1
|
Rossi M, Kai H, Baiardi S, Bartoletti-Stella A, Carlà B, Zenesini C, Capellari S, Kitamoto T, Parchi P. The characterization of AD/PART co-pathology in CJD suggests independent pathogenic mechanisms and no cross-seeding between misfolded Aβ and prion proteins. Acta Neuropathol Commun 2019; 7:53. [PMID: 30961668 PMCID: PMC6454607 DOI: 10.1186/s40478-019-0706-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 03/21/2019] [Indexed: 12/14/2022] Open
Abstract
Current evidence indicating a role of the human prion protein (PrP) in amyloid-beta (Aβ) formation or a synergistic effect between Aβ and prion pathology remains controversial. Conflicting results also concern the frequency of the association between the two protein misfolding disorders and the issue of whether the apolipoprotein E gene (APOE) and the prion protein gene (PRNP), the major modifiers of Aβ- and PrP-related pathologies, also have a pathogenic role in other proteinopathies, including tau neurofibrillary degeneration. Here, we thoroughly characterized the Alzheimer's disease/primary age-related tauopathy (AD/PART) spectrum in a series of 450 cases with definite sporadic or genetic Creutzfeldt-Jakob disease (CJD). Moreover, we analyzed: (i) the effect of variables known to affect CJD pathogenesis and the co-occurring Aβ- and tau-related pathologies; (II) the influence of APOE genotype on CJD pathology, and (III) the effect of AD/PART co-pathology on the clinical CJD phenotype. AD/PART characterized 74% of CJD brains, with 53.3% and 8.2% showing low or intermediate-high levels of AD pathology, and 12.4 and 11.8% definite or possible PART. There was no significant correlation between variables affecting CJD (i.e., disease subtype, prion strain, PRNP genotype) and those defining the AD/PART spectrum (i.e., ABC score, Thal phase, prevalence of CAA and Braak stage), and no difference in the distribution of APOE ε4 and ε2 genotypes among CJD subtypes. Moreover, AD/PART co-pathology did not significantly affect the clinical presentation of typical CJD, except for a tendency to increase the frequency of cognitive symptoms. Altogether, the present results seem to exclude an increased prevalence AD/PART co-pathology in sporadic and genetic CJD, and indicate that largely independent pathogenic mechanisms drive AD/PART and CJD pathology even when they coexist in the same brain.
Collapse
Affiliation(s)
- Marcello Rossi
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Via Altura 1/8, 40139 Bologna, Italy
| | - Hideaki Kai
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Via Altura 1/8, 40139 Bologna, Italy
- Department of Neurological Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Simone Baiardi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Anna Bartoletti-Stella
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Via Altura 1/8, 40139 Bologna, Italy
| | - Benedetta Carlà
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Via Altura 1/8, 40139 Bologna, Italy
| | - Corrado Zenesini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Via Altura 1/8, 40139 Bologna, Italy
| | - Sabina Capellari
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Via Altura 1/8, 40139 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Tetsuyuki Kitamoto
- Department of Neurological Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Piero Parchi
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Via Altura 1/8, 40139 Bologna, Italy
| |
Collapse
|
2
|
Wang X, Li N, Liu A, Ma L, Shan P, Jiang W, Zhang Q. Three sporadic cases of Creutzfeldt-Jakob disease in China and their clinical analysis. Exp Ther Med 2017; 14:2664-2670. [PMID: 28962210 DOI: 10.3892/etm.2017.4832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 01/06/2017] [Indexed: 11/05/2022] Open
Abstract
The present study described the characteristics of three cases of Creutzfeldt-Jakob disease (CJD) in China and analyzed their clinical presentations. The clinical information of the three cases was collected and analyzed. Blood and cerebrospinal fluid (CSF) specimens of the patients were collected for detection of the prion protein (PRNP) gene and 14-3-3 protein levels. Dynamic changes of electroencephalograms (EEGs) and brain magnetic resonance images (MRIs) were also observed. All the three cases were sporadic CJD cases. They presented with symptoms including hyposthenia, progressive memory loss, truncal and limb ataxia, dysarthria, lowered vision acuity, bucking, language disorders, myoclonia and akinetic mutism state. One of the three cases was associated with a prolonged duration of >6 years. The EEG of two cases showed slow biphasic waves. The diffusion-weighted MRI sequence revealed abnormal hyperintensity and bilateral ribboning in the cortex. Two patients tested positive for the 14-3-3 protein in the CSF. All patients were of methionine homozygosity at codon 129 in the gene encoding PRNP protein and one patient had a mutation. The CJD cases showed differences in terms of symptoms and disease duration. Subacute onset was common and with attentive nursing and supportive treatments, one of the patients had a prolonged survival time of >6 years.
Collapse
Affiliation(s)
- Xingbang Wang
- Department of Neurology, Cadre Clinic, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
| | - Na Li
- Department of Dermatology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250011, P.R. China
| | - Aifen Liu
- Department of Neurology, Cadre Clinic, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
| | - Lin Ma
- Department of Neurology, Cadre Clinic, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
| | - Peiyan Shan
- Department of Neurology, Cadre Clinic, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
| | - Wenjing Jiang
- Department of Neurology, Cadre Clinic, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
| | - Qun Zhang
- Department of Neurology, Cadre Clinic, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
| |
Collapse
|
3
|
Park SM, Kim HJ, Jeong BH. WITHDRAWN: Apolipoprotein E gene polymorphism may increase susceptibility to sporadic Creutzfeldt-Jakob disease in a Korean population. Neurobiol Aging 2015:S0197-4580(15)00592-8. [PMID: 26724961 DOI: 10.1016/j.neurobiolaging.2015.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/03/2015] [Accepted: 11/26/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Seon-Mi Park
- Korea Zoonosis Research Institute, Chonbuk National University, Iksan, Jeonbuk, Republic of Korea
| | - Hae-Jung Kim
- Korea Zoonosis Research Institute, Chonbuk National University, Iksan, Jeonbuk, Republic of Korea
| | - Byung-Hoon Jeong
- Korea Zoonosis Research Institute, Chonbuk National University, Iksan, Jeonbuk, Republic of Korea; Department of Bioactive Material Sciences, Chonbuk National University, Jeonju, Jeonbuk, Republic of Korea
| |
Collapse
|
4
|
Wei Y, Tang Y, He W, Qu Z, Zeng J, Qin C. APOE gene polymorphisms and susceptibility to Creutzfeldt-Jakob disease. J Clin Neurosci 2013; 21:390-4. [PMID: 24332811 DOI: 10.1016/j.jocn.2013.07.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 05/29/2013] [Accepted: 07/04/2013] [Indexed: 11/28/2022]
Abstract
Associations between apolipoprotein E (APOE) gene polymorphisms and Creutzfeldt-Jakob disease (CJD) have been reported, but the results from many of these studies are conflicting. To investigate the association between APOE polymorphisms and CJD risk, we performed a meta-analysis. We used odds ratios (OR) with 95% confidence intervals (CI) to assess the strength of the association. The frequency of putative risk alleles in control subjects was estimated with the Mantel-Haenszel method. Cochran's Q statistic and the inconsistency index (I(2)) were used to test heterogeneity. Egger's test and an inverted funnel plot were used to assess bias. Our study included 11 published case-control studies with APOE genotyping, involving a total of 1001 CJD patients and 1211 controls. Overall, the APOE 34 (OR 1.37, 95% CI: 1.09-1.72), and APOE 44 (OR 3.16, 95% CI: 1.37-7.26) genotypes and the APOE 4 (OR 1.41, 95% CI: 1.08-1.85) allele were associated with an increased risk of CJD, and the APOE 33 (OR 0.81, 95% CI: 0.67-0.97) genotype tended to protect against CJD. However, we did not find significant evidence supporting associations of the APOE 22 (OR 1.15, 95% CI: 0.45-2.93), APOE 23 (OR 0.84, 95% CI: 0.64-1.09), or APOE 24 (OR 1.40, 95% CI: 0.70-2.77) genotypes, nor the APOE 2 (OR 1.02, 95% CI: 0.73-1.42) or APOE 3 (OR 0.82, 95% CI: 0.65-1.02) alleles with CJD using a fixed-effects model. Our results support a genetic association between APOE polymorphisms and CJD.
Collapse
Affiliation(s)
- Yunfei Wei
- Department of Neurology, First Affiliated Hospital, Guangxi Medical University, No. 22, Shuang Yong Lu, Nanning 530021, Guangxi, China
| | - Yanyan Tang
- Department of Neurology, First Affiliated Hospital, Guangxi Medical University, No. 22, Shuang Yong Lu, Nanning 530021, Guangxi, China
| | - Wenwu He
- Department of Cardiothoracic Surgery, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Zhanli Qu
- Department of Neurology, First Affiliated Hospital, Guangxi Medical University, No. 22, Shuang Yong Lu, Nanning 530021, Guangxi, China
| | - Jinming Zeng
- Department of Anesthesiology, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Chao Qin
- Department of Neurology, First Affiliated Hospital, Guangxi Medical University, No. 22, Shuang Yong Lu, Nanning 530021, Guangxi, China.
| |
Collapse
|
5
|
Chen C, Wang JC, Shi Q, Zhou W, Zhang XM, Zhang J, Tian C, Gao C, Dong XP. Analyses of the survival time and the influencing factors of chinese patients with prion diseases based on the surveillance data from 2008-2011. PLoS One 2013; 8:e62553. [PMID: 23671608 PMCID: PMC3645993 DOI: 10.1371/journal.pone.0062553] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 03/23/2013] [Indexed: 11/25/2022] Open
Abstract
Background Prion diseases are kinds of progressive, incurable neurodegenerative disorders. So far, survival time of the patients with these diseases in China is unclear. Methods Based upon the surveillance data from Chinese Creutzfeldt-Jakob disease (CJD) surveillance network from January 2008 to December 2011, a retrospective follow-up survey was performed. The survival times of Chinese patients with prion diseases and the possible influencing factors were analyzed. Results Median survival time of 121 deceased patients was 7.1 months, while those for sporadic CJD (sCJD), familial CJD (fCJD) and fatal familial insomnia (FFI) cases were 6.1, 3.1 and 8.2 months, respectively. 74.0% of sCJD patients, 100% of fCJD cases and 91.7% FFI cases died within one year. The general socio-demographic factors, abnormalities in clinical examinations, clinical manifestations, and social factors did not significantly influence the survival times of Chinese prion patients. Conclusions Survival time of Chinese patients with prion diseases was comparable with that of many Western countries, but obviously shorter than that of Japan. Patients with acute onset and rapid progression had significantly short survival times.
Collapse
Affiliation(s)
- Cao Chen
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Ji-Chun Wang
- Division of Science and Technology, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Qi Shi
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Wei Zhou
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Xiao-Mei Zhang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Jin Zhang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Chan Tian
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Chen Gao
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Xiao-Ping Dong
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
- Chinese Academy of Sciences, Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, People’s Republic of China
- * E-mail:
| |
Collapse
|
6
|
Entzündliche Erkrankungen. KLINISCHE NEUROLOGIE 2011. [PMCID: PMC7123238 DOI: 10.1007/978-3-642-16920-5_33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Unter einer Meningitis versteht man eine Entzündung von Pia mater und Arachnoidea. Das Erregerspektrum ist weit und reicht von Bakterien, die hämatogen-metastatisch, fortgeleitet oder durch offene Hirnverletzung zur eitrigen Meningitis führen, über Viren zu Pilzen und Parasiten. Insbesondere bei den unbehandelt häufig letal verlaufenden eitrigen Meningitiden ist eine rasche Diagnose mit Erregernachweis notwendig. Unverzüglich ist daraufhin eine spezifische, der regionalen Resistenzentwicklung angepasste Therapie einzuleiten. Die meningeale Affektion im Rahmen einer Listeriose oder Tuberkulose verdient aufgrund des klinischen Bildes, des Verlaufs und der spezifischen Therapie besondere Beachtung. Die fungalen Infektionen werden, da klinisch häufig als Meningoenzephalitis imponierend, in Abschn. 33.3 abgehandelt.
Collapse
|