101
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Hayashi Y, Yamada M, Kimura A, Asano T, Satoh K, Kitamoto T, Yoneda M, Inuzuka T. Clinical findings of a probable case of MM2-cortical-type sporadic Creutzfeldt-Jakob disease with antibodies to anti-N-terminus of α-enolase. Prion 2017; 11:454-464. [PMID: 28967811 DOI: 10.1080/19336896.2017.1377876] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
We report the case of a 76-year-old woman presenting with 47-month history of progressive dementia and cortical blindness with no family history. Antibodies against thyroid glands and the N-terminus of α-enolase (NAE) were detected in her serum. Neurological examination revealed progressive dementia, frontal signs, visual disturbance, and exaggerated bilateral tendon reflexes in both legs. Diffusion MRI showed cortical hyper-intensities in the bilateral occipital and parietal, and the left frontal and temporal cortices. 99mTc-ethyl cysteinate dimer-single photon emission computed tomography indicated decreased regional cerebral blood flow throughout the bilateral parietal lobes and partially in the left frontal and temporal lobes. PRNP gene analysis showed no mutations with methionine homozygosity at codon 129 in peripheral blood. Cerebrospinal fluid examination, including 14-3-3 and total tau protein detection, revealed normal levels; however, prion proteins were amplified by the real-time quaking-induced conversion method. Hashimoto's encephalopathy was excluded on the basis of unresponsiveness to corticosteroids. The symptoms progressed slowly. Periodic sharp-wave complexes were observed on electroencephalogram 36 months after the onset of symptoms; the patient reached a state of akinetic mutism at 47 months. This was a probable case of MM2-cortical-type sCJD with anti-NAE antibodies based on the World Health Organization (WHO) diagnostic criteria for sCJD, genetic information, and the slowly progressive course. However, this case did not meet with the probable WHO diagnostic criteria until 3 years after symptom onset, highlighting the difficulty of diagnosing a living case of the MM2-type of sCJD. Therefore, establishment of clinical diagnostic criteria for MM2-type of sCJD is required.
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Affiliation(s)
- Yuichi Hayashi
- a Department of Neurology and Geriatrics , Gifu University Graduate School of Medicine , Gifu , Japan
| | - Megumi Yamada
- a Department of Neurology and Geriatrics , Gifu University Graduate School of Medicine , Gifu , Japan
| | - Akio Kimura
- a Department of Neurology and Geriatrics , Gifu University Graduate School of Medicine , Gifu , Japan
| | - Takahiko Asano
- b Department of Radiology , Gifu University Graduate School of Medicine , Gifu , Japan
| | - Katsuya Satoh
- c Department of Locomotive Rehabilitation Sciences , Nagasaki University Graduate School of Medicine , Nagasaki , Japan
| | - Tetsuyuki Kitamoto
- d Division of CJD Science and Technology , Department of Prion Research, Center for Translational and Advanced Animal Research on Human Diseases, Tohoku University School of Medicine , Sendai , Japan
| | - Makoto Yoneda
- e Faculty of Nursing and Social Welfare Science/ Department of Nursing Sciences , Fukui Prefectural University , Fukui , Japan
| | - Takashi Inuzuka
- a Department of Neurology and Geriatrics , Gifu University Graduate School of Medicine , Gifu , Japan
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102
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Altered rPrP substrate structures and their influence on real-time quaking induced conversion reactions. Protein Expr Purif 2017; 143:20-27. [PMID: 29031681 DOI: 10.1016/j.pep.2017.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/06/2017] [Accepted: 10/11/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Bacterially-produced recombinant prion protein (rPrP) has traditionally been used for in vitro fibrillation assays and reagent development for prion disease research. In recent years, it has also been used as a substrate for real-time quaking-induced conversion (RT-QuIC), a very sensitive method of detecting the presence of the misfolded, disease-associated isoform of the prion protein (PrPd). Multi-centre trials have demonstrated that RT-QuIC is a suitably reliable and robust technique for clinical practice; however, in the absence of a commercial supplier of rPrP as a substrate for RT-QuIC, laboratories have been required to independently generate this key component of the assay. No harmonized method for producing the protein has been agreed upon, in part due to the variety of substrates that have been applied in RT-QuIC. METHODS This study examines the effects of two different rPrP refolding protocols on the production, QuIC performance, and structure characteristics of two constructs of rPrP commonly used in QuIC: full length hamster and a sheep-hamster chimeric rPrP. RESULTS Under the described conditions, the best performing substrate was the chimeric sheep-hamster rPrP produced by shorter guanidine-HCl exposure and faster gradient elution. CONCLUSIONS The observation that different rPrP production protocols influence QuIC performance indicates that caution should be exercised when comparing inter-laboratory QuIC results.
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103
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Cheng YC, Hannaoui S, John TR, Dudas S, Czub S, Gilch S. Real-time Quaking-induced Conversion Assay for Detection of CWD Prions in Fecal Material. J Vis Exp 2017. [PMID: 28994814 DOI: 10.3791/56373] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The RT-QuIC technique is a sensitive in vitro cell-free prion amplification assay based mainly on the seeded misfolding and aggregation of recombinant prion protein (PrP) substrate using prion seeds as a template for the conversion. RT-QuIC is a novel high-throughput technique which is analogous to real-time polymerase chain reaction (PCR). Detection of amyloid fibril growth is based on the dye Thioflavin T, which fluoresces upon specific interaction with ᵦ-sheet rich proteins. Thus, amyloid formation can be detected in real time. We attempted to develop a reliable non-invasive screening test to detect chronic wasting disease (CWD) prions in fecal extract. Here, we have specifically adapted the RT-QuIC technique to reveal PrPSc seeding activity in feces of CWD infected cervids. Initially, the seeding activity of the fecal extracts we prepared was relatively low in RT-QuIC, possibly due to potential assay inhibitors in the fecal material. To improve seeding activity of feces extracts and remove potential assay inhibitors, we homogenized the fecal samples in a buffer containing detergents and protease inhibitors. We also submitted the samples to different methodologies to concentrate PrPSc on the basis of protein precipitation using sodium phosphotungstic acid, and centrifugal force. Finally, the feces extracts were tested by optimized RT-QuIC which included substrate replacement in the protocol to improve the sensitivity of detection. Thus, we established a protocol for sensitive detection of CWD prion seeding activity in feces of pre-clinical and clinical cervids by RT-QuIC, which can be a practical tool for non-invasive CWD diagnosis.
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Affiliation(s)
- Yo Ching Cheng
- Dept. of Ecosystem and Public Health, Calgary Prion Research Units, Faculty of Veterinary Medicine, University of Calgary
| | - Samia Hannaoui
- Dept. of Ecosystem and Public Health, Calgary Prion Research Units, Faculty of Veterinary Medicine, University of Calgary
| | | | - Sandor Dudas
- Canadian Food Inspection Agency, Lethbridge Laboratories
| | - Stefanie Czub
- Canadian Food Inspection Agency, Lethbridge Laboratories
| | - Sabine Gilch
- Dept. of Ecosystem and Public Health, Calgary Prion Research Units, Faculty of Veterinary Medicine, University of Calgary;
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104
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Llorens F, Schmitz M, Knipper T, Schmidt C, Lange P, Fischer A, Hermann P, Zerr I. Cerebrospinal Fluid Biomarkers of Alzheimer's Disease Show Different but Partially Overlapping Profile Compared to Vascular Dementia. Front Aging Neurosci 2017; 9:289. [PMID: 28955218 PMCID: PMC5601075 DOI: 10.3389/fnagi.2017.00289] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 08/18/2017] [Indexed: 11/13/2022] Open
Abstract
Vascular factors increase the risks of developing Alzheimer's disease (AD) and they contribute to AD pathology. Since amyloid beta (Aβ) deposits can be observed in both diseases, there is an overlap which impedes a clear discrimination and difficult clinical diagnosis. In the present study, we compared cerebrospinal fluid (CSF) profiles of neurodegenerative and inflammatory biomarkers in a patient cohort of controls (n = 50), AD (n = 65) and vascular dementia (VaD) (n = 31) cases. Main results were validated in a second cohort composed of AD (n = 26), rapidly progressive AD (rpAD) (n = 15), VaD (n = 21), and cognitively unimpaired patients with vascular encephalopathy (VE) (n = 25) cases. In the study, cohort significant differences were detected in tau, p-tau, and Aβ1-42 (Aβ42) levels between AD and VaD patients, but not for the neuron-specific enolase (NSE), S100B protein, 14-3-3 and YKL-40. Differential tau, p-tau, and Aβ42 levels between AD and VaD were confirmed in the validation cohort, which additionally showed no differences between AD and rpAD, nor between VaD and VE. The evaluation of the biomarker performance in discrimination between AD and VaD patients revealed that the best diagnostic accuracy could be obtained when tau, p-tau, and Aβ42 were combined in form of Aβ42/p-tau (AUC 0.84-0.90, sensitivity 77-81%, specificity 80-93%) and (tau × p-tau)/Aβ42 ratio (AUC 0.83-0.87, sensitivity 73-81%, specificity 78-87%). Altogether, our studies provided neurodegenerative biomarker profiles in two cohorts of AD and VaD patients favoring the combination of CSF biomarker to differentiate between diseases.
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Affiliation(s)
- Franc Llorens
- Department of Neurology, Universitätsmedizin GöttingenGöttingen, Germany
- Center for Networked Biomedical Research on Neurodegenerative DiseasesBarcelona, Spain
| | - Matthias Schmitz
- Department of Neurology, Universitätsmedizin GöttingenGöttingen, Germany
- German Center for Neurodegenerative Diseases–DZNE Site GöttingenBonn, Germany
| | - Tobias Knipper
- Department of Neurology, Universitätsmedizin GöttingenGöttingen, Germany
| | - Christian Schmidt
- Department of Neurology, Universitätsmedizin GöttingenGöttingen, Germany
| | - Peter Lange
- Department of Neurology, Universitätsmedizin GöttingenGöttingen, Germany
| | - Andre Fischer
- German Center for Neurodegenerative Diseases–DZNE Site GöttingenBonn, Germany
| | - Peter Hermann
- Department of Neurology, Universitätsmedizin GöttingenGöttingen, Germany
- German Center for Neurodegenerative Diseases–DZNE Site GöttingenBonn, Germany
| | - Inga Zerr
- Department of Neurology, Universitätsmedizin GöttingenGöttingen, Germany
- German Center for Neurodegenerative Diseases–DZNE Site GöttingenBonn, Germany
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105
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Candelise N, Schmitz M, Da Silva Correia SM, Arora AS, Villar-Piqué A, Zafar S, Llorens F, Cramm M, Zerr I. Applications of the real-time quaking-induced conversion assay in diagnosis, prion strain-typing, drug pre-screening and other amyloidopathies. Expert Rev Mol Diagn 2017; 17:897-904. [PMID: 28817974 DOI: 10.1080/14737159.2017.1368389] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The development of in vitro protein misfolding amplification assays for the detection and analysis of abnormally folded proteins, such as proteinase K resistant prion protein (PrPres) was a major innovation in the prion field. In prion diseases, these types of assays imitate the pathological conversion of the cellular PrP (PrPC) into a proteinase resistant associated conformer or amyloid, called PrPres. Areas covered: The most prominent protein misfolding amplification assays are the protein misfolding cyclic amplification (PMCA), which is based on sonication and the real-time quaking-induced conversion (RT-QuIC) technique based on shaking. The more recently established RT-QuIC is fully automatic and enables the monitoring of misfolded protein aggregates in real-time by using a fluorescent dye. Expert commentary: RT-QuIC is a very robust and highly reproducible test system which is applicable in diagnosis, prion strain-typing, drug pre-screening and other amyloidopathies.
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Affiliation(s)
- Niccolò Candelise
- a Department of Neurology , University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE) , Göttingen , Germany
| | - Matthias Schmitz
- a Department of Neurology , University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE) , Göttingen , Germany
| | - Susana Margarida Da Silva Correia
- a Department of Neurology , University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE) , Göttingen , Germany
| | - Amandeep Singh Arora
- a Department of Neurology , University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE) , Göttingen , Germany
| | - Anna Villar-Piqué
- a Department of Neurology , University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE) , Göttingen , Germany
| | - Saima Zafar
- a Department of Neurology , University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE) , Göttingen , Germany
| | - Franc Llorens
- b Department of Neuropathology , Center for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED) , Barcelona , Spain
| | - Maria Cramm
- a Department of Neurology , University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE) , Göttingen , Germany
| | - Inga Zerr
- a Department of Neurology , University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE) , Göttingen , Germany
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106
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Llorens F, Zarranz JJ, Fischer A, Zerr I, Ferrer I. Fatal Familial Insomnia: Clinical Aspects and Molecular Alterations. Curr Neurol Neurosci Rep 2017; 17:30. [PMID: 28324299 DOI: 10.1007/s11910-017-0743-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
PURPOSE OF REVIEW Fatal familiar insomnia (FFI) is an autosomal dominant inherited prion disease caused by D178N mutation in the prion protein gene (PRNP D178N) accompanied by the presence of a methionine at the codon 129 polymorphic site on the mutated allele. FFI is characterized by severe sleep disorder, dysautonomia, motor signs and abnormal behaviour together with primary atrophy of selected thalamic nuclei and inferior olives, and expansion to other brain regions with disease progression. This article reviews recent research on the clinical and molecular aspects of the disease. RECENT FINDINGS New clinical and biomarker tools have been implemented in order to assist in the diagnosis of the disease. In addition, the generation of mouse models, the availability of 'omics' data in brain tissue and the use of new seeding techniques shed light on the molecular events in FFI pathogenesis. Biochemical studies in human samples also reveal that neuropathological alterations in vulnerable brain regions underlie severe impairment in key cellular processes such as mitochondrial and protein synthesis machinery. Although the development of a therapy is still a major challenge, recent findings represent a step toward understanding of the clinical and molecular aspects of FFI.
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Affiliation(s)
- Franc Llorens
- Department of Neurology, Clinical Dementia Center, University Medical Center, Georg-August University, Robert Koch Strasse 40, Göttingen, Germany. .,German Center for Neurodegenerative Diseases (DZNE)-site Göttingen, Göttingen, Germany.
| | - Juan-José Zarranz
- Neurology Department, University Hospital Cruces, University of the Basque Country, Bilbao, Bizkaia, Spain
| | - Andre Fischer
- German Center for Neurodegenerative Diseases (DZNE)-site Göttingen, Göttingen, Germany
| | - Inga Zerr
- Department of Neurology, Clinical Dementia Center, University Medical Center, Georg-August University, Robert Koch Strasse 40, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE)-site Göttingen, Göttingen, Germany
| | - Isidro Ferrer
- Institute of Neuropathology, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, c/Feixa Llarga sn, 08907, Barcelona, Spain. .,University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain. .,CIBERNED (Network Centre for Biomedical Research of Neurodegenerative Diseases), Institute Carlos III, Ministry of Health, Madrid, Spain.
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107
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Caughey B, Orru CD, Groveman BR, Hughson AG, Manca M, Raymond LD, Raymond GJ, Race B, Saijo E, Kraus A. Amplified Detection of Prions and Other Amyloids by RT-QuIC in Diagnostics and the Evaluation of Therapeutics and Disinfectants. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2017; 150:375-388. [PMID: 28838670 DOI: 10.1016/bs.pmbts.2017.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Among the most sensitive, specific and practical of methods for detecting prions are the real-time quaking-induced conversion (RT-QuIC) assays. These assays exploit the fundamental self-propagating activity of prions to amplify the presence of prion seeds by as much as a trillion-fold. The reactions can detect most of the known mammalian prion diseases, often with sensitivities greater than those of animal bioassays. RT-QuIC assays are performed in multiwell plates with fluorescence detection and have now reached the sensitivity and practicality required for routine prion disease diagnostics. Some key strains of prions within particular host species, e.g., humans, cattle, and sheep, can be discriminated by comparison of RT-QuIC responses with different recombinant prion protein substrates. The most thoroughly validated diagnostic application of RT-QuIC is in the diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD) using cerebrospinal fluid. Diagnostic sensitivities as high as 96% can be achieved in less than 24h with specificities of 98%-100%. The ability, if needed, to also test nasal swab samples can increase the RT-QuIC sensitivity for sCJD to virtually 100%. In addition to diagnostic applications, RT-QuIC has also been used in the testing of prion disinfectants and potential therapeutics. Mechanistically related assays are also now being developed for other protein misfolding diseases.
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Affiliation(s)
- Byron Caughey
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, United States.
| | - Christina D Orru
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, United States
| | - Bradley R Groveman
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, United States
| | - Andrew G Hughson
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, United States
| | - Matteo Manca
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, United States
| | - Lynne D Raymond
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, United States
| | - Gregory J Raymond
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, United States
| | - Brent Race
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, United States
| | - Eri Saijo
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, United States
| | - Allison Kraus
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, United States
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108
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Hayashi Y, Iwasaki Y, Yoshikura N, Asano T, Mimuro M, Kimura A, Satoh K, Kitamoto T, Yoshida M, Inuzuka T. An autopsy-verified case of steroid-responsive encephalopathy with convulsion and a false-positive result from the real-time quaking-induced conversion assay. Prion 2017; 11:284-292. [PMID: 28749249 DOI: 10.1080/19336896.2017.1345416] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
We report an autopsy-verified case of steroid-responsive encephalopathy with convulsion and a false-positive result from the real-time quaking-induced conversion (RT-QUIC) assay. A 61-year-old Japanese man presented with acute onset of consciousness disturbance, and convulsions, but without a past medical or family history of progressive dementia, epilepsy, or prion disease. Brain diffusion and fluid-attenuated inverted recovery MR images revealed edematous cortical hyper-intensity, which diminished after the acute phase. Steroid pulse therapy was partially effective, although he continued to have dementia with myoclonus and psychiatric symptoms, despite resolution of the consciousness disturbance. Cerebrospinal fluid (CSF) analysis revealed a normal cell count, with significantly elevated levels of 14-3-3 protein and total tau protein. In addition, prion protein in the CSF was slowly amplified by the RT-QUIC assay. PRNP gene analysis revealed methionine homozygosity at codon 129 without mutation. The patient died of sudden cardiac arrest at 3 months after the onset of symptoms. The positive result from the RT-QUIC assay led us to suspect involvement of prion disease, although a postmortem assessment revealed that he had pathological changes after convulsion, and no prion disease. This case indicates that convulsion may cause false-positive RT-QUIC results, and that a postmortem evaluation remains the gold standard for diagnosing similar cases.
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Affiliation(s)
- Yuichi Hayashi
- a Department of Neurology and Geriatrics , Gifu University Graduate School of Medicine , Gifu , Japan
| | - Yasushi Iwasaki
- b Department of Neuropathology , Institute for Medical Science of Aging, Aichi Medical University , Nagakute , Japan
| | - Nobuaki Yoshikura
- a Department of Neurology and Geriatrics , Gifu University Graduate School of Medicine , Gifu , Japan
| | - Takahiko Asano
- c Department of Radiology , Gifu University Graduate School of Medicine , Gifu , Japan
| | - Maya Mimuro
- b Department of Neuropathology , Institute for Medical Science of Aging, Aichi Medical University , Nagakute , Japan
| | - Akio Kimura
- a Department of Neurology and Geriatrics , Gifu University Graduate School of Medicine , Gifu , Japan
| | - Katsuya Satoh
- d Department of Locomotive Rehabilitation Sciences , Nagasaki University Graduate School of Medicine , Nagasaki , Japan
| | - Tetsuyuki Kitamoto
- e Division of CJD Science and Technology, Department of Prion Research , Center for Translational and Advanced Animal Research on Human Diseases, Tohoku University School of Medicine , Sendai , Japan
| | - Mari Yoshida
- b Department of Neuropathology , Institute for Medical Science of Aging, Aichi Medical University , Nagakute , Japan
| | - Takashi Inuzuka
- a Department of Neurology and Geriatrics , Gifu University Graduate School of Medicine , Gifu , Japan
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109
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Prion Diagnosis: Application of Real-Time Quaking-Induced Conversion. BIOMED RESEARCH INTERNATIONAL 2017; 2017:5413936. [PMID: 28596963 PMCID: PMC5449729 DOI: 10.1155/2017/5413936] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 04/14/2017] [Accepted: 04/24/2017] [Indexed: 02/06/2023]
Abstract
Prions composed of pathogenic scrapie prion protein (PrPSc) are infectious pathogens that cause progressive neurological conditions known as prion diseases or transmissible spongiform encephalopathies. Although these diseases pose considerable risk to public health, procedures for early diagnosis have not been established. One of the most recent attempts at sensitive and specific detection of prions is the real-time quaking-induced conversion (RT-QuIC) method, which measures the activity of PrPSc aggregates or amyloid formation triggered by PrPSc seeds in the presence of recombinant PrP. In this review, we summarize prions, prion diseases, and current approaches to diagnosis, including the principle, conditions for assay performance, and current diagnostic applications of RT-QuIC.
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110
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Redaelli V, Tagliavini F, Moda F. Clinical features, pathophysiology and management of fatal familial insomnia. Expert Opin Orphan Drugs 2017. [DOI: 10.1080/21678707.2017.1311251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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111
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Ultrasensitive and selective detection of 3-repeat tau seeding activity in Pick disease brain and cerebrospinal fluid. Acta Neuropathol 2017; 133:751-765. [PMID: 28293793 DOI: 10.1007/s00401-017-1692-z] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 02/28/2017] [Accepted: 03/01/2017] [Indexed: 10/20/2022]
Abstract
The diagnosis and treatment of diseases involving tau-based pathology such as Alzheimer disease and certain frontotemporal dementias is hampered by the inability to detect pathological forms of tau with sufficient sensitivity, specificity and practicality. In these neurodegenerative diseases, tau accumulates in self-seeding filaments. For example, Pick disease (PiD) is associated with frontotemporal degeneration and accumulation of 3-repeat (3R) tau isoforms in filaments constituting Pick bodies. Exploiting the self-seeding activity of tau deposits, and using a 3R tau fragment as a substrate, we have developed an assay (tau RT-QuIC) that can detect tau seeds in 2 µl aliquots of PiD brain dilutions down to 10-7-10-9. PiD seeding activities were 100-fold higher in frontal and temporal lobes compared to cerebellar cortex. Strikingly, this test was 103- to 105-fold less responsive when seeded with brain containing predominant 4-repeat (4R) tau aggregates from cases of corticobasal degeneration, argyrophilic grain disease, and progressive supranuclear palsy. Alzheimer disease brain, with 3R + 4R tau deposits, also gave much weaker responses than PiD brain. When applied to cerebrospinal fluid samples (5 µl), tau RT-QuIC analyses discriminated PiD from non-PiD cases. These findings demonstrate that abnormal tau aggregates can be detected with high sensitivity and disease-specificity in crude tissue and fluid samples. Accordingly, this tau RT-QuIC assay exemplifies a new approach to diagnosing tauopathies and monitoring therapeutic trials using aggregated tau itself as a biomarker.
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112
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Llorens F, Thüne K, Sikorska B, Schmitz M, Tahir W, Fernández-Borges N, Cramm M, Gotzmann N, Carmona M, Streichenberger N, Michel U, Zafar S, Schuetz AL, Rajput A, Andréoletti O, Bonn S, Fischer A, Liberski PP, Torres JM, Ferrer I, Zerr I. Altered Ca 2+ homeostasis induces Calpain-Cathepsin axis activation in sporadic Creutzfeldt-Jakob disease. Acta Neuropathol Commun 2017; 5:35. [PMID: 28449707 PMCID: PMC5408381 DOI: 10.1186/s40478-017-0431-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 04/06/2017] [Indexed: 12/25/2022] Open
Abstract
Sporadic Creutzfeldt-Jakob disease (sCJD) is the most prevalent form of human prion disease and it is characterized by the presence of neuronal loss, spongiform degeneration, chronic inflammation and the accumulation of misfolded and pathogenic prion protein (PrPSc). The molecular mechanisms underlying these alterations are largely unknown, but the presence of intracellular neuronal calcium (Ca2+) overload, a general feature in models of prion diseases, is suggested to play a key role in prion pathogenesis. Here we describe the presence of massive regulation of Ca2+ responsive genes in sCJD brain tissue, accompanied by two Ca2+-dependent processes: endoplasmic reticulum stress and the activation of the cysteine proteases Calpains 1/2. Pathogenic Calpain proteins activation in sCJD is linked to the cleavage of their cellular substrates, impaired autophagy and lysosomal damage, which is partially reversed by Calpain inhibition in a cellular prion model. Additionally, Calpain 1 treatment enhances seeding activity of PrPSc in a prion conversion assay. Neuronal lysosomal impairment caused by Calpain over activation leads to the release of the lysosomal protease Cathepsin S that in sCJD mainly localises in axons, although massive Cathepsin S overexpression is detected in microglial cells. Alterations in Ca2+ homeostasis and activation of Calpain-Cathepsin axis already occur at pre-clinical stages of the disease as detected in a humanized sCJD mouse model. Altogether our work indicates that unbalanced Calpain-Cathepsin activation is a relevant contributor to the pathogenesis of sCJD at multiple molecular levels and a potential target for therapeutic intervention.
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113
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Hayashi Y, Inuzuka T. Reply to: Amyotrophic lateral sclerosis with frontotemporal dementia (ALS-FTD) syndrome as a phenotype of Creutzfeldt-Jakob disease (CJD)? A case report. J Neurol Sci 2017; 375:489. [PMID: 28258726 DOI: 10.1016/j.jns.2017.02.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 02/23/2017] [Indexed: 11/18/2022]
Affiliation(s)
- Yuichi Hayashi
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan.
| | - Takashi Inuzuka
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
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Llorens F, Kruse N, Karch A, Schmitz M, Zafar S, Gotzmann N, Sun T, Köchy S, Knipper T, Cramm M, Golanska E, Sikorska B, Liberski PP, Sánchez-Valle R, Fischer A, Mollenhauer B, Zerr I. Validation of α-Synuclein as a CSF Biomarker for Sporadic Creutzfeldt-Jakob Disease. Mol Neurobiol 2017; 55:2249-2257. [PMID: 28321768 PMCID: PMC5840235 DOI: 10.1007/s12035-017-0479-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/02/2017] [Indexed: 01/15/2023]
Abstract
The analysis of cerebrospinal fluid (CSF) biomarkers gains importance in the differential diagnosis of prion diseases. However, no single diagnostic tool or combination of them can unequivocally confirm prion disease diagnosis. Electrochemiluminescence (ECL)-based immunoassays have demonstrated to achieve high diagnostic accuracy in a variety of sample types due to their high sensitivity and dynamic range. Quantification of CSF α-synuclein (a-syn) by an in-house ECL-based ELISA assay has been recently reported as an excellent approach for the diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD), the most prevalent form of human prion disease. In the present study, we validated a commercially available ECL-based a-syn ELISA platform as a diagnostic test for correct classification of sCJD cases. CSF a-syn was analysed in 203 sCJD cases with definite diagnosis and in 445 non-CJD cases. We investigated reproducibility and stability of CSF a-syn and made recommendations for its analysis in the sCJD diagnostic workup. A sensitivity of 98% and a specificity of 97% were achieved when using an optimal cut-off of 820 pg/mL a-syn. Moreover, we were able to show a negative correlation between a-syn levels and disease duration suggesting that CSF a-syn may be a good prognostic marker for sCJD patients. The present study validates the use of a-syn as a CSF biomarker of sCJD and establishes the clinical and pre-analytical parameters for its use in differential diagnosis in clinical routine. Additionally, the current test presents some advantages compared to other diagnostic approaches: it is fast, economic, requires minimal amount of CSF and a-syn levels are stable along disease progression.
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Affiliation(s)
- Franc Llorens
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany. .,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.
| | - Niels Kruse
- Institute for Neuropathology, University Medical Center Göttingen, Göttingen, Germany
| | - André Karch
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Matthias Schmitz
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Saima Zafar
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Nadine Gotzmann
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Ting Sun
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Silja Köchy
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Tobias Knipper
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Maria Cramm
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Ewa Golanska
- Department of Molecular Pathology and Neuropathology, Medical University of Lodz, Lodz, Poland
| | - Beata Sikorska
- Department of Molecular Pathology and Neuropathology, Medical University of Lodz, Lodz, Poland
| | - Pawel P Liberski
- Department of Molecular Pathology and Neuropathology, Medical University of Lodz, Lodz, Poland
| | - Raquel Sánchez-Valle
- Creutzfeldt-Jakob disease unit. Alzheimer's disease and other cognitive disorders unit. Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andre Fischer
- German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
| | - Brit Mollenhauer
- Institute for Neuropathology, University Medical Center Göttingen, Göttingen, Germany.,Paracelsus-Elena Klinik, Center for Parkinsonism and Movement Disorders, Kassel, Germany.,Department of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany
| | - Inga Zerr
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Site Göttingen, Robert Koch Stasse 40, 37075, Göttingen, Germany
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Shi Q, Xiao K, Chen C, Zhou W, Gao C, Wang J, Zhang BY, Wang Y, Dong XP. Clinical and laboratory features of 14 young Chinese probable sCJD patients. Prion 2017; 11:128-135. [PMID: 28278113 DOI: 10.1080/19336896.2017.1287656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Sporadic Creutzfeldt-Jakob disease (sCJD) occurs frequently in the relatively older population, mainly in the groups of 60-69 and 70-79 year-old. Since 2006 when China performed national CJD surveillance, 14 young probable sCJD patients below 40 year-old were identified, counting for 1.93% of all probable sCJD cases. The clinical features of young probable sCJD cases, including the onset feature, the presence of sCJD-associated signs and the clinical duration, are indistinguishable from those of older patients. Special sCJD-associated abnormalities on EEG and MRI were noticed in 7 and 10 cases. CSF 14-3-3 was positive in 7 cases. CSF RT-QuIC showed positive reactive curves in 9 cases, with short lag phases. PRNP sequencing did not find any mutation. Due to low rate of brain autopsy in China, performances of other CJD-associated examinations as much as possible are extremely important for the distinguish diagnosis of young probable sCJD patients.
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Affiliation(s)
- Qi Shi
- a State Key Laboratory for Infectious Disease Prevention and Control , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing , China
| | - Kang Xiao
- a State Key Laboratory for Infectious Disease Prevention and Control , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing , China
| | - Cao Chen
- a State Key Laboratory for Infectious Disease Prevention and Control , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing , China
| | - Wei Zhou
- a State Key Laboratory for Infectious Disease Prevention and Control , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing , China
| | - Chen Gao
- a State Key Laboratory for Infectious Disease Prevention and Control , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing , China
| | - Jing Wang
- a State Key Laboratory for Infectious Disease Prevention and Control , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing , China
| | - Bao-Yun Zhang
- a State Key Laboratory for Infectious Disease Prevention and Control , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing , China
| | - Yuan Wang
- a State Key Laboratory for Infectious Disease Prevention and Control , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing , China
| | - Xiao-Ping Dong
- a State Key Laboratory for Infectious Disease Prevention and Control , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing , China
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Kondru N, Manne S, Greenlee J, West Greenlee H, Anantharam V, Halbur P, Kanthasamy A, Kanthasamy A. Integrated Organotypic Slice Cultures and RT-QuIC (OSCAR) Assay: Implications for Translational Discovery in Protein Misfolding Diseases. Sci Rep 2017; 7:43155. [PMID: 28233859 PMCID: PMC5324099 DOI: 10.1038/srep43155] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 01/19/2017] [Indexed: 01/13/2023] Open
Abstract
Protein misfolding is a key pathological event in neurodegenerative diseases like prion diseases, synucleinopathies, and tauopathies that are collectively termed protein misfolding disorders. Prions are a prototypic model to study protein aggregation biology and therapeutic development. Attempts to develop anti-prion therapeutics have been impeded by the lack of screening models that faithfully replicate prion diseases and the lack of rapid, sensitive biological screening systems. Therefore, a sensitive model encompassing prion replication and neurotoxicity would be indispensable to the pursuit of intervention strategies. We present an ultra-sensitive screening system coupled to an ex vivo prion organotypic slice culture model to rapidly advance rationale-based high-throughput therapeutic strategies. This hybrid Organotypic Slice Culture Assay coupled with RT-QuIC (OSCAR) permits sensitive, specific and quantitative detection of prions from an infectious slice culture model on a reduced time scale. We demonstrate that the anti-prion activity of test compounds can be readily resolved based on the power and kinetics of seeding activity in the OSCAR screening platform and that the prions generated in slice cultures are biologically active. Collectively, our results imply that OSCAR is a robust model of prion diseases that offers a promising platform for understanding prion proteinopathies and advancing anti-prion therapeutics.
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Affiliation(s)
- Naveen Kondru
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Sireesha Manne
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Justin Greenlee
- Virus and Prion Research Unit, National Animal Disease Center, Agricultural Research Service, United States Department of Agriculture, Ames, IA 50011, USA
| | - Heather West Greenlee
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Vellareddy Anantharam
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Patrick Halbur
- Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Arthi Kanthasamy
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | - Anumantha Kanthasamy
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
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117
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Foutz A, Appleby BS, Hamlin C, Liu X, Yang S, Cohen Y, Chen W, Blevins J, Fausett C, Wang H, Gambetti P, Zhang S, Hughson A, Tatsuoka C, Schonberger LB, Cohen ML, Caughey B, Safar JG. Diagnostic and prognostic value of human prion detection in cerebrospinal fluid. Ann Neurol 2017; 81:79-92. [PMID: 27893164 PMCID: PMC5266667 DOI: 10.1002/ana.24833] [Citation(s) in RCA: 157] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 11/23/2016] [Accepted: 11/23/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Several prion amplification systems have been proposed for detection of prions in cerebrospinal fluid (CSF), most recently, the measurements of prion seeding activity with second-generation real-time quaking-induced conversion (RT-QuIC). The objective of this study was to investigate the diagnostic performance of the RT-QuIC prion test in the broad phenotypic spectrum of prion diseases. METHODS We performed CSF RT-QuIC testing in 2,141 patients who had rapidly progressive neurological disorders, determined diagnostic sensitivity and specificity in 272 cases that were autopsied, and evaluated the impact of mutations and polymorphisms in the PRNP gene, and type 1 or type 2 human prions on diagnostic performance. RESULTS The 98.5% diagnostic specificity and 92% sensitivity of CSF RT-QuIC in a blinded retrospective analysis matched the 100% specificity and 95% sensitivity of a blind prospective study. The CSF RT-QuIC differentiated 94% of cases of sporadic Creutzfeldt-Jakob disease (sCJD) MM1 from the sCJD MM2 phenotype, and 80% of sCJD VV2 from sCJD VV1. The mixed prion type 1-2 and cases heterozygous for codon 129 generated intermediate CSF RT-QuIC patterns, whereas genetic prion diseases revealed distinct profiles for each PRNP gene mutation. INTERPRETATION The diagnostic performance of the improved CSF RT-QuIC is superior to surrogate marker tests for prion diseases such as 14-3-3 and tau proteins, and together with PRNP gene sequencing the test allows the major prion subtypes to be differentiated in vivo. This differentiation facilitates prediction of the clinicopathological phenotype and duration of the disease-two important considerations for envisioned therapeutic interventions. ANN NEUROL 2017;81:79-92.
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Affiliation(s)
- Aaron Foutz
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Brian S. Appleby
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Clive Hamlin
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Xiaoqin Liu
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Sheng Yang
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Yvonne Cohen
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Wei Chen
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Janis Blevins
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Cameron Fausett
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Han Wang
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Pierluigi Gambetti
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Shulin Zhang
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Andrew Hughson
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT
| | - Curtis Tatsuoka
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Lawrence B. Schonberger
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mark L. Cohen
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Byron Caughey
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT
| | - Jiri G. Safar
- National Prion Disease Pathology Surveillance Center; Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH
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119
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Groveman BR, Orrú CD, Hughson AG, Bongianni M, Fiorini M, Imperiale D, Ladogana A, Pocchiari M, Zanusso G, Caughey B. Extended and direct evaluation of RT-QuIC assays for Creutzfeldt-Jakob disease diagnosis. Ann Clin Transl Neurol 2016; 4:139-144. [PMID: 28168213 PMCID: PMC5288466 DOI: 10.1002/acn3.378] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 11/04/2016] [Accepted: 11/11/2016] [Indexed: 11/11/2022] Open
Abstract
Real-Time Quaking-Induced Conversion (RT-QuIC) testing of human cerebrospinal fluid (CSF) is highly sensitive and specific in discriminating sporadic CJD patients from those without prion disease. Here, using CSF samples from 113 CJD and 64 non-prion disease patients, we provide the first direct and concurrent comparison of our improved RT-QuIC assay to our previous assay, which is similar to those commonly used internationally for CJD diagnosis. This extended comparison demonstrated a ~21% increase in diagnostic sensitivity, a 2-day reduction in average detection time, and 100% specificity.
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Affiliation(s)
- Bradley R Groveman
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Christina D Orrú
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Andrew G Hughson
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Matilde Bongianni
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Michele Fiorini
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | | | - Anna Ladogana
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy
| | - Maurizio Pocchiari
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy
| | - Gianluigi Zanusso
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Byron Caughey
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
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120
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Affiliation(s)
- Franc Llorens
- Department of Neurology, University Medicine Goettingen, Germany.,German Center for Neurodegenerative Diseases, Goettingen, Germany
| | - Matthias Schmitz
- Department of Neurology, University Medicine Goettingen, Germany.,German Center for Neurodegenerative Diseases, Goettingen, Germany
| | - Inga Zerr
- Department of Neurology, University Medicine Goettingen, Germany.,German Center for Neurodegenerative Diseases, Goettingen, Germany
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121
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Abstract
Since the term protein was first coined in 1838 and protein was discovered to be the essential component of fibrin and albumin, all cellular proteins were presumed to play beneficial roles in plants and mammals. However, in 1967, Griffith proposed that proteins could be infectious pathogens and postulated their involvement in scrapie, a universally fatal transmissible spongiform encephalopathy in goats and sheep. Nevertheless, this novel hypothesis had not been evidenced until 1982, when Prusiner and coworkers purified infectious particles from scrapie-infected hamster brains and demonstrated that they consisted of a specific protein that he called a "prion." Unprecedentedly, the infectious prion pathogen is actually derived from its endogenous cellular form in the central nervous system. Unlike other infectious agents, such as bacteria, viruses, and fungi, prions do not contain genetic materials such as DNA or RNA. The unique traits and genetic information of prions are believed to be encoded within the conformational structure and posttranslational modifications of the proteins. Remarkably, prion-like behavior has been recently observed in other cellular proteins-not only in pathogenic roles but also serving physiological functions. The significance of these fascinating developments in prion biology is far beyond the scope of a single cellular protein and its related disease.
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122
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Hayashi Y, Iwasaki Y, Takekoshi A, Yoshikura N, Asano T, Mimuro M, Kimura A, Satoh K, Kitamoto T, Yoshida M, Inuzuka T. An autopsy-verified case of FTLD-TDP type A with upper motor neuron-predominant motor neuron disease mimicking MM2-thalamic-type sporadic Creutzfeldt-Jakob disease. Prion 2016; 10:492-501. [PMID: 27929803 DOI: 10.1080/19336896.2016.1243192] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Here we report an autopsy-verified case of frontotemporal lobar degeneration (FTLD)-transactivation responsive region (TAR) DNA binding protein (TDP) type A with upper motor neuron-predominant motor neuron disease mimicking MM2-thalamic-type sporadic Creutzfeldt-Jakob disease (sCJD). A 69-year-old woman presented with an 11-month history of progressive dementia, irritability, insomnia, and gait disturbance without a family history of dementia or prion disease. Neurological examination revealed severe dementia, frontal signs, and exaggerated bilateral tendon reflexes. Periodic sharp-wave complexes were not observed on the electroencephalogram. Brain diffusion MRI did not reveal abnormal changes. An easy Z score (eZIS) analysis for 99mTc-ECD-single photon emission computed tomography (99mTc-ECD-SPECT) revealed a bilateral decrease in thalamic regional cerebral blood flow (rCBF). PRNP gene analysis demonstrated methionine homozygosity at codon 129 without mutation. Cerebrospinal fluid (CSF) analysis showed normal levels of both 14-3-3 and total tau proteins. Conversely, prion protein was slowly amplified in the CSF by a real-time quaking-induced conversion assay. Her symptoms deteriorated to a state of akinetic mutism, and she died of sudden cardiac arrest, one year after symptom onset. Despite the SPECT results supporting a clinical diagnosis of MM2-thalamic-type sCJD, a postmortem assessment revealed that this was a case of FTLD-TDP type A, and excluded prion disease. Thus, this case indicates that whereas a bilateral decreasing thalamic rCBF detected by 99mTc-ECD-SPECT can be useful for diagnosing MM2-thalamic-type sCJD, it is not sufficiently specific. Postmortem diagnosis remains the gold standard for the diagnosis of this condition.
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Affiliation(s)
- Yuichi Hayashi
- a Department of Neurology and Geriatrics , Gifu University Graduate School of Medicine , Gifu , Japan
| | - Yasushi Iwasaki
- b Department of Neuropathology , Institute for Medical Science of Aging, Aichi Medical University , Nagakute , Japan
| | - Akira Takekoshi
- a Department of Neurology and Geriatrics , Gifu University Graduate School of Medicine , Gifu , Japan
| | - Nobuaki Yoshikura
- a Department of Neurology and Geriatrics , Gifu University Graduate School of Medicine , Gifu , Japan
| | - Takahiko Asano
- c Department of Radiology , Gifu University Graduate School of Medicine , Gifu , Japan
| | - Maya Mimuro
- b Department of Neuropathology , Institute for Medical Science of Aging, Aichi Medical University , Nagakute , Japan
| | - Akio Kimura
- a Department of Neurology and Geriatrics , Gifu University Graduate School of Medicine , Gifu , Japan
| | - Katsuya Satoh
- d Department of Locomotive Rehabilitation Sciences . Nagasaki University Graduate School of Medicine , Nagasaki , Japan
| | - Tetsuyuki Kitamoto
- e Division of CJD Science and Technology, Department of Prion Research , Center for Translational and Advanced Animal Research on Human Diseases, Tohoku University School of Medicine , Sendai , Japan
| | - Mari Yoshida
- b Department of Neuropathology , Institute for Medical Science of Aging, Aichi Medical University , Nagakute , Japan
| | - Takashi Inuzuka
- a Department of Neurology and Geriatrics , Gifu University Graduate School of Medicine , Gifu , Japan
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Abstract
Prion diseases are neurodegenerative diseases affecting both humans and animal species. The phenotypic spectrum is broad and includes Creutzfeldt-Jakob disease (CJD) and its variant zoonotic form (vCJD) in humans, while in animals, scrapie of sheep and goats, bovine spongiform encephalopathy and chronic wasting disease of deer, elk and moose are naturally occurring forms. Transmission and pathogenesis appear causally linked to the misfolding of the normal form of the prion protein (PrPC) into disease associated conformers (PrPD), the latter enriched in β-strand secondary structure. Over the past 10 years two protein amplification techniques, the protein misfolding cyclic amplification (PMCA) assay and real-time quaking induced conversion (RT-QuIC) assay have been developed and successfully deployed in prion biology across a range of scientific and clinical applications, including generation of de novo prions, quantitation of prion infectivity and ultra-sensitive detection of PrPD. While PMCA utilises sonication to facilitate protein amplification, RT-QuIC employs vigorous shaking to achieve this outcome, with both techniques sharing the ability to amplify miniscule quantities of PrPD seed present in various tissues and body fluids to levels detectable using routine biochemical methods. The enhanced specificity of the RT-QuIC for detection of PrPD in cerebrospinal fluid (CSF) has spawned international collaborations to rigorously assess and validate the assay for clinical diagnostic purposes. In parallel with collaborative CSF validation studies have been successful efforts to refine the RT-QuIC allowing its use for more accessible body fluids or tissues such as urine and nasal brushings, as well as promote higher sample throughput, shorten assay times and offer accurate quantification of PrPD even at levels below those detectable by animal bioassays. Animal studies support the generic capacity of the RT-QuIC for PrPD detection, underpinning the utility of this assay for studying prion disease and the high likelihood of inter-convertibility of technical refinements for human and animal use.
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124
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Llorens F, Kruse N, Schmitz M, Gotzmann N, Golanska E, Thüne K, Zejneli O, Kanata E, Knipper T, Cramm M, Lange P, Zafar S, Sikorska B, Liberski PP, Mitrova E, Varges D, Schmidt C, Sklaviadis T, Mollenhauer B, Zerr I. Evaluation of α‐synuclein as a novel cerebrospinal fluid biomarker in different forms of prion diseases. Alzheimers Dement 2016; 13:710-719. [DOI: 10.1016/j.jalz.2016.09.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/15/2016] [Accepted: 09/29/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Franc Llorens
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Niels Kruse
- Institute for Neuropathology University Medical Center Göttingen Göttingen Germany
| | - Matthias Schmitz
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Nadine Gotzmann
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Ewa Golanska
- Department of Molecular Pathology and Neuropathology Medical University of Lodz Lodz Poland
| | - Katrin Thüne
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Orgeta Zejneli
- Laboratory of Pharmacology, School of Health Sciences, Department of Pharmacy Aristotle University of Thessaloniki Thessaloniki Greece
| | - Eirini Kanata
- Laboratory of Pharmacology, School of Health Sciences, Department of Pharmacy Aristotle University of Thessaloniki Thessaloniki Greece
| | - Tobias Knipper
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
| | - Maria Cramm
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Peter Lange
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
| | - Saima Zafar
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Beata Sikorska
- Department of Molecular Pathology and Neuropathology Medical University of Lodz Lodz Poland
| | - Pawel P. Liberski
- Department of Molecular Pathology and Neuropathology Medical University of Lodz Lodz Poland
| | - Eva Mitrova
- Department of Prion Diseases Slovak Medical University Bratislava Bratislava Slovakia
| | - Daniela Varges
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
| | - Christian Schmidt
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
| | - Theodoros Sklaviadis
- Laboratory of Pharmacology, School of Health Sciences, Department of Pharmacy Aristotle University of Thessaloniki Thessaloniki Greece
| | - Brit Mollenhauer
- Institute for Neuropathology University Medical Center Göttingen Göttingen Germany
- Paracelsus‐Elena Klinik Center for Parkinsonism and Movement Disorders Kassel Germany
- Department of Neurosurgery University Medical Center Göttingen Göttingen Germany
| | - Inga Zerr
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
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Schmitz M, Llorens F, Pracht A, Thom T, Correia Â, Zafar S, Ferrer I, Zerr I. Regulation of human cerebrospinal fluid malate dehydrogenase 1 in sporadic Creutzfeldt-Jakob disease patients. Aging (Albany NY) 2016; 8:2927-2935. [PMID: 27852982 PMCID: PMC5191879 DOI: 10.18632/aging.101101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 10/26/2016] [Indexed: 12/03/2022]
Abstract
The identification of reliable diagnostic biomarkers in differential diagnosis of neurodegenerative diseases is an ongoing topic. A previous two-dimensional proteomic study on cerebrospinal fluid (CSF) revealed an elevated level of an enzyme, mitochondrial malate dehydrogenase 1 (MDH1), in sporadic Creutzfeldt-Jakob disease (sCJD) patients. Here, we could demonstrate the expression of MDH1 in neurons as well as in the neuropil. Its levels are lower in sCJD brains than in control brains. An examination of CSF-MDH1 in sCJD patients by ELISA revealed a significant elevation of CSF-MDH1 levels in sCJD patients (independently from the PRNP codon 129 MV genotype or the prion protein scrapie (PrPSc) type) in comparison to controls. In combination with total tau (tau), CSF-MDH1 detection exhibited a high diagnostic accuracy for sCJD diagnosis with a sensitivity of 97.5% and a specificity of 95.6%. A correlation study of MDH1 level in CSF with other neurodegenerative marker proteins revealed a significant positive correlation between MDH1 concentration with tau, 14-3-3 and neuron specific enolase level. In conclusion, our study indicated the potential of MDH1 in combination with tau as an additional biomarker in sCJD improving diagnostic accuracy of tau markedly.
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Affiliation(s)
- Matthias Schmitz
- From the Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE) – Göttingen Campus, Göttingen, Germany
| | - Franc Llorens
- From the Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE) – Göttingen Campus, Göttingen, Germany
| | - Alexander Pracht
- From the Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Tobias Thom
- From the Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Ângela Correia
- From the Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Saima Zafar
- From the Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE) – Göttingen Campus, Göttingen, Germany
| | - Isidre Ferrer
- Institute of Neuropathology, Bellvitge University Hospital, CIBERNED, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Inga Zerr
- From the Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE) – Göttingen Campus, Göttingen, Germany
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126
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Schmitz M, Cramm M, Llorens F, Müller-Cramm D, Collins S, Atarashi R, Satoh K, Orrù CD, Groveman BR, Zafar S, Schulz-Schaeffer WJ, Caughey B, Zerr I. The real-time quaking-induced conversion assay for detection of human prion disease and study of other protein misfolding diseases. Nat Protoc 2016; 11:2233-2242. [PMID: 27735933 DOI: 10.1038/nprot.2016.120] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 05/19/2016] [Indexed: 12/31/2022]
Abstract
The development and adaption of in vitro misfolded protein amplification systems has been a major innovation in the detection of abnormally folded prion protein scrapie (PrPSc) in human brain and cerebrospinal fluid (CSF) samples. Herein, we describe a fast and efficient protein amplification technique, real-time quaking-induced conversion (RT-QuIC), for the detection of a PrPSc seed in human brain and CSF. In contrast to other in vitro misfolded protein amplification assays-such as protein misfolding cyclic amplification (PMCA)-which are based on sonication, the RT-QuIC technique is based on prion seed-induced misfolding and aggregation of recombinant prion protein substrate, accelerated by alternating cycles of shaking and rest in fluorescence plate readers. A single RT-QuIC assay typically analyzes up to 32 samples in triplicate, using a 96-well-plate format. From sample preparation to analysis of results, the protocol takes ∼87 h to complete. In addition to diagnostics, this technique has substantial generic analytical applications, including drug screening, prion strain discrimination, biohazard screening (e.g., to reduce transmission risk related to prion diseases) and the study of protein misfolding; in addition, it can potentially be used for the investigation of other protein misfolding diseases such as Alzheimer's and Parkinson's disease.
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Affiliation(s)
- Matthias Schmitz
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Maria Cramm
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Franc Llorens
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Dominik Müller-Cramm
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Steven Collins
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Ryuichiro Atarashi
- Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Katsuya Satoh
- Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Christina D Orrù
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, Montana, USA
| | - Bradley R Groveman
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, Montana, USA
| | - Saima Zafar
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Walter J Schulz-Schaeffer
- Department of Neuropathology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
| | - Byron Caughey
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, Montana, USA
| | - Inga Zerr
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
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127
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Schmitz M, Cramm M, Llorens F, Candelise N, Müller-Cramm D, Varges D, Schulz-Schaeffer WJ, Zafar S, Zerr I. Application of an in vitro-amplification assay as a novel pre-screening test for compounds inhibiting the aggregation of prion protein scrapie. Sci Rep 2016; 6:28711. [PMID: 27385410 PMCID: PMC4935936 DOI: 10.1038/srep28711] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 06/07/2016] [Indexed: 11/09/2022] Open
Abstract
In vitro amplification assays, such as real-time quaking-induced conversion (RT-QuIC) are used to detect aggregation activity of misfolded prion protein (PrP) in brain, cerebrospinal fluid (CSF) and urine samples from patients with a prion disease. We believe that the method also has a much broader application spectrum. In the present study, we applied RT-QuIC as a pre-screening test for substances that potentially inhibit the aggregation process of the cellular PrP (PrP(C)) to proteinase (PK)-resistant PrP(res). We chose doxycycline as the test substance as it has been tested successfully in animal models and proposed in clinical studies as a therapeutic for prion diseases. The RT-QuIC-reaction was seeded with brain tissue or CSF from sCJD patients and doxycycline was then added in different concentrations as well as at different time points. In both experiments, we observed a dose- and time-dependent inhibition of the RT-QuIC seeding response and a decrease of PK resistant PrP(res) when doxycycline was added. In contrast, ampicillin or sucrose had no effect on the RT-QuIC seeding response. Our study is the first to apply RT-QuIC as a pre-screening assay for compounds inhibiting the PrP aggregation in vitro and confirms that doxycycline is an efficient inhibitor of the PrP aggregation process in RT-QuIC analysis.
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Affiliation(s)
- Matthias Schmitz
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE)-Göttingen campus, Göttingen, Germany
| | - Maria Cramm
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE)-Göttingen campus, Göttingen, Germany
| | - Franc Llorens
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE)-Göttingen campus, Göttingen, Germany
| | - Niccolò Candelise
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE)-Göttingen campus, Göttingen, Germany
| | - Dominik Müller-Cramm
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE)-Göttingen campus, Göttingen, Germany
| | - Daniela Varges
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE)-Göttingen campus, Göttingen, Germany
| | | | - Saima Zafar
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE)-Göttingen campus, Göttingen, Germany
| | - Inga Zerr
- Department of Neurology, University Medical Center Göttingen and German Center for Neurodegenerative Diseases (DZNE)-Göttingen campus, Göttingen, Germany
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McGuire LI, Poleggi A, Poggiolini I, Suardi S, Grznarova K, Shi S, de Vil B, Sarros S, Satoh K, Cheng K, Cramm M, Fairfoul G, Schmitz M, Zerr I, Cras P, Equestre M, Tagliavini F, Atarashi R, Knox D, Collins S, Haïk S, Parchi P, Pocchiari M, Green A. Cerebrospinal fluid real-time quaking-induced conversion is a robust and reliable test for sporadic creutzfeldt-jakob disease: An international study. Ann Neurol 2016; 80:160-5. [PMID: 27130376 PMCID: PMC4982084 DOI: 10.1002/ana.24679] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/18/2016] [Accepted: 04/19/2016] [Indexed: 11/18/2022]
Abstract
Real-time quaking-induced conversion (RT-QuIC) has been proposed as a sensitive diagnostic test for sporadic Creutzfeldt-Jakob disease; however, before this assay can be introduced into clinical practice, its reliability and reproducibility need to be demonstrated. Two international ring trials were undertaken in which a set of 25 cerebrospinal fluid samples were analyzed by a total of 11 different centers using a range of recombinant prion protein substrates and instrumentation. The results show almost complete concordance between the centers and demonstrate that RT-QuIC is a suitably reliable and robust technique for clinical practice. Ann Neurol 2016;80:160-165.
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Affiliation(s)
- Lynne I McGuire
- National CJD Research & Surveillance Unit, Western General Hospital, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Anna Poleggi
- Department of Neurological Sciences, National Institute of Health, Rome, Italy
| | - Ilaria Poggiolini
- Institute of Neurological Sciences, Scientific Institute for Research, Hospitalization and Health Care, Bologna, Italy
| | - Silvia Suardi
- Department of Neurodegenerative Diseases, Scientific Institute for Research, Hospitalization and Health Care, Carlo Besta Neurological Institute, Milan, Italy
| | - Katarina Grznarova
- Sorbonne Universities, Pierre and Marie Curie University, Brain and Spine Institute, Paris, France
- National Reference Centre for Unconventional Transmissible Agents, Paris, France
| | - Song Shi
- Center for Neuropathology and Prion Research, Ludwig Maximilian University, Munich, Germany
| | - Bart de Vil
- Department of Neurology, Institute of Born Bunge, University of Antwerp, Antwerp, Belgium
| | - Shannon Sarros
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Katsuya Satoh
- Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Keding Cheng
- Prion Laboratory Section, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Maria Cramm
- Department of Neurology, University Medical Center and German Center for Neurodegenerative Diseases, University of Göttingen, Göttingen, Germany
| | - Graham Fairfoul
- National CJD Research & Surveillance Unit, Western General Hospital, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Matthias Schmitz
- Department of Neurology, University Medical Center and German Center for Neurodegenerative Diseases, University of Göttingen, Göttingen, Germany
| | - Inga Zerr
- Department of Neurology, University Medical Center and German Center for Neurodegenerative Diseases, University of Göttingen, Göttingen, Germany
| | - Patrick Cras
- Department of Neurology, Institute of Born Bunge, University of Antwerp, Antwerp, Belgium
| | - Michele Equestre
- Department of Neurological Sciences, National Institute of Health, Rome, Italy
| | - Fabrizio Tagliavini
- Department of Neurodegenerative Diseases, Scientific Institute for Research, Hospitalization and Health Care, Carlo Besta Neurological Institute, Milan, Italy
| | - Ryuichiro Atarashi
- Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - David Knox
- Prion Laboratory Section, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Steven Collins
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Stéphane Haïk
- Sorbonne Universities, Pierre and Marie Curie University, Brain and Spine Institute, Paris, France
- National Reference Centre for Unconventional Transmissible Agents, Paris, France
- APHP, Pitié-Salpêtrière Hospital, Paris, France
| | - Piero Parchi
- Institute of Neurological Sciences, Scientific Institute for Research, Hospitalization and Health Care, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Maurizio Pocchiari
- Department of Neurological Sciences, National Institute of Health, Rome, Italy
| | - Alison Green
- National CJD Research & Surveillance Unit, Western General Hospital, University of Edinburgh, Edinburgh, Scotland, United Kingdom
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129
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Schmitz M, Dittmar K, Llorens F, Gelpi E, Ferrer I, Schulz-Schaeffer WJ, Zerr I. Hereditary Human Prion Diseases: an Update. Mol Neurobiol 2016; 54:4138-4149. [PMID: 27324792 DOI: 10.1007/s12035-016-9918-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 05/03/2016] [Indexed: 01/19/2023]
Abstract
Prion diseases in humans are neurodegenerative diseases which are caused by an accumulation of abnormal, misfolded cellular prion protein known as scrapie prion protein (PrPSc). Genetic, acquired, or spontaneous (sporadic) forms are known. Pathogenic mutations in the human prion protein gene (PRNP) have been identified in 10-15 % of CJD patients. These mutations may be single point mutations, STOP codon mutations, or insertions or deletions of octa-peptide repeats. Some non-coding mutations and new mutations in the PrP gene have been identified without clear evidence for their pathogenic significance. In the present review, we provide an updated overview of PRNP mutations, which have been documented in the literature until now, describe the change in the DNA, the family history, the pathogenicity, and the number of described cases, which has not been published in this complexity before. We also provide a description of each genetic prion disease type, present characteristic histopathological features, and the PrPSc isoform expression pattern of various familial/genetic prion diseases.
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Affiliation(s)
- Matthias Schmitz
- Department of Neurology, University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany. .,Department of Neuropathology, Georg-August University, Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
| | - Kathrin Dittmar
- Department of Neurology, University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Franc Llorens
- Department of Neurology, University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Ellen Gelpi
- Neurological Tissue Bank, Biobanc-Hospital Clinic-IDIBAPS, Barcelona, Spain
| | - Isidre Ferrer
- Institute of Neuropathology, Bellvitge University Hospital, CIBERNED, Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Walter J Schulz-Schaeffer
- Department of Neuropathology, Georg-August University, Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Inga Zerr
- Department of Neurology, University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
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130
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Orrú CD, Hughson AG, Groveman BR, Campbell KJ, Anson KJ, Manca M, Kraus A, Caughey B. Factors That Improve RT-QuIC Detection of Prion Seeding Activity. Viruses 2016; 8:E140. [PMID: 27223300 PMCID: PMC4885095 DOI: 10.3390/v8050140] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/09/2016] [Accepted: 05/12/2016] [Indexed: 12/14/2022] Open
Abstract
Rapid and sensitive detection of prions is important in managing prion diseases. The real-time quaking-induced conversion (RT-QuIC) assay for prion seeding activity has been applied to many prion diseases and provides for specific antemortem diagnostic testing. We evaluated RT-QuIC's long-term consistency and varied multiple reaction parameters. Repeated assays of a single scrapie sample using multiple plate readers and recombinant prion protein (rPrP(Sen)) substrates gave comparable results. N-terminal truncated hamster rPrP(Sen) (residues 90-231) hastened both prion-seeded and prion-independent reactions but maintained a clear kinetic distinction between the two. Raising temperatures or shaking speeds accelerated RT-QuIC reactions without compromising specificity. When applied to nasal brushings from Creutzfeldt-Jakob disease patients, higher temperatures accelerated RT-QuIC kinetics, and the use of hamster rPrP(Sen) (90-231) strengthened RT-QuIC responses. Elongation of shaking periods reduced scrapie-seeded reaction times, but continuous shaking promoted false-positive reactions. Furthermore, pH 7.4 provided for more rapid RT-QuIC reactions than more acidic pHs. Additionally, we show that small variations in the amount of sodium dodecyl sulfate (SDS) significantly impacted the assay. Finally, RT-QuIC performed in multiplate thermoshakers followed by fluorescence readings in separate plate readers enhanced assay throughput economically. Collectively, these results demonstrate improved speed, efficacy and practicality of RT-QuIC assays and highlight variables to be optimized for future applications.
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Affiliation(s)
- Christina D Orrú
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, 59840 MT, USA.
| | - Andrew G Hughson
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, 59840 MT, USA.
| | - Bradley R Groveman
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, 59840 MT, USA.
| | - Katrina J Campbell
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, 59840 MT, USA.
| | - Kelsie J Anson
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, 59840 MT, USA.
| | - Matteo Manca
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, 59840 MT, USA.
| | - Allison Kraus
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, 59840 MT, USA.
| | - Byron Caughey
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Hamilton, 59840 MT, USA.
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Abstract
Early and accurate diagnosis of Creutzfeldt-Jakob disease (CJD) is a necessary to distinguish this untreatable disease from treatable rapidly progressive dementias, and to prevent iatrogenic transmission. Currently, definitive diagnosis of CJD requires detection of the abnormally folded, CJD-specific form of protease-resistant prion protein (PrP(CJD)) in brain tissue obtained postmortem or via biopsy; therefore, diagnosis of sporadic CJD in clinical practice is often challenging. Supporting investigations, including MRI, EEG and conventional analyses of cerebrospinal fluid (CSF) biomarkers, are helpful in the diagnostic work-up, but do not allow definitive diagnosis. Recently, novel ultrasensitive seeding assays, based on the amplified detection of PrP(CJD), have improved the diagnostic process; for example, real-time quaking-induced conversion (RT-QuIC) is a sensitive method to detect prion-seeding activity in brain homogenate from humans with any subtype of sporadic CJD. RT-QuIC can also be used for in vivo diagnosis of CJD: its diagnostic sensitivity in detecting PrP(CJD) in CSF samples is 96%, and its specificity is 100%. Recently, we provided evidence that RT-QuIC of olfactory mucosa brushings is a 97% sensitive and 100% specific for sporadic CJD. These assays provide a basis for definitive antemortem diagnosis of prion diseases and, in doing so, improve prospects for reducing the risk of prion transmission. Moreover, they can be used to evaluate outcome measures in therapeutic trials for these as yet untreatable infections.
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132
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Requena JR, Kristensson K, Korth C, Zurzolo C, Simmons M, Aguilar-Calvo P, Aguzzi A, Andreoletti O, Benestad SL, Böhm R, Brown K, Calgua B, del Río JA, Espinosa JC, Girones R, Godsave S, Hoelzle LE, Knittler MR, Kuhn F, Legname G, Laeven P, Mabbott N, Mitrova E, Müller-Schiffmann A, Nuvolone M, Peters PJ, Raeber A, Roth K, Schmitz M, Schroeder B, Sonati T, Stitz L, Taraboulos A, Torres JM, Yan ZX, Zerr I. The Priority position paper: Protecting Europe's food chain from prions. Prion 2016; 10:165-81. [PMID: 27220820 PMCID: PMC4981192 DOI: 10.1080/19336896.2016.1175801] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 03/28/2016] [Accepted: 04/01/2016] [Indexed: 01/09/2023] Open
Abstract
Bovine spongiform encephalopathy (BSE) created a global European crisis in the 1980s and 90s, with very serious health and economic implications. Classical BSE now appears to be under control, to a great extent as a result of a global research effort that identified the sources of prions in meat and bone meal (MBM) and developed new animal-testing tools that guided policy. Priority ( www.prionpriority.eu ) was a European Union (EU) Framework Program 7 (FP7)-funded project through which 21 European research institutions and small and medium enterprises (SMEs) joined efforts between 2009 and 2014, to conduct coordinated basic and applied research on prions and prion diseases. At the end of the project, the Priority consortium drafted a position paper ( www.prionpriority.eu/Priority position paper) with its main conclusions. In the present opinion paper, we summarize these conclusions. With respect to the issue of re-introducing ruminant protein into the feed-chain, our opinion is that sustaining an absolute ban on feeding ruminant protein to ruminants is essential. In particular, the spread and impact of non-classical forms of scrapie and BSE in ruminants is not fully understood and the risks cannot be estimated. Atypical prion agents will probably continue to represent the dominant form of prion diseases in the near future in Europe. Atypical L-type BSE has clear zoonotic potential, as demonstrated in experimental models. Similarly, there are now data indicating that the atypical scrapie agent can cross various species barriers. More epidemiological data from large cohorts are necessary to reach any conclusion on the impact of its transmissibility on public health. Re-evaluations of safety precautions may become necessary depending on the outcome of these studies. Intensified searching for molecular determinants of the species barrier is recommended, since this barrier is key for important policy areas and risk assessment. Understanding the structural basis for strains and the basis for adaptation of a strain to a new host will require continued fundamental research, also needed to understand mechanisms of prion transmission, replication and how they cause nervous system dysfunction and death. Early detection of prion infection, ideally at a preclinical stage, also remains crucial for development of effective treatment strategies.
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Affiliation(s)
- Jesús R. Requena
- CIMUS Biomedical Research Institute, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Sue Godsave
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | | | | | | | - Paul Laeven
- University of Maastricht, Maastricht, The Netherlands
| | | | - Eva Mitrova
- Medical University of Slovakia, Bratislava, Slovakia
| | | | | | - Peter J. Peters
- The Maastricht Multimodal Molecular Imaging Institute, University of Maastricht, Maastricht, The Netherlands
| | | | | | | | | | | | - Lothar Stitz
- Friedrich Löffler Institut, Insel Reims, Germany
| | | | | | | | - Inga Zerr
- Universitätmedizin Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
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Karch A, Koch A, Zapf A, Zerr I, Karch A. Partial verification bias and incorporation bias affected accuracy estimates of diagnostic studies for biomarkers that were part of an existing composite gold standard. J Clin Epidemiol 2016; 78:73-82. [PMID: 27107877 DOI: 10.1016/j.jclinepi.2016.03.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 03/08/2016] [Accepted: 03/30/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate how choice of gold standard biases estimates of sensitivity and specificity in studies reassessing the diagnostic accuracy of biomarkers that are already part of a lifetime composite gold standard (CGS). STUDY DESIGN AND SETTING We performed a simulation study based on the real-life example of the biomarker "protein 14-3-3" used for diagnosing Creutzfeldt-Jakob disease. Three different types of gold standard were compared: perfect gold standard "autopsy" (available in a small fraction only; prone to partial verification bias), lifetime CGS (including the biomarker under investigation; prone to incorporation bias), and "best available" gold standard (autopsy if available, otherwise CGS). RESULTS Sensitivity was unbiased when comparing 14-3-3 with autopsy but overestimated when using CGS or "best available" gold standard. Specificity of 14-3-3 was underestimated in scenarios comparing 14-3-3 with autopsy (up to 24%). In contrast, overestimation (up to 20%) was observed for specificity compared with CGS; this could be reduced to 0-10% when using the "best available" gold standard. CONCLUSION Choice of gold standard affects considerably estimates of diagnostic accuracy. Using the "best available" gold standard (autopsy where available, otherwise CGS) leads to valid estimates of specificity, whereas sensitivity is estimated best when tested against autopsy alone.
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Affiliation(s)
- Annika Karch
- Institute for Biostatistics, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Armin Koch
- Institute for Biostatistics, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Antonia Zapf
- Department of Medical Statistics, University Göttingen, Humboldtallee 32, 37073 Göttingen, Germany
| | - Inga Zerr
- National Reference Centre for TSE, Department for Neurology, University Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
| | - André Karch
- National Reference Centre for TSE, Department for Neurology, University Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany; Department of Epidemiology, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124 Braunschweig, Germany; German Center for Infection Research, Hannover-Braunschweig Site, Feodor-Lynen-Str. 7, 30625 Hannover, Germany.
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134
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Endpoint Quaking-Induced Conversion: a Sensitive, Specific, and High-Throughput Method for Antemortem Diagnosis of Creutzfeldt-Jacob Disease. J Clin Microbiol 2016; 54:1751-1754. [PMID: 27076662 PMCID: PMC4922112 DOI: 10.1128/jcm.00542-16] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 04/08/2016] [Indexed: 11/20/2022] Open
Abstract
The Prion Laboratory Section of the Public Health Agency of Canada supports heath care professionals dealing with patients suspected to have Creutzfeldt-Jakob disease (CJD) by testing cerebrospinal fluid (CSF) for protein markers of CJD. To better serve Canadian diagnostic requirements, a quaking-induced conversion (QuIC)-based assay has been added to the test panel. The QuIC tests exploit the ability of disease-associated prion protein, found in the CSF of a majority of CJD patients, to convert a recombinant prion protein (rPrP) into detectable amounts of a misfolded, aggregated form of rPrP. The rPrP aggregates interact with a specific dye, causing a measurable change in the dye's fluorescence emission spectrum. Optimal test and analysis parameters were empirically determined. Taking both practical and performance considerations into account, an endpoint QuIC (EP-QuIC) configuration was chosen. EP-QuIC uses a thermo-mixer to perform the shaking necessary to produce the quaking-induced conversions. Fluorescence readings are obtained from a microwell fluorescence reader only at the beginning and the end of EP-QuIC reactions. Samples for which the relative fluorescence unit ratio between the initial and final readings represent a ≥4 increase in signal intensity in at least two of the three replicates are classified as positive. A retrospective analysis of 91 CSF samples that included 45 confirmed cases of CJD and 46 non-CJD cases was used to estimate the performance characteristics of the EP-QuIC assay. The diagnostic sensitivity and specificity of the EP-QuIC test of this set of samples were 98 and 91%, respectively.
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135
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Seeded Amplification of Chronic Wasting Disease Prions in Nasal Brushings and Recto-anal Mucosa-Associated Lymphoid Tissues from Elk by Real-Time Quaking-Induced Conversion. J Clin Microbiol 2016; 54:1117-26. [PMID: 26888899 DOI: 10.1128/jcm.02700-15] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 02/06/2016] [Indexed: 11/20/2022] Open
Abstract
Chronic wasting disease (CWD), a transmissible spongiform encephalopathy of cervids, was first documented nearly 50 years ago in Colorado and Wyoming and has since been detected across North America and the Republic of Korea. The expansion of this disease makes the development of sensitive diagnostic assays and antemortem sampling techniques crucial for the mitigation of its spread; this is especially true in cases of relocation/reintroduction or prevalence studies of large or protected herds, where depopulation may be contraindicated. This study evaluated the sensitivity of the real-time quaking-induced conversion (RT-QuIC) assay of recto-anal mucosa-associated lymphoid tissue (RAMALT) biopsy specimens and nasal brushings collected antemortem. These findings were compared to results of immunohistochemistry (IHC) analysis of ante- and postmortem samples. RAMALT samples were collected from populations of farmed and free-ranging Rocky Mountain elk (Cervus elaphus nelsoni;n= 323), and nasal brush samples were collected from a subpopulation of these animals (n= 205). We hypothesized that the sensitivity of RT-QuIC would be comparable to that of IHC analysis of RAMALT and would correspond to that of IHC analysis of postmortem tissues. We found RAMALT sensitivity (77.3%) to be highly correlative between RT-QuIC and IHC analysis. Sensitivity was lower when testing nasal brushings (34%), though both RAMALT and nasal brush test sensitivities were dependent on both thePRNPgenotype and disease progression determined by the obex score. These data suggest that RT-QuIC, like IHC analysis, is a relatively sensitive assay for detection of CWD prions in RAMALT biopsy specimens and, with further investigation, has potential for large-scale and rapid automated testing of antemortem samples for CWD.
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136
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Llorens F, Schmitz M, Karch A, Cramm M, Lange P, Gherib K, Varges D, Schmidt C, Zerr I, Stoeck K. Comparative analysis of cerebrospinal fluid biomarkers in the differential diagnosis of neurodegenerative dementia. Alzheimers Dement 2015; 12:577-89. [PMID: 26718584 DOI: 10.1016/j.jalz.2015.10.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/02/2015] [Accepted: 10/27/2015] [Indexed: 11/18/2022]
Affiliation(s)
- Franc Llorens
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.
| | - Matthias Schmitz
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - André Karch
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Maria Cramm
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Peter Lange
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Kerim Gherib
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Daniela Varges
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Christian Schmidt
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Inga Zerr
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Katharina Stoeck
- Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
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137
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Llorens F, Kruse N, Schmitz M, Shafiq M, da Cunha JEG, Gotzman N, Zafar S, Thune K, de Oliveira JRM, Mollenhauer B, Zerr I. Quantification of CSF biomarkers using an electrochemiluminescence-based detection system in the differential diagnosis of AD and sCJD. J Neurol 2015; 262:2305-11. [DOI: 10.1007/s00415-015-7837-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 06/24/2015] [Accepted: 06/24/2015] [Indexed: 01/26/2023]
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138
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Orrú CD, Groveman BR, Raymond LD, Hughson AG, Nonno R, Zou W, Ghetti B, Gambetti P, Caughey B. Bank Vole Prion Protein As an Apparently Universal Substrate for RT-QuIC-Based Detection and Discrimination of Prion Strains. PLoS Pathog 2015; 11:e1004983. [PMID: 26086786 PMCID: PMC4472236 DOI: 10.1371/journal.ppat.1004983] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 05/26/2015] [Indexed: 01/20/2023] Open
Abstract
Prions propagate as multiple strains in a wide variety of mammalian species. The detection of all such strains by a single ultrasensitive assay such as Real Time Quaking-induced Conversion (RT-QuIC) would facilitate prion disease diagnosis, surveillance and research. Previous studies have shown that bank voles, and transgenic mice expressing bank vole prion protein, are susceptible to most, if not all, types of prions. Here we show that bacterially expressed recombinant bank vole prion protein (residues 23-230) is an effective substrate for the sensitive RT-QuIC detection of all of the different prion types that we have tested so far – a total of 28 from humans, cattle, sheep, cervids and rodents, including several that have previously been undetectable by RT-QuIC or Protein Misfolding Cyclic Amplification. Furthermore, comparison of the relative abilities of different prions to seed positive RT-QuIC reactions with bank vole and not other recombinant prion proteins allowed discrimination of prion strains such as classical and atypical L-type bovine spongiform encephalopathy, classical and atypical Nor98 scrapie in sheep, and sporadic and variant Creutzfeldt-Jakob disease in humans. Comparison of protease-resistant RT-QuIC conversion products also aided strain discrimination and suggested the existence of several distinct classes of prion templates among the many strains tested. Prion diseases are neurodegenerative disorders that propagate as multiple strains in a variety of mammalian species. The detection of all such prion types by a single ultrasensitive assay, such as the Real Time Quaking-induced Conversion (RT-QuIC) assay, would facilitate prion disease diagnosis, surveillance, and research. Here we show detection of minute amounts of 28 different prion types from humans, cattle, sheep, cervids and rodents, some of which were previously undetectable, using a single recombinant bank vole prion protein substrate. We also demonstrate the generation of prion type-dependent RT-QuIC conversion products which may help with prion strain discrimination and the characterization of distinct classes of prion templates. Finally, we describe a practical strategy for prion strain discrimination, e.g. classical and atypical L-type bovine spongiform encephalopathy; classical and atypical Nor98 sheep scrapie; and human sporadic and variant Creutzfeldt-Jakob disease. Thus, our study provides a basis for wide-ranging prion detection and strain discrimination.
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Affiliation(s)
- Christina D. Orrú
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, Montana, United States of America
| | - Bradley R. Groveman
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, Montana, United States of America
| | - Lynne D. Raymond
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, Montana, United States of America
| | - Andrew G. Hughson
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, Montana, United States of America
| | - Romolo Nonno
- Department of Veterinary Public Health and Food Safety, Istituto Superiore di Sanità, Rome, Italy
| | - Wenquan Zou
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Bernardino Ghetti
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Pierluigi Gambetti
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Byron Caughey
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, Montana, United States of America
- * E-mail:
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139
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Validation of 14-3-3 Protein as a Marker in Sporadic Creutzfeldt-Jakob Disease Diagnostic. Mol Neurobiol 2015; 53:2189-99. [DOI: 10.1007/s12035-015-9167-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/31/2015] [Indexed: 11/26/2022]
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