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Classical complement pathway factor alterations in narcolepsy

Published online by Cambridge University Press:  17 January 2022

Hande Yüceer
Affiliation:
Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
Duygu Gezen Ak
Affiliation:
Brain and Neurodegenerative Disorders Research Laboratories, Department of Medical Biology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
Gülçin Benbir Şenel
Affiliation:
Sleep Laboratory, Department of Neurology, Cerrahpaşa Faculty of Medicine, Istanbul University Cerrahpaşa, Istanbul, Turkey
Erdinç Dursun
Affiliation:
Brain and Neurodegenerative Disorders Research Laboratories, Department of Medical Biology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey Department of Neuroscience, Institute of Neurological Sciences, Istanbul University-Cerrahpaşa, Istanbul, Turkey
Vuslat Yılmaz
Affiliation:
Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
Derya Karadeniz
Affiliation:
Sleep Laboratory, Department of Neurology, Cerrahpaşa Faculty of Medicine, Istanbul University Cerrahpaşa, Istanbul, Turkey
Erdem Tüzün
Affiliation:
Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
Cem İsmail Küçükali*
Affiliation:
Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
*
Author for correspondence: Cem İsmail Küçükali, Email: cemsmile@gmail.com

Abstract

Objective:

Narcolepsy is a chronic sleep disorder long hypothesised to be an autoimmune disease. Complement-mediated immune mechanisms have not been investigated in detail in narcolepsy. Our aim was to establish the significance of classical pathway activation in narcolepsy.

Methods:

Sera of 42 narcolepsy patients and 26 healthy controls were screened with ELISA to determine the levels of C1q, C3a, C4d and complement component 4 binding protein (C4BP). A home-made ELISA method was developed to detect antibodies to C4BP-alpha (anti-C4BPA). The correlation between complement levels and clinical findings was examined.

Results:

C1q levels were significantly higher in narcolepsy patients while C4d and C4BP levels were significantly lower compared to healthy controls. C3a levels were comparable among patients and controls. Eleven narcolepsy patients showed serum anti-C4BPA levels. Total rapid eye movements (REM) time, sleep onset latency, REM sleep latency, sleep activity, percentage of wakefulness after sleep onset and Epworth sleepiness scale scores were correlated with levels of different complement factors.

Conclusion:

Complement-mediated immune mechanisms might partake in narcolepsy pathogenesis. The precise role of autoantibodies on complement level alterations needs to be investigated. Levels of complement factors and degradation products may potentially be utilised as biomarkers to predict the clinical severity of narcolepsy.

Information

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Scandinavian College of Neuropsychopharmacology

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