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Narcolepsy is widely believed to have an autoimmune basis, but conventional i mmunological approaches have failed to detect a serum autoantibody marker. Since cholinergic hyperactivity is a feature of narcolepsy cataplexy, we transferre d IgG from nine patients with narcolepsy and nine healthy controls to mice and a ssessed the effect on smooth muscle contractile responses to cholinergic stimula tion. IgG from all narcolepsy patients significantly enhanced bladder contractil e responses to the muscarinic agonist carbachol and to neuronally released acety lcholine compared with control IgG (p < 0 0001) , whereas contraction of the s ympathetically innervated vas deferens was unaltered. Our findings provide direc t evidence for the autoimmune hypothesis of narcolepsy.
Since cholinergic hyperactivity is a feature of narcolepsy-cataplexy, we transferre d IgG from nine patients with narcolepsy and nine healthy controls to mice and a sounded the effect on smooth muscle contractile responses to cholinergic stimuli. IgG from all narcolepsy patients significantly enhanced bladder contractile e responses to the muscarinic agonist carbachol and to neuronally released acety lcholine compared with control IgG (p <0. 0001), while contraction of the s ympathetically innervated vas deferens was unaltered. Our findings provide direc t evidence for the autoimmune hypothesis of narcolepsy.