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Sleep Europe 2026 | Immune cells in the hypothalamus in narcolepsy type 1: evidence for autoimmunity
Ling Shan, PhD, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands, discusses findings supporting the autoimmune hypothesis of narcolepsy type 1 (NT1). Dr Shan explains that while genetic and environmental evidence point to NT1 being autoimmune, previous post-mortem and imaging studies found no direct evidence in the human brain. He highlights his group’s finding of lymphocytes in the hypothalamus of patients with NT1, which may reflect an early autoimmune attack or a response to hypocretin cell loss, and could open new avenues for future treatments. This interview took place at Sleep Europe 2026 in Maastricht, the Netherlands.
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Transcript
This is a long-hanging research question for us because everyone, also because of multiple evidence like genetic environment, pointing out narcolepsy is an autoimmune disorder, especially narcolepsy type 1. However, no one ever actually sees a direct evidence from the human brain. Several groups tried post-mortem work and didn’t see astrocyte or glial changes or not consistent changes. And also the neuroimaging data recently revealed that there is no microglia activation through the PET scanning...
This is a long-hanging research question for us because everyone, also because of multiple evidence like genetic environment, pointing out narcolepsy is an autoimmune disorder, especially narcolepsy type 1. However, no one ever actually sees a direct evidence from the human brain. Several groups tried post-mortem work and didn’t see astrocyte or glial changes or not consistent changes. And also the neuroimaging data recently revealed that there is no microglia activation through the PET scanning. First of all, these immune lymphocytes cells are present in the brain tissue of patients, especially in the hypothalamic region, which is a strong support of the autoimmune or immune process having happened in this area. Well, in terms of clinical practice, I’m not a clinical doctor, but from our perspective, we believe this is an early sign of autoimmune attack happening or because of the hypocretin cell loss caused this immune cell activation. So from our perspective, this could be a potential avenue for new future treatments.
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