Antibody Affinity Against 2009 A/H1N1 Influenza and Pandemrix Vaccine Nucleoproteins Differs Between Childhood Narcolepsy Patients and Controls.

Abstract

Increased narcolepsy incidence was observed in Sweden following the 2009 influenza vaccination with Pandemrix®. A substitution of the 2009 nucleoprotein for the 1934 variant has been implicated in narcolepsy development. The aims were to determine (a) antibody levels toward wild-type A/H1N1-2009[A/California/04/2009(H1N1)] (NP-CA2009) and Pandemrix-[A/Puerto Rico/8/1934(H1N1)] (NP-PR1934) nucleoproteins in 43 patients and 64 age-matched controls; (b) antibody affinity in reciprocal competitive assays in 11 childhood narcolepsy patients compared with 21 age-matched controls; and (c) antibody levels toward wild-type A/H1N1-2009[A/California/04/2009(H1N1)] (H1N1 NS1), not a component of the Pandemrix vaccine. In vitro transcribed and translated 35S-methionine-labeled H1N1 influenza A virus proteins were used in radiobinding reciprocal competition assays to estimate antibody levels and affinity (Kd). Childhood patients had higher NP-CA2009 (p = 0.0339) and NP-PR1934 (p = 0.0246) antibody levels compared with age-matched controls. These childhood controls had lower NP-CA2009 (p = 0.0221) and NP-PR1934 (p = 0.00619) antibodies compared with controls 13 years or older. In contrast, in patients 13 years or older, the levels of NP-PR1934 (p = 0.279) and NP-CA2009 (p = 0.0644) antibodies did not differ from the older controls. Childhood antibody affinity (Kd) against NP-CA2009 was comparable between controls (68 ng/mL) and patients (74 ng/mL; p = 0.21) with NP-CA2009 and NP-PR1934 displacement (controls: 165 ng/mL; patients: 199 ng/mL; p = 0.48). In contrast, antibody affinity against NP-PR1934 was higher in controls with either NP-PR1934 (controls: 9 ng/mL; patients: 20 ng/mL; p = 0.0031) or NP-CA2009 (controls: 14 ng/mL; patients: 23 ng/mL; p = 0.0048). A/H1N1-NS1 antibodies were detected in 0/43 of the narcolepsy patients compared with 3/64 (4.7%) controls (p = 0.272). Similarly, none (0/11) of the childhood patients and 1/21 (4.8%) of the childhood controls had A/H1N1-NS1 antibodies. The higher antibody affinities against NP-PR1934 in controls suggest better protection against wild-type virus. In contrast, the reduced NP-PR1934 antibody affinities among childhood narcolepsy patients suggest poor protection from the wild-type A/H1N1 virus and possibly increased risk for viral damage.

• Authors: Alexander Lind, Eva Freyhult, Anita Ramelius, Tomas Olsson, Lisen Arnheim-Dahlström, Favelle Lamb, Mohsen Khademi, Aditya Ambati, Markus Maeurer, Izaura Lima Bomfim, Katharina Fink, Malin Fex, Carina Törn, Helena Elding Larsson, Åke Lernmark
• Journal: Viral immunology (Viral Immunol) Vol. 30 Issue 8 Pg. 590-600 (10 2017) ISSN: 1557-8976 [Electronic] United States
• PMID: 28796576 (Publication Type: Journal Article)

Chemical References

• Antibodies, Viral
• Influenza Vaccines
• Nucleocapsid Proteins
• Nucleoproteins
• Viral Nonstructural Proteins
• pandemrix

Topics

• Adolescent
• Antibodies, Viral (blood)
• Antibody Affinity (immunology)
• Child
• Female
• Humans
• Influenza A Virus, H1N1 Subtype (immunology)
• Influenza Vaccines (adverse effects, immunology, therapeutic use)
• Influenza, Human (therapy)
• Male
• Narcolepsy (epidemiology, immunology)
• Nucleocapsid Proteins (genetics, immunology)
• Nucleoproteins (genetics, immunology)
• Radioligand Assay
• Sweden (epidemiology)
• Vaccination (adverse effects)
• Viral Nonstructural Proteins (genetics)