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Deletion of Kif5c Does Not Alter Prion Disease Tempo or Spread in Mouse Brain. Viruses 2021; 13:v13071391. [PMID: 34372599 PMCID: PMC8310152 DOI: 10.3390/v13071391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/06/2021] [Accepted: 07/15/2021] [Indexed: 11/16/2022] Open
Abstract
In prion diseases, the spread of infectious prions (PrPSc) is thought to occur within nerves and across synapses of the central nervous system (CNS). However, the mechanisms by which PrPSc moves within axons and across nerve synapses remain undetermined. Molecular motors, including kinesins and dyneins, transport many types of intracellular cargo. Kinesin-1C (KIF5C) has been shown to transport vesicles carrying the normal prion protein (PrPC) within axons, but whether KIF5C is involved in PrPSc axonal transport is unknown. The current study tested whether stereotactic inoculation in the striatum of KIF5C knock-out mice (Kif5c−/−) with 0.5 µL volumes of mouse-adapted scrapie strains 22 L or ME7 would result in an altered rate of prion spreading and/or disease timing. Groups of mice injected with each strain were euthanized at either pre-clinical time points or following the development of prion disease. Immunohistochemistry for PrP was performed on brain sections and PrPSc distribution and tempo of spread were compared between mouse strains. In these experiments, no differences in PrPSc spread, distribution or survival times were observed between C57BL/6 and Kif5c−/− mice.
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Abstract
UNLABELLED Natural transmission of prion diseases depends upon the spread of prions from the nervous system to excretory or secretory tissues, but the mechanism of prion transport in axons and into peripheral tissue is unresolved. Here, we examined the temporal and spatial movement of prions from the brain stem along cranial nerves into skeletal muscle as a model of axonal transport and transynaptic spread. The disease-specific isoform of the prion protein, PrP(Sc), was observed in nerve fibers of the tongue approximately 2 weeks prior to PrP(Sc) deposition in skeletal muscle. Initially, PrP(Sc) deposits had a small punctate pattern on the edge of muscle cells that colocalized with synaptophysin, a marker for the neuromuscular junction (NMJ), in >50% of the cells. At later time points PrP(Sc) was widely distributed in muscle cells, but <10% of prion-infected cells exhibited PrP(Sc) deposition at the NMJ, suggesting additional prion replication and dissemination within muscle cells. In contrast to the NMJ, PrP(Sc) was not associated with synaptophysin in nerve fibers but was found to colocalize with LAMP-1 and cathepsin D during early stages of axonal spread. We propose that PrP(Sc)-bound endosomes can lead to membrane recycling in which PrP(Sc) is directed to the synapse, where it either moves across the NMJ into the postsynaptic muscle cell or induces PrP(Sc) formation on muscle cells across the NMJ. IMPORTANCE Prion diseases are transmissible and fatal neurodegenerative diseases in which prion dissemination to excretory or secretory tissues is necessary for natural disease transmission. Despite the importance of this pathway, the cellular mechanism of prion transport in axons and into peripheral tissue is unresolved. This study demonstrates anterograde spread of prions within nerve fibers prior to infection of peripheral synapses (i.e., neuromuscular junction) and infection of peripheral tissues (i.e., muscle cells). Within nerve fibers prions were associated with the endosomal-lysosomal pathway prior to entry into muscle cells. Since early prion spread is anterograde and endosome-lysosomal movement within axons is primarily retrograde, these findings suggest that endosome-bound prions may have an alternate fate that directs prions to the peripheral synapse.
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Schiavo G, Greensmith L, Hafezparast M, Fisher EMC. Cytoplasmic dynein heavy chain: the servant of many masters. Trends Neurosci 2013; 36:641-51. [PMID: 24035135 PMCID: PMC3824068 DOI: 10.1016/j.tins.2013.08.001] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 07/23/2013] [Accepted: 08/05/2013] [Indexed: 12/20/2022]
Abstract
The cytoplasmic dynein complex is the main retrograde motor in all eukaryotic cells. This complex is built around a dimer of cytoplasmic dynein heavy chains (DYNC1H1). Mouse DYNC1H1 mutants have sensory defects, but motor defects have been controversial. Now human DYNC1H1 mutations with sensory, motor, and cognitive deficits are being found. The study of these mutations will give us new insight into DYNC1H1 function in the nervous system.
Cytoplasmic dynein is the main retrograde motor in all eukaryotic cells. This complex comprises different subunits assembled on a cytoplasmic dynein heavy chain 1 (DYNC1H1) dimer. Cytoplasmic dynein is particularly important for neurons because it carries essential signals and organelles from distal sites to the cell body. In the past decade, several mouse models have helped to dissect the numerous functions of DYNC1H1. Additionally, several DYNC1H1 mutations have recently been found in human patients that give rise to a broad spectrum of developmental and midlife-onset disorders. Here, we discuss the effects of mutations of mouse and human DYNC1H1 and how these studies are giving us new insight into the many critical roles DYNC1H1 plays in the nervous system.
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Affiliation(s)
- Giampietro Schiavo
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, National Hospital for Neurology and Neurosurgery, University College London, Queen Square, London WC1N 3BG, UK; Molecular NeuroPathobiology, Cancer Research UK London Research Institute, 44 Lincoln's Inn Fields, London WC2A 3LY, UK.
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Eschbach J, Dupuis L. Cytoplasmic dynein in neurodegeneration. Pharmacol Ther 2011; 130:348-63. [PMID: 21420428 DOI: 10.1016/j.pharmthera.2011.03.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Accepted: 03/01/2011] [Indexed: 12/11/2022]
Abstract
Cytoplasmic dynein 1 (later referred to as dynein) is the major molecular motor moving cargoes such as mitochondria, organelles and proteins towards the minus end of microtubules. Dynein is involved in multiple basic cellular functions, such as mitosis, autophagy and structure of endoplasmic reticulum and Golgi, but also in neuron specific functions in particular retrograde axonal transport. Dynein is regulated by a number of protein complexes, notably by dynactin. Several studies have supported indirectly the involvement of dynein in neurodegeneration associated with Alzheimer's disease, Parkinson's disease, Huntington's disease and motor neuron diseases. First, axonal transport disruption represents a common feature occurring in neurodegenerative diseases. Second, a number of dynein-dependent processes, including autophagy or clearance of aggregation-prone proteins, are found defective in most of these diseases. Third, a number of mutant genes in various neurodegenerative diseases are involved in the regulation of dynein transport. This includes notably mutations in the P150Glued subunit of dynactin that are found in Perry syndrome and motor neuron diseases. Interestingly, gene products that are mutant in Huntington's disease, Parkinson's disease, motor neuron disease or spino-cerebellar ataxia are also involved in the regulation of dynein motor activity or of cargo binding. Despite a constellation of indirect evidence, direct links between the motor itself and neurodegeneration are few, and this might be due to the requirement of fully active dynein for development. Here, we critically review the evidence of dynein involvement in different neurodegenerative diseases and discuss potential underlying mechanisms.
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Affiliation(s)
- Judith Eschbach
- Inserm U692, Laboratoire de Signalisations Moléculaires et Neurodégénérescence, Strasbourg, F-67085, France
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Change in tau phosphorylation associated with neurodegeneration in the ME7 model of prion disease. Biochem Soc Trans 2010; 38:545-51. [PMID: 20298219 DOI: 10.1042/bst0380545] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Hyperphosphorylation of the microtubule-associated protein tau is a significant determinant in AD (Alzheimer's disease), where it is associated with disrupted axonal transport and probably causes synaptic dysfunction. Although less well studied, hyperphosphorylation has been observed in prion disease. We have investigated the expression of hyperphosphorylated tau in the hippocampus of mice infected with the ME7 prion agent. In ME7-infected animals, there is a selective loss of CA1 synapse, first discernable at 13 weeks of disease. There is a potential that dysfunctional axonal transport contributes to this synaptopathy. Thus investigating hyperphosphorylated tau that is dysfunctional in AD could illuminate whether and how they are significant in prion disease. We observed no differences in the levels of phosphorylated tau (using MC1, PHF-1 and CP13 antibodies) in detergent-soluble and detergent-insoluble fractions extracted from ME7- and NBH- (normal brain homogenate) treated animals across disease. In contrast, we observed an increase in phospho-tau staining for several epitopes using immunohistochemistry in ME7-infected hippocampal sections. Although the changes were not of the magnitude seen in AD tissue, clear differences for several phospho-tau species were seen in the CA1 and CA3 of ME7-treated animals (pSer(199-202)>pSer(214)>PHF-1 antibody). Temporally, these changes were restricted to animals at 20 weeks and none of the disease-related staining was associated with the axons or dendrites that hold CA1 synapses. These findings suggest that phosphorylation of tau at the epitopes examined does not underpin the early synaptic dysfunction. These data suggest that the changes in tau phosphorylation recorded here and observed by others relate to end-stage prion pathology when early dysfunctions have progressed to overt neuronal loss.
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Ermolayev V, Cathomen T, Merk J, Friedrich M, Härtig W, Harms GS, Klein MA, Flechsig E. Impaired axonal transport in motor neurons correlates with clinical prion disease. PLoS Pathog 2009; 5:e1000558. [PMID: 19696919 PMCID: PMC2723930 DOI: 10.1371/journal.ppat.1000558] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Accepted: 07/27/2009] [Indexed: 12/29/2022] Open
Abstract
Prion diseases are fatal neurodegenerative disorders causing motor dysfunctions, dementia and neuropathological changes such as spongiosis, astroglyosis and neuronal loss. The chain of events leading to the clinical disease and the role of distinct brain areas are still poorly understood. The role of nervous system integrity and axonal properties in prion pathology are still elusive. There is no evidence of both the functional axonal impairments in vivo and their connection with prion disease. We studied the functional axonal impairments in motor neurons at the onset of clinical prion disease using the combination of tracing as a functional assay for axonal transport with immunohistochemistry experiments. Well-established and novel confocal and ultramicroscopy techniques were used to image and quantify labeled neurons. Despite profound differences in the incubation times, 30% to 45% of neurons in the red nucleus of different mouse lines showed axonal transport impairments at the disease onset bilaterally after intracerebral prion inoculation and unilaterally—after inoculation into the right sciatic nerve. Up to 94% of motor cortex neurons also demonstrated transport defects upon analysis by alternative imaging methods. Our data connect axonal transport impairments with disease symptoms for different prion strains and inoculation routes and establish further insight on the development of prion pathology in vivo. The alterations in localization of the proteins involved in the retrograde axonal transport allow us to propose a mechanism of transport disruption, which involves Rab7-mediated cargo attachment to the dynein-dynactin pathway. These findings suggest novel targets for therapeutic and diagnostic approaches in the early stages of prion disease. For almost a century, prion disease symptoms, such as dementia and motor system defects, have been accompanied with neuropathological hallmarks in the central nervous system. In past decades, discrepancies between neuropathological changes and clinical symptoms showed that the processes triggering the disease remain elusive. We concentrated on the hypothesis that nervous system integrity and axonal properties may play an important role in the disease development. Since motor system defects are typical for prion disease, we investigated the centers of the motor system, red nucleus and hindlimb area of motor cortex. Although intracerebral prion infection led to a 30% to 45% bilateral reduction of labeled neurons in the red nucleus, infection into the right sciatic nerve—the major hindlimb nerve—led to unilateral reduction of labeled neurons in the red nucleus. Up to 94% reduction was found in the neurons of motor cortex hindlimb area. This reduction is probably caused by functional axonal impairments in motor neurons. Prion-induced alterations in protein distribution implicate a mechanism of transport disruption at cargo attachment to the retrograde axonal transport complex. Our work reveals a connection between axonal transport impairments and disease symptoms in vivo, providing further insight in the development of prion pathology and suggesting novel targets for therapeutic and diagnostic approaches.
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Affiliation(s)
- Vladimir Ermolayev
- Molecular Microscopy Group, DFG Rudolf Virchow Center for Experimental Biomedicine, University of Würzburg, Würzburg, Germany
- Institute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Toni Cathomen
- Department of Virology, Institute of Infectious Diseases, Charité Medical School, Berlin, Germany
| | - Julia Merk
- Institute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Mike Friedrich
- Molecular Microscopy Group, DFG Rudolf Virchow Center for Experimental Biomedicine, University of Würzburg, Würzburg, Germany
| | - Wolfgang Härtig
- University of Leipzig, Paul Flechsig Institute for Brain Research, Leipzig, Germany
| | - Gregory S. Harms
- Molecular Microscopy Group, DFG Rudolf Virchow Center for Experimental Biomedicine, University of Würzburg, Würzburg, Germany
- * E-mail: (GSH); (MAK)
| | - Michael A. Klein
- Institute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany
- * E-mail: (GSH); (MAK)
| | - Eckhard Flechsig
- Institute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany
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Ermolayev V, Friedrich M, Nozadze R, Cathomen T, Klein MA, Harms GS, Flechsig E. Ultramicroscopy reveals axonal transport impairments in cortical motor neurons at prion disease. Biophys J 2009; 96:3390-8. [PMID: 19383482 PMCID: PMC2718265 DOI: 10.1016/j.bpj.2009.01.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 12/02/2008] [Accepted: 01/14/2009] [Indexed: 02/04/2023] Open
Abstract
The functional imaging of neuronal circuits of the central nervous system is crucial for phenotype screenings or investigations of defects in neurodegenerative disorders. Current techniques yield either low penetration depth, yield poor resolution, or are restricted by the age of the animals. Here, we present a novel ultramicroscopy protocol for fluorescence imaging and three-dimensional reconstruction in the central nervous system of adult mice. In combination with tracing as a functional assay for axonal transport, retrogradely labeled descending motor neurons were visualized with >4 mm penetration depth. The analysis of the motor cortex shortly before the onset of clinical prion disease revealed that >80% neurons have functional impairments in axonal transport. Our study provides evidence that prion disease is associated with severe axonal transport defects in the cortical motor neurons and suggests a novel mechanism for prion-mediated neurodegeneration.
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Affiliation(s)
- Vladimir Ermolayev
- Institute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Mike Friedrich
- Molecular Microscopy Group, Rudolf Virchow Center, University of Würzburg, Würzburg, Germany
| | - Revaz Nozadze
- Molecular Microscopy Group, Rudolf Virchow Center, University of Würzburg, Würzburg, Germany
| | - Toni Cathomen
- Charité Medical School, Institute of Virology, Berlin, Germany
| | - Michael A. Klein
- Institute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Gregory S. Harms
- Molecular Microscopy Group, Rudolf Virchow Center, University of Würzburg, Würzburg, Germany
| | - Eckhard Flechsig
- Institute of Virology and Immunobiology, University of Würzburg, Würzburg, Germany
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Making it to the synapse: measles virus spread in and among neurons. Curr Top Microbiol Immunol 2009; 330:3-30. [PMID: 19203102 DOI: 10.1007/978-3-540-70617-5_1] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Measles virus (MV) is one of the most transmissible microorganisms known, continuing to result in extensive morbidity and mortality worldwide. While rare, MV can infect the human central nervous system, triggering fatal CNS diseases weeks to years after exposure. The advent of crucial laboratory tools to dissect MV neuropathogenesis, including permissive transgenic mouse models, the capacity to manipulate the viral genome using reverse genetics, and cell biology advances in understanding the processes that govern intracellular trafficking of viral components, have substantially clarified how MV infects, spreads, and persists in this unique cell population. This review highlights some of these technical advances, followed by a discussion of our present understanding of MV neuronal infection and transport. Because some of these processes may be shared among diverse viruses, comparisons are made to parallel studies with other neurotropic viruses. While a crystallized view of how the unique environment of the neuron affects MV replication, spread, and, ultimately, neuropathogenesis is not fully realized, the tools and ideas are in place for exciting advances in the coming years.
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Kratzel C, Krüger D, Beekes M. Prion propagation in a nerve conduit model containing segments devoid of axons. J Gen Virol 2008; 88:3479-3485. [PMID: 18024919 DOI: 10.1099/vir.0.83187-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Prions, the putative causative agents of transmissible spongiform encephalopathies, are neurotropic pathogens that spread to the central nervous system via synaptically linked neural conduits upon peripheral infection. Axons and their transport processes have been suggested as mediators of nerve-associated prion dissemination. However, the exact cellular components and molecular mechanisms underlying neural spread are unknown. This study used an established hamster scrapie model to pursue a novel experimental approach using nerve conduits containing segments devoid of neurites generated by incomplete nerve regeneration following Wallerian degeneration to probe the necessity of axons for the neural propagation of prions. For this purpose, animals were subjected to unilateral sciatic neurectomy 4 weeks before footpad inoculation with scrapie agent. The results showed that the regional nerve is the prime conduit for cerebral neuroinvasion and revealed, as evidenced by the accumulation of pathological prion protein PrP TSE, that prions can proceed along segments of peripheral neural projections without detectable axonal structures.
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Affiliation(s)
| | | | - Michael Beekes
- Robert Koch Institute, Nordufer 20, D-13353 Berlin, Germany
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Beekes M, McBride PA. The spread of prions through the body in naturally acquired transmissible spongiform encephalopathies. FEBS J 2007; 274:588-605. [PMID: 17288548 DOI: 10.1111/j.1742-4658.2007.05631.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Transmissible spongiform encephalopathies are fatal neurodegenerative diseases that are caused by unconventional pathogens and affect the central nervous system of animals and humans. Several different forms of these diseases result from natural infection (i.e. exposure to transmissible spongiform encephalopathy agents or prions, present in the natural environment of the respective host). This holds true also for scrapie in sheep, bovine spongiform encephalopathy in cattle, chronic wasting disease in elk and deer, or variant Creutzfeldt-Jakob disease in humans, all of which are assumed to originate predominantly from peroral prion infection. This article intends to provide an overview of the current state of knowledge on the spread of scrapie, chronic wasting disease, bovine spongiform encephalopathy and variant Creutzfeldt-Jakob disease agents through the body in naturally affected hosts, and in model animals experimentally challenged via the alimentary tract. Special attention is given to the tissue components and spreading pathways involved in the key stages of prion routing through the body, such as intestinal uptake, neuroinvasion of nerves and the central nervous system, and centrifugal spread from the brain and spinal cord to peripheral sites (e.g. sensory ganglia or muscles). The elucidation of the pathways and mechanisms by which prions invade a host and spread through the organism can contribute to efficient infection control strategies and the improvement of transmissible spongiform encephalopathy diagnostics. It may also help to identify prophylactic or therapeutic approaches that would impede naturally acquired transmissible spongiform encephalopathy infections.
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Affiliation(s)
- Michael Beekes
- Robert Koch-Institut (P24 - Transmissible Spongiforme Enzephalopathien), Berlin, Germany.
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Abstract
The infectious particle causing transmissible spongiform encephalopathy (TSE), a fatal neurodegenerative disease of humans and animals, has been termed prion. Its major component is an aggregated variant of the cellular prion protein, PrP(C). The main target of prion pathology is the central nervous system (CNS), yet most prion diseases are initiated or accompanied by prion replication at extracerebral locations, including secondary lymphoid organs, muscle and, in some instances, blood. How do prions travel from the periphery into the CNS? Is this an active or a passive process and does neuronal prion transport explain the long incubation times in prion diseases? Alternatively, if prion infectivity arises spontaneously in the CNS, as believed from sporadic Creutzfeldt-Jakob patients, how do prions manage to travel from the CNS into the periphery (e.g., spleen, muscle) of the infected host? The mechanisms of neuronal prion transport from the periphery into the CNS or vice versa are heavily investigated and debated but poorly understood. Although research in the past has accumulated knowledge on prion progression from the periphery to the brain, we are far from understanding the molecular mechanisms of neuronal prion transport.
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Affiliation(s)
- Mathias Heikenwalder
- Department of Pathology, Institute of Neuropathology, University Hospital of Zürich, Zürich, Switzerland.
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Kratzel C, Mai J, Madela K, Beekes M, Krüger D. Propagation of scrapie in peripheral nerves after footpad infection in normal and neurotoxin exposed hamsters. Vet Res 2006; 38:127-39. [PMID: 17181988 DOI: 10.1051/vetres:2006047] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2006] [Accepted: 09/01/2006] [Indexed: 11/14/2022] Open
Abstract
As is known from various animal models, the spread of agents causing transmissible spongiform encephalopathies (TSE) after peripheral infection affects peripheral nerves before reaching the central nervous system (CNS) and leading to a fatal end of the disease. The lack of therapeutic approaches for TSE is partially due to the limited amount of information available on the involvement of host biological compartments and processes in the propagation of the infectious agent. The in vivo model presented here can provide information on the spread of the scrapie agent via the peripheral nerves of hamsters under normal and altered axonal conditions. Syrian hamsters were unilaterally footpad (f.p.) infected with scrapie. The results of the spatiotemporal ultrasensitive immunoblot-detection of scrapie-associated prion protein (PrP(Sc)) in serial nerve segments of both distal sciatic nerves could be interpreted as a centripetal and subsequent centrifugal neural spread of PrP(Sc) for this route of infection. In order to determine whether this propagation is dependent on main components in the axonal cytoskeleton (e.g. neurofilaments, also relevant for the component ;a' of slow axonal transport mechanisms), hamsters were treated -in an additional experiment- with the neurotoxin beta,beta-iminodiproprionitrile (IDPN) around the beginning of the scrapie infection. A comparison of the Western blot signals of PrP(Sc) in the ipsilateral and in the subsequently affected contralateral sciatic nerve segments with the results revealed from IDPN-untreated animals at preclinical and clinical stages of the TSE disease, indicated similar amounts of PrP(Sc). Furthermore, the mean survival time was unchanged in both groups. This in vivo model, therefore, suggests that the propagation of PrP(Sc) along peripheral nerves is not dependent on an intact neurofilament component of the axonal cytoskeleton. Additionally, the model indicates that the spread of PrP(Sc) is not mediated by the slow component ;a' of the axonal transport mechanism.
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Affiliation(s)
- Christine Kratzel
- Robert Koch-Institut, P24 - Transmissible Spongiforme Enzephalopathien, Nordufer 20, 13353 Berlin, Germany.
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