC class II expression by the microglia. Moreover, the highest values were found between 3 and 8 months of age, strikingly concomitant to the development of narcolepsy in the canine model. In humans, class II expression was not found significantly different between control and narcoleptic subjects. This result could be explained by the old age of the subjects (69.86 +/- 5.31 and 68.36 +/- 4.74 years in narcoleptics and controls, respectively), because class II expression is significantly correlated with age in both humans and dogs. For the first time, this study demonstrated that the expression of MHC class II molecules in the CNS is age-dependent and that a consistent increase of their expression by the microglia might be critically involved in the development of narcolepsy.
人类发作性睡病是一种已知与HLA - DR2和DQB1*0602密切相关的神经系统疾病。由于大多数自身免疫性疾病都与HLA相关,因此有人提出发作性睡病也有类似机制。然而,从未有过关于自身免疫异常的全身性或中枢神经系统证据的报道。在本研究中,使用免疫组织化学和Northern分析研究了人类和犬类发作性睡病患者中枢神经系统中主要组织相容性复合体(MHC)I类和II类分子的表达。结果表明,犬类发作性睡病与小胶质细胞MHC II类分子表达显著增加有关。此外,在3至8个月龄时发现最高值,这与犬类模型中发作性睡病的发生明显同步。在人类中,对照组和发作性睡病患者之间未发现II类分子表达有显著差异。这一结果可以用受试者的年龄较大来解释(发作性睡病患者和对照组的年龄分别为69.86±5.31岁和68.36±4.74岁),因为II类分子表达在人类和犬类中均与年龄显著相关。本研究首次证明,中枢神经系统中MHC II类分子的表达与年龄有关,小胶质细胞中其表达的持续增加可能在发作性睡病的发生中起关键作用。