ELISA antibodies to cysticerci of Taenia solium in human populations in New Guinea, Oceania, and Southeast Asia

The presence of ELISA antibodies to cysticerci of Taenia solium was surveyed in populations of New Guinea, Micronesia, and several areas of Southeast Asia. It is confirmed that cysticercosis in New Guinea remains limited to the primary Wissel Lakes focus in Irian Jaya, where the disease was introduced by the importation of infected pigs, and that it has not spread to populations east or south of the Wissel Lakes, or to Papua New Guinea. On the island of Bali, Indonesia, 21% of sera were positive from one village where pigs are especially numerous, whereas in Sumatra, Indonesia, only 3%-4% of sera were positive. In Singapore, there was a higher proportion of positive sera among the Chinese (13%) than among the Indian (5%) or Malay (3%) Moslems. From 3 to 13% of sera from populations in Micronesia, Burma, Vietnam, and the Philippines were also found to react with cysticercus antigen. However, the problem of incomplete ELISA specificity raises the possibility that in areas not known to be endemic for T. solium, seropositive results could represent either subclinical infection with cysticerci or crossreactivity to other parasitic infections.

Monoclonal antibodies to central nervous system antigens

Thirty monoclonal antibodies produced by mouse hybrid myelomas which react with antigens in hamster or mouse nervous system tissues were derived. Using these antibodies as probes with indirect immunofluorescence and immunoperoxidase techniques, we can selectively identify by morphological criteria many of the structural components of the brain seen at a light-microscopic level, including the neutrophil, neuronal cytoplasm, nuclei, axons, astrocytes and ependyma. Some of the antibodies display cytoskeletal and filamentous structures, including intermediate filaments, microfilaments, neurofilaments, glial and ependymal filaments. The specificity to neural tissue components of these hybridoma antibodies was assessed by their reactivity to mouse and hamster non-neural tissues and selected mouse, hamster, rat and human cultured cell lines. Of the 30 clones analyzed, specificity ranged from 3 clones reacting only with grey matter of mouse and hamster brain, one clone reacting only with axons in animal and human brain, to 19 clones reactive with both neural and non-neural tissue components.

Creutzfeldt-Jakob disease in an adolescent

A 16-year-old boy was stricken with a progressive neurologic disorder characterized primarily by dementia progressing to severe neurologic debility in 12 months and death 28 months following the first symptoms. Pathologic examination showed a spongiform encephalopathy, consistent witha clinical diagnosis of Creutzfeldt-Jakob disease (CJD). The noteworthy features of the case are the age of onset, the somewhat prolonged course an the amount of white matter change. These are discussed within the frame of reference of CJD and the spongiform encephalopathies of infancy and childhood. Animal inoculation studies employing post-mortem embalmed brain as inoculum are currently in progress to determine the transmissibility of this patient's disease.

Virus detection by nucleic acid hybridization: examination of normal and ALS tissues for the presence of poliovirus

A nucleic acid hybridization assay was developed as a sensitive assay for the presence of poliovirus RNA in human tissue. The assay could detect the presence of an average of one poliovirus per 200 cells. A method for determining the extent of degradation of the tissue RNA was developed and used to show that a significant fraction of human central nervous system (CNS) autopsy material contains highly degraded RNA which is unsuitable for hybridization studies. A total of 15 different control and amyotrophic lateral sclerosis tissues were assayed for the presence of poliovirus-like RNA. Virus RNA was detected in one of the control tissues and in none of the ALS tissues.

The familial occurrence of Creutzfeldt-Jakob disease and Alzheimer's disease

We have analysed the familial occurrence of Creutzfeldt-Jakob disease (CJD) in 27 families selected from a total of 73 families. Fifteen per cent of all cases of CJD have a family history of disease consistent with autosomal dominant transmission. The onset of disease in familial cases is significantly earlier than in sporadic cases. A maternal effect was not found, nor was there evidence for prenatal vertical transmission of the virus. Temporal and spatial separations between affected members demonstrates that incubation periods ranging at least from one to four decades are to be expected. Affected siblings tend to die at the same age, and not at the same time, which is consistent with some form of vertical transmission (either prenatal or early postnatal), assuming rather uniform incubation periods. CJD occurred in four families in members related by marriage, evidence in favour of horizontal or common source transmission in occasional cases. The familial occurrence of CJD and Alzheimer's disease (AD) were compared using data on 52 families with AD. The age at death and duration of disease in familial AD is greater than in familial CJD. Familial AD also occurs in a pattern of autosomal dominant transmission, without maternal effect. There were four families with AD in which one or more members died from CJD. There were an additional 17 families with AD in which one or more members presented with clinical features resembling CJD. Although virus causing an experimental spongiform encephalopathy was isolated from the brain of two cases of familial AD, most cases of sporadic and familial AD tested failed to cause disease when brain tissue was inoculated into nonhuman primates. The precise mechanism of spread of the virus in familial CJD remains unknown. The results of the present study are consistent with the hypothesis of a genetically inherited susceptibility to infection which is acquired in early infancy or childhood. Other proposed mechanisms such as prenatal vertical transmission or a common environmental source of infection seem less likely.

Brain destruction alone does not elevate brain aluminum

Graphite furnace atomic-absorption spectroscopy was used to measure aluminum concentrations in brain samples from 33 patients dying from a variety of neurologic diseases. Four samples from patients dying of nonneurologic causes also were studied. Nine samples (one from each of nine patients) of Creutzfeldt-Jakob disease brain contained normal amounts of aluminum. Aluminum was increased in 9 of 18 brain specimens with seven different pathologic processes. This included three of seven Alzheimer disease, two of three Huntington disease, two of two Parkinson disease, one of one progressive supranuclear palsy, one of one acoustic neuroma, one of two cerebrovascular disease, and one of two Guamanian amyotrophic lateral sclerosis (ALS). Aluminum was normal in the remaining samples (four normal, two ALS, one multiple sclerosis, one Pick disease, and two Guamanian parkinsonism-dementia). The significance of high aluminum values is not clear, but the normal values from the Creutzfeldt-Jakob cases imply that neuronal destruction per se need not lead to accumulation of aluminum in the brain.

Measles virus genome in infections of the central nervous system

The measles virus genome was traced in acute and chronic infections of the central nervous system in hamsters and humans. The extent of viral replication and gene expression was assessed by the techniques of in situ hybridization and immunofluorescence. Both replication and gene expression were restricted in chronically infected hamsters and in humans with subacute sclerosing panencephalitis. It is proposed that restriction plays an important role in persistence of measles virus and the slow evolution of disease in these and other slow infections.

Transmissible spongiform encephalopathy (Creutzfeldt-Jakob disease). Atypical clinical and pathological findings

A middle-aged neurosurgeon had an 18-month illness characterized by abnormal sleep patterns, paresthesias, and necrotizing cutaneous lesions with vasculitis and signs of cerebral, brainstem, vestibulocerebellar, and progressive spinal cord involvement. Biopsy specimens of nerve and skin showed an acute vasculitis with endovascular cellular proliferation in the pattern of a Köhlmeier-Degos lesion and focal epidermal necrosis. Mental changes and cranial-nerve signs developed. Myoclonus occurred occasionally during sleep. Akinetic mutism ensued. At autopsy, major abnormalities were limited to the nervous system and skin. Spongiform encephalopathy typical of Creutzfeldt-Jakob disease was found with amyloid kuru plaques. A cribriform change distinct from the spongiform change was seen focally in the white matter. Scarred skin lesions and a healed, partially obliterative arteritis were noted. Inoculation of brain and lung into nonhuman primates resulted in a spongiform encephalopathy.

Humoral immunity in Guamanians with amyotrophic lateral sclerosis and parkinsonism-dementia

Among Guamanian natives, serum IgA and IgG levels were found to be higher than normal in amyotrophic lateral sclerosis (ALS); serum IgA was higher and IgM lower than normal in parkinsonism-dementia (PD). IgA levels increased with age in ALS, PD, and normal subjects; IgG increased with age in ALS and IgM decreased with age in PD. Serum immunoglobulin (Ig) levels did not correlate with the duration of either disease. Immunodeficient ALS and PD patients had higher IgM and lower IgA levels than the other ALS and PD patients. Neither differences in viral antibody titers nor the presence of autoantibodies or circulating immune complexes could account for the variations in serum Ig levels between patients and controls. We conclude that differences in serum Ig levels in ALS and PD patients are probably due to repeated infections and abnormal immunoregulation accompanying immunodeficiency during the course of ALS and PD, rather than to a specific antiviral or autoimmune response.

Evidence for normal cell-mediated immunity in scrapie-infected mice

Comparisons between mixed lymphocyte cultures of splenocytes from scrapie-infected and normal mouse brain-inoculated control mice did not reveal any evidence of an impaired cell-mediated immune response in scrapie-infected mice. Likewise, mixed lymphocyte cultures of splenocytes from scrapie-infected and normal mice demonstrated that infected spleen cells had no scrapie-specific antigens on their surfaces. These data suggested that the absence of a detectable scrapie-specific immune response in infected mice was the result of an absence of an exposed scrapie-specific antigen and not due to any direct effect on the immune system.

Measles virus nucleotide sequences: detection by hybridization in situ

A tritium-labeled probe that detects measles virus nucleotide sequences was hybridized in situ to cells infected with measles virus and to sections of brain tissue from patients with subacute sclerosing panencephalitis and from patients with multiple sclerosis. The measles virus genome was detected in many cells in subacute sclerosing panencephalitis where this virus would have been missed by methods such as immunofluorescence. Measles virus sequences were also found in two foci in one of four cases of multiple sclerosis. This refined method of hybridization in situ, which can be useful in the search for covert virus infections of man, provides evidence that viruses may be involved in multiple sclerosis.

Epidemic hemorrhagic fever in Hubei Province, The People's Republic of China: a clinical and serological study

Between July 1975 and April 1980, 71 patients were admitted to the Second Attached Hospital of Hubei Provincial Medical College in Wuchang with the diagnosis of epidemic hemorrhagic fever (EHF). The clinical course among these patients was similar to that described for patients with Korean hemorrhagic fever, and hemorrhagic fever with renal syndrome of the U.S.S.R. The overall mortality was 11.2 percent. Sera obtained from some of these patients as well as from patients admitted to the First Attached Hospital of Hubei Provincial Medical College were tested against an antigen associated with Korean hemorrhagic fever and showed exceedingly high antibody titers. We conclude that EHF in Central China represents the same or a closely related disease process as Korean hemorrhagic fever.

Propagation of Korean hemorrhagic fever virus in laboratory rats

Korean hemorrhagic fever virus (KHFV) has been adapted to the Wistar and Fisher strains of rats. Infection was detected by the appearance of specific antigen in the lung tissue of the infected rats at 14 to 64 days after inoculation and by the appearance of circulating antibodies in ther serum which reacted specifically with KHFV antigen in the lungs of infected Apodemus agrarius subsp. coreae 3 weeks after inoculation. Distribution of antigen in rat tissues as determined by immunofluorescent staining was the same as that in Apodemus mice except that antigen was present in the spleens of rats. Adaptation of KHFV to the laboratory rat provides an animal model that is free of wild rodent viruses and is readily available for use in studies on the characterization of KHFV.

Transmission and scanning electron microscopy of spongiform change in Creutzfeldt-Jakob disease

Brains from three human cases of Creutzfeldt-Jakob disease and three monkey cases of transmitted Creutzfeldt-Jakob disease were examined. Spongiform change was present in all cases on both light and electron microscopic examination. Electron microscopic examination revealed membrane alterations within vacuoles in all cases. On SEM, both ulcerated and focally thickened membranes were apparent; TEM revealed splitting of unit membranes as well as focally thickened amorphous membranes. Small blisters with 70 to 150 nm particulates were seen on membranes in SEM. TEM revealed 10 nm electron-dense particles which might be either part of the infectious agent or a membrane alteration caused by it. The significance of these findings was discussed.

Autoantibodies against axonal neurofilaments in patients with Kuru and Creutzfeldt-Jakob disease

The serums of some patients with subacute spongiform encephalopathies contain an autoantibody in higher titer against a normal fibrillar protein within the axon of mature central neurons in culture. The morphological features of this neurofilament, as demonstrated by immunofluorescence and immunoperoxidase staining, and the partial characterization of the antibody are described. The detection of this hetero-specific autoantibody is the first evidence of an immune reaction in the spongiform encephalopathies.

Evidence for and against the transmissibility of Alzheimer disease

Nonhuman primates were inoculated intracerebrally with brain tissue from 52 patients with confirmed Alzheimer disease (AD) in order to investigate the possibility of an infectious etiology. Animals inoculated with brain tissue from two patients with familial AD developed a spongiform encephalopathy that was indistinguishable from Creutzfeldt-Jakob disease (CJD). Seventeen other cases of AD on test for more than 50 months failed to produce similar changes, and 33 cases have not been incubating for a sufficient period of time to ascertain the presence of a transmissible agent. The initial transmission of spongiform encephalopathy with brain tissue from the two familial cases of AD has not been reproduced and the association between AD and an infectious agent has not yet been demonstrated with any reasonable degree of certainty. The frequent overlap of clinical symptoms of AD and CJD, and the occurrence of cases of CJD and AD in the same families indicate the need for continuing research on the relationship between the two diseases.

Oral transmission of kuru, Creutzfeldt-Jakob disease, and scrapie to nonhuman primates

Kuru and Creutzfeldt-Jakob disease of humans and scrapie disease of sheep and goats were transmitted to squirrel monkeys (Saimiri sciureus) that were exposed to the infectious agents only by their nonforced consumption of known infectious tissues. The asymptomatic incubation period in the one monkey exposed to the virus of kuru was 36 months; that in the two monkeys exposed to the virus of Creutzfeldt-Jakob disease was 23 and 27 months, respectively; and that in the two monkeys exposed to the virus of scrapie was 25 and 32 months, respectively. Careful physical examination of the buccal cavities of all of the monkeys failed to reveal signs or oral lesions. One additional monkey similarly exposed to kuru has remained asymptomatic during the 39 months that it has been under observation.