T cell receptor associations in NT1 modulated TRAJ*24, TRAJ*28 and TRBV*4-2 chain-usage. Significant signals at TRA and DQB1*06:02 loci were found in 245 vaccination-related cases, who also shared polygenic risk. 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). Here, we dissect disease mechanisms and interactions with environmental triggers in a multi-ethnic sample of 6,073 cases and 84,856 controls. Risk factors include pandemic 2009 H1N1 influenza A infection and immunization with Pandemrix®. Narcolepsy type 1 (NT1) is caused by a loss of hypocretin/orexin transmission. Nature Communications volume 14, Article number: 2709 ( 2023) Narcolepsy risk loci outline role of T cell autoimmunity and infectious triggers in narcolepsy
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