Narcolepsy type 1 (NT1) is caused by a loss of hypocretin/orexin transmission. Risk factors include pandemic 2009 H1N1 influenza A infection and immunization with Pandemrix®. Here, we dissect disease mechanisms and interactions with environmental triggers in a multi-ethnic sample of 6,073 cases and 84,856 controls. We fine-mapped GWAS signals within HLA (DQ0602, DQB1*03:01 and DPB1*04:02) and discovered seven novel associations (CD207, NAB1, IKZF4-ERBB3, CTSC, DENND1B, SIRPG, PRF1). Significant signals at TRA and DQB1*06:02 loci were found in 245 vaccination-related cases, who also shared polygenic risk. T cell receptor associations in NT1 modulated TRAJ*24, TRAJ*28 and TRBV*4-2 chain-usage. Partitioned heritability and immune cell enrichment analyses found genetic signals to be driven by dendritic and helper T cells. Lastly comorbidity analysis using data from FinnGen, suggests shared effects between NT1 and other autoimmune diseases. NT1 genetic variants shape autoimmunity and response to environmental triggers, including influenza A infection and immunization with Pandemrix®.
FörderungenGerman-Academic Exchange Service (DAAD) Einstein Center for Neurosciences NSFC Ministry of Science and Technology Swedish medical product agency Jazz Pharmaceuticals National Institute of Mental Health GlaxoSmithKline Stanford University through the Stanford Graduate Fellowship program United States Department of Defense (DoD) through the National Defense Science & Engineering Graduate Fellowship (NDSEG) program Jalmari and Rauha Ahokas Foundation Instrumentarium Science Foundation Orion Farmos Research Foundation Finnish Cultural Foundation Sigrid Juselius Foundation Academy of Finland wake-up narcolepsy Academy of Finland (AKA)
BBMRI-ERIC operations in Finland Finnish Biobank Cooperative-FINBB Finnish Clinical Biobank Tampere Biobank Borealis of Northern Finland THL Biobank NIMH Novartis AG Sanofi US Services Inc. GlaxoSmithKline Intellectual Property Development Ltd. Merck Sharp Dohme Corp. Genentech Inc. Biogen MA Inc. Stanford University - Business Finland Boehringer Ingelheim