目的:1型发作性睡病(NT1)归因于脑脊液食欲素缺乏,并被认为与自身免疫有关。某些发作性睡病伴猝倒患者的血清中抗Tribbles同源物2(TRIB2)自身抗体的水平升高。此外,向发作性睡病患者注射抗TRIB2抗体阳性的血清免疫球蛋白可诱导下丘脑神经元丢失和睡眠模式改变。因此,我们假设抗TRIB2抗体与发作性睡病之间存在潜在关联.为了测试这种可能性,我们使用基于细胞的测定法(CBA)和酶联免疫吸附测定法(ELISA)检测中国发作性睡病患者中是否存在抗TRIB2抗体.
方法:我们纳入了68例NT1患者;39例其他中枢性嗜睡障碍患者;43例健康对照(HCs)。使用CBA和常规ELISA检测患者血清中的抗TRIB2抗体水平。
结果:CBA用于检测中国发作性睡病患者的血清抗TRIB2抗体,结果是阴性。然而,当使用ELISA时,只有2例NT1患者的TRIB2抗体滴度高于HCs的平均滴度+2SD.
结论:在我们的研究中,ELISA鉴定了发作性睡病患者血清中的TRIB2自身抗体,而CBA未能证明它们。与我们的假设相反,这一有趣的发现值得进一步研究,以阐明TRIB2和NT1之间的潜在关联.探索TRIB2自身抗体在发作性睡病中的意义以及ELISA和CBA之间的不同结果可以提供重要的见解。
OBJECTIVE: Narcolepsy type 1 is attributed to a deficiency in cerebrospinal fluid orexin and is considered linked to autoimmunity. The levels of anti-Tribbles homolog 2 (TRIB2) autoantibodies are elevated in the sera of some patients with narcolepsy with cataplexy. Additionally, injecting mice with serum immunoglobulin from patients with narcolepsy with positive anti-TRIB2 antibodies can induce hypothalamic neuron loss and alterations in sleep patterns. Consequently, we hypothesized the existence of a potential association between anti-TRIB2 antibodies and narcolepsy. To test this possibility, we used cell-based assays (CBAs) and enzyme-linked immunosorbent assays (ELISAs) to detect the presence of anti-TRIB2 antibodies in Chinese patients with narcolepsy.
METHODS: We included 68 patients with narcolepsy type 1, 39 patients with other central disorders of hypersomnolence, and 43 healthy controls. A
CBA and a conventional ELISA were used to detect anti-TRIB2 antibody levels in patients\' sera.
RESULTS: CBA was used to detect serum anti-TRIB2 antibodies in Chinese patients with narcolepsy, and the results were negative. However, when the ELISA was used, only 2 patients with narcolepsy type 1 had TRIB2 antibody titers higher than the mean titer plus 2 standard deviations of the healthy controls.
CONCLUSIONS: In our study, ELISA identified TRIB2 autoantibodies in sera of patients with narcolepsy where
CBA failed to demonstrate them. Contrary to our hypothesis, this intriguing finding deserves further research to elucidate the potential association between TRIB2 and narcolepsy type 1. Exploring the implications of TRIB2 autoantibodies in narcolepsy and disparate outcomes between ELISA and
CBA could provide crucial insights.
BACKGROUND: Zhong X, Yuan Y, Zhan Q, et al. Cell-based vs enzyme-linked immunosorbent assay for detection of anti-Tribbles homolog 2 autoantibodies in Chinese patients with narcolepsy. J Clin Sleep Med. 2024;20(6):941-946.