ArticlePloS one2014
Antigenic differences between AS03 adjuvanted influenza A (H1N1) pandemic vaccines: implications for pandemrix-associated narcolepsy risk.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Safety of Influenza A H1N1pdm09 Vaccines: An Overview of Systematic Reviews.Frontiers in immunology · 2021Pooled it
- Oil-in-water emulsion adjuvants for pediatric influenza vaccines: a systematic review and meta-analysis.Nature communications · 2020Pooled it
- Fiber type-specific expression of LACTB leverages a function in oxidative metabolism.Histochemistry and cell biology · 2026Article
- Cytokines in narcolepsy type 1: pathogenic relevance, biomarker potential, and future directions.Frontiers in neurology · 2026Review
- Narcolepsy: Pathophysiology, Diagnosis, Management, and Future Directions, a Narrative Review.Brain and behavior · 2025Review
- Human genetics of responses to vaccines.Clinical and experimental immunology · 2025Review
- Avian Influenza Virus A(H5Nx) and Prepandemic Candidate Vaccines: State of the Art.International journal of molecular sciences · 2024Review
- Role of Placental Glucose Transporters in Determining Fetal Growth.Reproductive sciences (Thousand Oaks, Calif.) · 2022Review
- The 2009 H1N1 pandemic, vaccine-associated narcolepsy, and the politics of risk and harm.Health (London, England : 1997) · 2022Article
- Narcolepsy and H1N1 influenza immunology a decade later: What have we learned?Frontiers in immunology · 2022Review
- Regulation of PaRBOH1-mediated ROS production in Norway spruce by CaFrontiers in plant science · 2022Article
- Hepsin regulates TGFβ signaling via fibronectin proteolysis.EMBO reports · 2021Article
- Update on Influenza Vaccines: Needs and Progress.The journal of allergy and clinical immunology. In practice · 2021Article
- Enhanced influenza A H1N1 T cell epitope recognition and cross-reactivity to protein-O-mannosyltransferase 1 in Pandemrix-associated narcolepsy type 1.Nature communications · 2021Observational
- A/H1N1 hemagglutinin antibodies show comparable affinity in vaccine-related Narcolepsy type 1 and control and are unlikely to contribute to pathogenesis.Scientific reports · 2021Article
- Vaccines for COVID-19.Clinical and experimental immunology · 2020Review
- Mass Spectrometric Characterization of Narcolepsy-Associated Pandemic 2009 Influenza Vaccines.Vaccines · 2020Article
- Sourdough Fermentation Degrades Wheat Alpha-Amylase/Trypsin Inhibitor (ATI) and Reduces Pro-Inflammatory Activity.Foods (Basel, Switzerland) · 2020Article
- Physiology of gangliosides and the role of antiganglioside antibodies in human diseases.Cellular & molecular immunology · 2020Review
- No evidence of autoimmunity to human OXJournal of translational autoimmunity · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNarcolepsy results from immune-mediated destruction of hypocretin secreting neurons in hypothalamus, however the triggers and disease mechanisms are poorly understood. Vaccine-attributable risk of narcolepsy reported so far with the AS03 adjuvanted H1N1 vaccination Pandemrix has been manifold compared to the AS03 adjuvanted Arepanrix, which contained differently produced H1N1 viral antigen preparation. Hence, antigenic differences and antibody response to these vaccines were investigated. METHODS AND
findingsIncreased circulating IgG-antibody levels to Pandemrix H1N1 antigen were found in 47 children with Pandemrix-associated narcolepsy when compared to 57 healthy children vaccinated with Pandemrix. H1N1 antigen of Arepanrix inhibited poorly these antibodies indicating antigenic difference between Arepanrix and Pandemrix. High-resolution gel electrophoresis quantitation and mass spectrometry identification analyses revealed higher amounts of structurally altered viral nucleoprotein (NP) in Pandemrix. Increased antibody levels to hemagglutinin (HA) and NP, particularly to detergent treated NP, was seen in narcolepsy. Higher levels of antibodies to NP were found in children with DQB1*06:02 risk allele and in DQB1*06:02 transgenic mice immunized with Pandemrix when compared to controls.
conclusionsThis work identified 1) higher amounts of structurally altered viral NP in Pandemrix than in Arepanrix, 2) detergent-induced antigenic changes of viral NP, that are recognized by antibodies from children with narcolepsy, and 3) increased antibody response to NP in association of DQB1*06:02 risk allele of narcolepsy. These findings provide a link between Pandemrix and narcolepsy. Although detailed mechanisms of Pandemrix in narcolepsy remain elusive, our results move the focus from adjuvant(s) onto the H1N1 viral proteins.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.