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Basic Immunology


Since narcolepsy is caused by an allergy-  you also need to learn a little about immunology.


When the immune system detects a foreign protein in your body, it sends antibodies out to start the immune process.   Antibody molecules go and find the invading proteins and attach to them.  They then act as flares, signalling for assistance.   The immune system then sends out scavenger cells to dispose of the protein, sort of like a tow truck.


There are five different kinds of antibodies that have different purposes and properties.   What they have in common is the epitope, the protein sequence that binds them to the target.   If you think of epitope like a key.... then the Ig types are keychains.  You can put the same shape key on five different keychains.    Those are the isotypes, IgA, IgD, IgE, IgG, and IgM (Ig stands for immunoglobulin).  So you can produce five different kinds of antibodies to a protein.

  • IgE produces the commonly known allergies.   They are bound to cell membranes and release histamine when the allergen comes in contact with the cell.  This triggers a rapid immune response.   These basically cause inflammation reactions, asthma, hay fever, hives, etc.  The most violent reaction is anaphalaxis, like peanut and shellfish allergies.   This is the one that allergy skin tests measure.

  • IgD is bound to cell membranes of immature immune cells.

  • IgM is a rapid response circulating antibody which appears before IgG.

  • IgA circulates in the blood. It is too big to get into the brain though.

  • IgG is a long living circulating antibody.  It is smaller and can pass into the brain and cross the placenta.   It's associated with delayed food allergies.   

Autoimmunity happens when similarity between the foreign and host proteins results in the antibody  mistakenly attacking the host tissue instead.  


Celiac disease is an autoimmune disorder caused by antibodies to gliadin, a specific gluten protein found in grains such as wheat, barley and rye.   IgA anti-gliadin antibodies are produced after ingestion of gluten.   IgA antigliadin may also bind to epithelial cells.  They attack the gluten, but also mistakenly bind to and create an autoimmune reaction in the cells of the small intestine causing severe damage.   If that happens in the skin instead of the intestine, it causes dermatitis herpetiformis, a nasty blister rash.


Celiac is IgA antigliadin.  IgG antigliadin is what I think binds to the neurons, clogs them up, and causes the problems in narcolepsy.


The thing about it is, you can produce one without the other, or a combination.  IgA deficiency is common, my father only produces IgG.  The reason I am stressing this is because there is only one doctor in the world who thinks that IgG antigliadin is pathogenic (oops, two.). Celiac tests are specific for intestinal tissue antibodies and usually DO NOT include an assay for IgG antigliadin.  If you get tested by a gastroenterologist and are negative for IgA, they will tell you that you are not gluten sensitive.   




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