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Luk CC, Mathiason CK, Orrù CD, Jansen GH, Thiele A, Caughey B, Sim VL. Creutzfeldt-Jakob disease in pregnancy: the use of modified RT-QuIC to determine infectivity in placental tissues. Prion 2021; 15:107-111. [PMID: 34132175 PMCID: PMC8210859 DOI: 10.1080/19336896.2021.1933872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Sporadic Creutzfeldt–Jakob Disease (sCJD) rarely affects women of childbearing age. There is currently no evidence of vertical transmission. Given the biosafety implications of performing Caesarean sections (C-section) in these patients, we used sensitive real-time quaking-induced conversion (RT-QuIC) assays to test for the infectious prion protein (PrPSc) in products of gestation. A 35-year-old woman with sCJD presented in her 10th gestational week with an eight month history of progressive cognitive impairment. During C-section, amniotic fluid, cord blood and placental tissue were collected and analysed using RT-QuIC protocols adapted for use with these tissues. The patient’s diagnosis of sCJD, MM2 subtype, was confirmed at autopsy. There were borderline positive results in one sampled area of the placenta, but otherwise the cord blood and amniotic fluid were negative on our RT-QuIC assays. A healthy baby was delivered via C-section at 36 weeks and 3 days gestational age, with no evidence of neurological disease to date. We conclude that precautions should be taken with products of gestation, but the level of PrPSc is extremely low.
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Affiliation(s)
- Collin C Luk
- Division of Neurology, Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Candace K Mathiason
- Department of Microbiology, Immunology, and Pathology, Prion Research Center, Colorado State University, Fort Collins, CO, USA
| | - Christina D Orrù
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, NIH, Hamilton, MT, USA
| | - Gerard H Jansen
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada
| | - Allison Thiele
- Department of Obstetrics and Gynaecology, Faculty of Medicine & Dentistry, Edmonton, Canada
| | - Byron Caughey
- Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, NIH, Hamilton, MT, USA
| | - Valerie L Sim
- Division of Neurology, Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada.,Centre for Prions & Protein Folding Diseases, University of Alberta, Edmonton, Canada
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Infectious Prions in the Pregnancy Microenvironment of Chronic Wasting Disease-Infected Reeves' Muntjac Deer. J Virol 2017; 91:JVI.00501-17. [PMID: 28539446 DOI: 10.1128/jvi.00501-17] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/05/2017] [Indexed: 11/20/2022] Open
Abstract
Ample evidence exists for the presence of infectious agents at the maternal-fetal interface, often with grave outcomes to the developing fetus (i.e., Zika virus, brucella, cytomegalovirus, and toxoplasma). While less studied, pregnancy-related transmissible spongiform encephalopathies (TSEs) have been implicated in several species, including humans. Our previous work has shown that prions can be transferred from mother to offspring, resulting in the development of clinical TSE disease in offspring born to muntjac dams infected with chronic wasting disease (CWD) (1). We further demonstrated protein misfolding cyclic amplification (PMCA)-competent prions within the female reproductive tract and in fetal tissues harvested from CWD experimentally and naturally exposed cervids (1, 2). To assess whether the PMCA-competent prions residing at the maternal-fetal interface were infectious and to determine if the real-time quaking-induced conversion (RT-QuIC) methodology may enhance our ability to detect amyloid fibrils within the pregnancy microenvironment, we employed a mouse bioassay and RT-QuIC. In this study, we have demonstrated RT-QuIC seeding activity in uterus, placentome, ovary, and amniotic fluid but not in allantoic fluids harvested from CWD-infected Reeves' muntjac dams showing clinical signs of infection (clinically CWD-infected) and in some placentomes from pre-clinically CWD-infected dams. Prion infectivity was confirmed within the uterus, amniotic fluid, and the placentome, the semipermeable interface that sustains the developing fetus, of CWD-infected dams. This is the first report of prion infectivity within the cervid pregnancy microenvironment, revealing a source of fetal CWD exposure prior to the birthing process, maternal grooming, or encounters with contaminated environments.IMPORTANCE The facile dissemination of chronic wasting disease within captive and free-range cervid populations has led to questions regarding the transmission dynamics of this disease. Direct contact with infected animals and indirect contact with infectious prions in bodily fluids and contaminated environments are suspected to explain the majority of this transmission. A third mode of transmission, from mother to offspring, may be underappreciated. The presence of pregnancy-related prion infectivity within the uterus, amniotic fluid, and the placental structure reveals that the developing fetus is exposed to a source of prions long before exposure to the infectious agent during and after the birthing process or via contact with contaminated environments. These findings have impact on our current concept of CWD disease transmission.
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Nalls AV, McNulty E, Powers J, Seelig DM, Hoover C, Haley NJ, Hayes-Klug J, Anderson K, Stewart P, Goldmann W, Hoover EA, Mathiason CK. Mother to offspring transmission of chronic wasting disease in reeves' muntjac deer. PLoS One 2013; 8:e71844. [PMID: 23977159 PMCID: PMC3743758 DOI: 10.1371/journal.pone.0071844] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 07/03/2013] [Indexed: 01/09/2023] Open
Abstract
The horizontal transmission of prion diseases has been well characterized in bovine spongiform encephalopathy (BSE), chronic wasting disease (CWD) of deer and elk and scrapie of sheep, and has been regarded as the primary mode of transmission. Few studies have monitored the possibility of vertical transmission occurring within an infected mother during pregnancy. To study the potential for and pathway of vertical transmission of CWD in the native cervid species, we used a small cervid model-the polyestrous breeding, indoor maintainable, Reeves' muntjac deer-and determined that the susceptibility and pathogenesis of CWD in these deer reproduce that in native mule and white-tailed deer. Moreover, we demonstrate here that CWD prions are transmitted from doe to fawn. Maternal CWD infection also appears to result in lower percentage of live birth offspring. In addition, evolving evidence from protein misfolding cyclic amplification (PMCA) assays on fetal tissues suggest that covert prion infection occurs in utero. Overall, our findings demonstrate that transmission of prions from mother to offspring can occur, and may be underestimated for all prion diseases.
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Affiliation(s)
- Amy V. Nalls
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Erin McNulty
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Jenny Powers
- Biological Resource Management Division, National Park Service, Fort Collins, Colorado, United States of America
| | - Davis M. Seelig
- Department of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, Minnesota, United States of America
| | - Clare Hoover
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Nicholas J. Haley
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Jeanette Hayes-Klug
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Kelly Anderson
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Paula Stewart
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, Scotland, United Kingdom
| | - Wilfred Goldmann
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, Scotland, United Kingdom
| | - Edward A. Hoover
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Candace K. Mathiason
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
- * E-mail:
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Rubenstein R, Chang B. Re-assessment of PrP(Sc) distribution in sporadic and variant CJD. PLoS One 2013; 8:e66352. [PMID: 23843953 PMCID: PMC3700981 DOI: 10.1371/journal.pone.0066352] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 05/07/2013] [Indexed: 11/18/2022] Open
Abstract
Human prion diseases are fatal neurodegenerative disorders associated with an accumulation of PrPSc in the central nervous system (CNS). Of the human prion diseases, sporadic Creutzfeldt-Jakob disease (sCJD), which has no known origin, is the most common form while variant CJD (vCJD) is an acquired human prion disease reported to differ from other human prion diseases in its neurological, neuropathological, and biochemical phenotype. Peripheral tissue involvement in prion disease, as judged by PrPSc accumulation in the tonsil, spleen, and lymph node has been reported in vCJD as well as several animal models of prion diseases. However, this distribution of PrPSc has not been consistently reported for sCJD. We reexamined CNS and non-CNS tissue distribution and levels of PrPSc in both sCJD and vCJD. Using a sensitive immunoassay, termed SOFIA, we also assessed PrPSc levels in human body fluids from sCJD as well as in vCJD-infected humanized transgenic mice (Tg666). Unexpectedly, the levels of PrPSc in non-CNS human tissues (spleens, lymph nodes, tonsils) from both sCJD and vCJD did not differ significantly and, as expected, were several logs lower than in the brain. Using protein misfolding cyclic amplification (PMCA) followed by SOFIA, PrPSc was detected in cerebrospinal fluid (CSF), but not in urine or blood, in sCJD patients. In addition, using PMCA and SOFIA, we demonstrated that blood from vCJD-infected Tg666 mice showing clinical disease contained prion disease-associated seeding activity although the data was not statistically significant likely due to the limited number of samples examined. These studies provide a comparison of PrPSc in sCJD vs. vCJD as well as analysis of body fluids. Further, these studies also provide circumstantial evidence that in human prion diseases, as in the animal prion diseases, a direct comparison and intraspecies correlation cannot be made between the levels of PrPSc and infectivity.
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Affiliation(s)
- Richard Rubenstein
- Department of Neurology and Physiology/Pharmacology, State University of New York Downstate Medical Center, Brooklyn, New York, United States of America.
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Cervenakova L, Akimov S, Vasilyeva I, Yakovleva O, McKenzie C, Cervenak J, Piccardo P, Asher DM. Fukuoka-1 strain of transmissible spongiform encephalopathy agent infects murine bone marrow-derived cells with features of mesenchymal stem cells. Transfusion 2011; 51:1755-68. [PMID: 21303371 DOI: 10.1111/j.1537-2995.2010.03041.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The possible risk of iatrogenic transmissible spongiform encephalopathies (TSEs, prion diseases) from transplantation of marrow-derived mesenchymal stem cells (MSCs) is uncertain. While most cell lines resist infection, a few propagate TSE agents. STUDY DESIGN AND METHODS We generated MSC-like (MSC-L) cell cultures from bone marrow (BM) of mice inoculated with the human-derived Fukuoka-1 (Fu) strain of TSE agent. Cultured cells were characterized for various markers and cellular prion protein (PrP(C) ) by fluorescence-activated cell sorting and for PrP(C) and its pathologic TSE-associated form (PrP(TSE) ) by Western blotting (WB). Cell cultures were tested for their susceptibility to infection with Fu in vitro. The infectivity of one Fu-infected cell culture was assayed in mice. RESULTS BM cells from Fu-infected mice expressed neither PrP(C) nor PrP(TSE) after 3 days in culture as demonstrated by WB. Cells adherent to plastic and maintained under two different culture conditions became spontaneously immortalized and began to express PrP(C) at about the same time. One culture became transformed shortly after exposure to Fu in vitro and remained persistently infected, continuously generating PrP(TSE) through multiple passages; the infectivity of cultured cells was confirmed by intracerebral inoculation of lysates into mice. Both persistently TSE-infected and uninfected cells expressed a number of typical MSC markers. CONCLUSION BM-derived MSC-L cells of mice became persistently infected with the Fu agent under certain conditions in culture-conditions that differ substantially from those currently used to develop investigational human stem cell therapies.
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Affiliation(s)
- Larisa Cervenakova
- Transmissible Diseases Department, American Red Cross Holland Laboratory, Rockville, MD 20855, USA.
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Puopolo M, Ladogana A, Vetrugno V, Pocchiari M. Transmission of sporadic Creutzfeldt-Jakob disease by blood transfusion: risk factor or possible biases. Transfusion 2011; 51:1556-66. [DOI: 10.1111/j.1537-2995.2010.03004.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mathiason CK, Hayes-Klug J, Hays SA, Powers J, Osborn DA, Dahmes SJ, Miller KV, Warren RJ, Mason GL, Telling GC, Young AJ, Hoover EA. B cells and platelets harbor prion infectivity in the blood of deer infected with chronic wasting disease. J Virol 2010; 84:5097-107. [PMID: 20219916 PMCID: PMC2863796 DOI: 10.1128/jvi.02169-09] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Accepted: 02/23/2010] [Indexed: 11/20/2022] Open
Abstract
Substantial evidence for prion transmission via blood transfusion exists for many transmissible spongiform encephalopathy (TSE) diseases. Determining which cell phenotype(s) is responsible for trafficking infectivity has important implications for our understanding of the dissemination of prions, as well as their detection and elimination from blood products. We used bioassay studies of native white-tailed deer and transgenic cervidized mice to determine (i) if chronic wasting disease (CWD) blood infectivity is associated with the cellular versus the cell-free/plasma fraction of blood and (ii) in particular if B-cell (MAb 2-104(+)), platelet (CD41/61(+)), or CD14(+) monocyte blood cell phenotypes harbor infectious prions. All four deer transfused with the blood mononuclear cell fraction from CWD(+) donor deer became PrP(CWD) positive by 19 months postinoculation, whereas none of the four deer inoculated with cell-free plasma from the same source developed prion infection. All four of the deer injected with B cells and three of four deer receiving platelets from CWD(+) donor deer became PrP(CWD) positive in as little as 6 months postinoculation, whereas none of the four deer receiving blood CD14(+) monocytes developed evidence of CWD infection (immunohistochemistry and Western blot analysis) after 19 months of observation. Results of the Tg(CerPrP) mouse bioassays mirrored those of the native cervid host. These results indicate that CWD blood infectivity is cell associated and suggest a significant role for B cells and platelets in trafficking CWD infectivity in vivo and support earlier tissue-based studies associating putative follicular B cells with PrP(CWD). Localization of CWD infectivity with leukocyte subpopulations may aid in enhancing the sensitivity of blood-based diagnostic assays for CWD and other TSEs.
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Affiliation(s)
- Candace K. Mathiason
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, National Park Service, Fort Collins, Colorado, Warnell School of Forestry and Natural Resources, University of Georgia, Athens, Georgia, WASCO Inc., Monroe, Georgia, University of Kentucky Medical Center, Lexington, Kentucky, South Dakota State University, Brookings, South Dakota
| | - Jeanette Hayes-Klug
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, National Park Service, Fort Collins, Colorado, Warnell School of Forestry and Natural Resources, University of Georgia, Athens, Georgia, WASCO Inc., Monroe, Georgia, University of Kentucky Medical Center, Lexington, Kentucky, South Dakota State University, Brookings, South Dakota
| | - Sheila A. Hays
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, National Park Service, Fort Collins, Colorado, Warnell School of Forestry and Natural Resources, University of Georgia, Athens, Georgia, WASCO Inc., Monroe, Georgia, University of Kentucky Medical Center, Lexington, Kentucky, South Dakota State University, Brookings, South Dakota
| | - Jenny Powers
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, National Park Service, Fort Collins, Colorado, Warnell School of Forestry and Natural Resources, University of Georgia, Athens, Georgia, WASCO Inc., Monroe, Georgia, University of Kentucky Medical Center, Lexington, Kentucky, South Dakota State University, Brookings, South Dakota
| | - David A. Osborn
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, National Park Service, Fort Collins, Colorado, Warnell School of Forestry and Natural Resources, University of Georgia, Athens, Georgia, WASCO Inc., Monroe, Georgia, University of Kentucky Medical Center, Lexington, Kentucky, South Dakota State University, Brookings, South Dakota
| | - Sallie J. Dahmes
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, National Park Service, Fort Collins, Colorado, Warnell School of Forestry and Natural Resources, University of Georgia, Athens, Georgia, WASCO Inc., Monroe, Georgia, University of Kentucky Medical Center, Lexington, Kentucky, South Dakota State University, Brookings, South Dakota
| | - Karl V. Miller
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, National Park Service, Fort Collins, Colorado, Warnell School of Forestry and Natural Resources, University of Georgia, Athens, Georgia, WASCO Inc., Monroe, Georgia, University of Kentucky Medical Center, Lexington, Kentucky, South Dakota State University, Brookings, South Dakota
| | - Robert J. Warren
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, National Park Service, Fort Collins, Colorado, Warnell School of Forestry and Natural Resources, University of Georgia, Athens, Georgia, WASCO Inc., Monroe, Georgia, University of Kentucky Medical Center, Lexington, Kentucky, South Dakota State University, Brookings, South Dakota
| | - Gary L. Mason
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, National Park Service, Fort Collins, Colorado, Warnell School of Forestry and Natural Resources, University of Georgia, Athens, Georgia, WASCO Inc., Monroe, Georgia, University of Kentucky Medical Center, Lexington, Kentucky, South Dakota State University, Brookings, South Dakota
| | - Glenn C. Telling
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, National Park Service, Fort Collins, Colorado, Warnell School of Forestry and Natural Resources, University of Georgia, Athens, Georgia, WASCO Inc., Monroe, Georgia, University of Kentucky Medical Center, Lexington, Kentucky, South Dakota State University, Brookings, South Dakota
| | - Alan J. Young
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, National Park Service, Fort Collins, Colorado, Warnell School of Forestry and Natural Resources, University of Georgia, Athens, Georgia, WASCO Inc., Monroe, Georgia, University of Kentucky Medical Center, Lexington, Kentucky, South Dakota State University, Brookings, South Dakota
| | - Edward A. Hoover
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, National Park Service, Fort Collins, Colorado, Warnell School of Forestry and Natural Resources, University of Georgia, Athens, Georgia, WASCO Inc., Monroe, Georgia, University of Kentucky Medical Center, Lexington, Kentucky, South Dakota State University, Brookings, South Dakota
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Rutala WA, Weber DJ. Guideline for disinfection and sterilization of prion-contaminated medical instruments. Infect Control Hosp Epidemiol 2010; 31:107-17. [PMID: 20055640 DOI: 10.1086/650197] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- William A Rutala
- Hospital Epidemiology, University of North Carolina School of Medicine, Chapel Hill, 27599-7030, USA.
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Xiao X, Miravalle L, Yuan J, McGeehan J, Dong Z, Wyza R, MacLennan GT, Golichowski AM, Kneale G, King N, Kong Q, Spina S, Vidal R, Ghetti B, Roos K, Gambetti P, Zou WQ. Failure to detect the presence of prions in the uterine and gestational tissues from a Gravida with Creutzfeldt-Jakob disease. THE AMERICAN JOURNAL OF PATHOLOGY 2009; 174:1602-8. [PMID: 19349373 DOI: 10.2353/ajpath.2009.081045] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The vertical transmission of a prion disease from infected mothers to their offspring is believed to be one of the routes for the natural spread of animal prion diseases. Supporting this notion is the observation that prion infectivity occurs in the placenta of infected ewes. Furthermore, the prion protein (PrP), both in its cellular form (PrP(C)) and its pathological isoform (PrP(Sc)), has been observed at the fetal-maternal interface of scrapie-infected sheep. However, whether these features of prion infectivity also hold true for human prion diseases is currently unknown. To begin to address such an important question, we examined PrP in the uterus as well as gestational tissues, including the placenta and amniotic fluid, in a pregnant woman with sporadic Creutzfeldt-Jakob disease (CJD). Although the proteinase K (PK)-resistant prion protein, PrP27-30, was present in the brain tissues of the mother, the PrP detected in the uterus, placenta, and amniotic fluid was sensitive to PK digestion. Unlike PrP(C) in the brain and adjacent cerebrospinal fluid, the predominant PrP species in the reproductive and gestational tissues were N-terminally truncated, similar to urine PrP. Our study did not detect abnormal PrP in the reproductive and gestational tissues in this case of CJD. Nevertheless, examination by a highly sensitive bioassay is ongoing to ascertain possible prion infectivity from CJD in the amniotic fluid.
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Affiliation(s)
- Xiangzhu Xiao
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio 44106, USA
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Novakofski J, Brewer MS, Mateus-Pinilla N, Killefer J, McCusker RH. Prion biology relevant to bovine spongiform encephalopathy. J Anim Sci 2007; 83:1455-76. [PMID: 15890824 DOI: 10.2527/2005.8361455x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Bovine spongiform encephalopathy (BSE) and chronic wasting disease (CWD) of deer and elk are a threat to agriculture and natural resources, as well as a human health concern. Both diseases are transmissible spongiform encephalopathies (TSE), or prion diseases, caused by autocatalytic conversion of endogenously encoded prion protein (PrP) to an abnormal, neurotoxic conformation designated PrPsc. Most mammalian species are susceptible to TSE, which, despite a range of species-linked names, is caused by a single highly conserved protein, with no apparent normal function. In the simplest sense, TSE transmission can occur because PrPsc is resistant to both endogenous and environmental proteinases, although many details remain unclear. Questions about the transmission of TSE are central to practical issues such as livestock testing, access to international livestock markets, and wildlife management strategies, as well as intangible issues such as consumer confidence in the safety of the meat supply. The majority of BSE cases seem to have been transmitted by feed containing meat and bone meal from infected animals. In the United Kingdom, there was a dramatic decrease in BSE cases after neural tissue and, later, all ruminant tissues were banned from ruminant feed. However, probably because of heightened awareness and widespread testing, there is growing evidence that new variants of BSE are arising "spontaneously," suggesting ongoing surveillance will continue to find infected animals. Interspecies transmission is inefficient and depends on exposure, sequence homology, TSE donor strain, genetic polymorphism of the host, and architecture of the visceral nerves if exposure is by an oral route. Considering the low probability of interspecies transmission, the low efficiency of oral transmission, and the low prion levels in nonnervous tissues, consumption of conventional animal products represents minimal risk. However, detection of rare events is challenging, and TSE literature is characterized by subsequently unsupported claims of species barriers or absolute tissue safety. This review presents an overview of TSE and summarizes recent research on pathogenesis and transmission.
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Affiliation(s)
- J Novakofski
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, IL 61801-4737, USA.
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Everest SJ, Thorne LT, Hawthorn JA, Jenkins R, Hammersley C, Ramsay AM, Hawkins SA, Venables L, Flynn L, Sayers R, Kilpatrick J, Sach A, Hope J, Jackman R. No abnormal prion protein detected in the milk of cattle infected with the bovine spongiform encephalopathy agent. J Gen Virol 2006; 87:2433-2441. [PMID: 16847140 DOI: 10.1099/vir.0.81491-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Milk specimens were collected from lactating cows that had previously been challenged with bovine spongiform encephalopathy (BSE)-infected brain at 4–6 months of age. One group of 10 animals received a single oral dose of 100 g, a second group received 1 g and the third was made up of unexposed controls. The cows were inseminated artificially, and calved at approximately 2 years of age and annually thereafter. Milking was done within the first week following calving and at 10-weekly intervals during the lactation period. Specimens were centrifuged to obtain a fraction enriched for somatic cells and these fractions were analysed for disease-associated, abnormal prion protein (PrPBSE) by using a modified commercial BSE ELISA and a different confirmatory assay. No abnormal prion protein has so far been identified in the cell fraction of milk from cattle incubating BSE by using these methods at their limits of detection.
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Affiliation(s)
- Sally J Everest
- Veterinary Laboratories Agency (VLA), New Haw, Addlestone, Surrey KT15 3NB, UK
| | - Leigh T Thorne
- Veterinary Laboratories Agency (VLA), New Haw, Addlestone, Surrey KT15 3NB, UK
| | - Jeremy A Hawthorn
- Veterinary Laboratories Agency (VLA), New Haw, Addlestone, Surrey KT15 3NB, UK
| | - Russell Jenkins
- Veterinary Laboratories Agency (VLA), New Haw, Addlestone, Surrey KT15 3NB, UK
| | - Clare Hammersley
- Veterinary Laboratories Agency (VLA), New Haw, Addlestone, Surrey KT15 3NB, UK
| | - Andrew M Ramsay
- Veterinary Laboratories Agency (VLA), New Haw, Addlestone, Surrey KT15 3NB, UK
| | - Stephen A Hawkins
- Veterinary Laboratories Agency (VLA), New Haw, Addlestone, Surrey KT15 3NB, UK
| | - Lindsay Venables
- Veterinary Laboratories Agency (VLA), New Haw, Addlestone, Surrey KT15 3NB, UK
| | - Linda Flynn
- Veterinary Laboratories Agency (VLA), New Haw, Addlestone, Surrey KT15 3NB, UK
| | - Robin Sayers
- Veterinary Laboratories Agency (VLA), New Haw, Addlestone, Surrey KT15 3NB, UK
| | | | - Amanda Sach
- ADAS Defra Drayton, Stratford-upon-Avon, Warwickshire CV37 9RQ, UK
| | - James Hope
- VLA Lasswade, Pentlands Science Park, Bush Loan, Penicuik, Midlothian EH26 0PZ, UK
| | - Roy Jackman
- Veterinary Laboratories Agency (VLA), New Haw, Addlestone, Surrey KT15 3NB, UK
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Clauss M. Do cows fed BSE-infected meat and bone meal in the colostrum-producing stage pass on infectious BSE agent to their calves? Med Hypotheses 2003; 61:439-43. [PMID: 13679008 DOI: 10.1016/s0306-9877(03)00191-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Direct ingestion of the infectious BSE agent via meat and bone meal (MBM) is commonly regarded as the main route of infection for cattle. I propose that another plausible route of infection has been overlooked so far, namely the ingestion of MBM by mother animals who susequently pass on the infectious agent in their colostrum and thus infect their offspring. This theory could explain why, although infection is thought to occur at very early stages in life, many BSE animals had not received MBM containing feeds when calves. Literature evidence on intact protein absorption in adult mammals, on the presence of the infectious BSE agent in the blood in the pre-symptomatic stage, and on the incorporation of intact dietary protein into colostrum or milk in humans and pigs, support this hypothesis. This hypothesis does not necessarily mean that colostrum or milk from BSE-positive animals is infectious. Rather, the mother animals in the hypothesis scenario will be themselves infected, but probably not develop the disease due to its long incubation period, thus occurring in statistics as 'negative' animals.
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Affiliation(s)
- M Clauss
- Institute of Animal Physiology, Physiological Chemistry and Animal Nutrition, Veterinary Faculty of the Ludwigs-Maximilians-University of Munich, Veterinaerstr. 13, 80539, Munich, Germany.
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13
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Andréoletti O, Lacroux C, Chabert A, Monnereau L, Tabouret G, Lantier F, Berthon P, Eychenne F, Lafond-Benestad S, Elsen JM, Schelcher F. PrP(Sc) accumulation in placentas of ewes exposed to natural scrapie: influence of foetal PrP genotype and effect on ewe-to-lamb transmission. J Gen Virol 2002; 83:2607-2616. [PMID: 12237445 DOI: 10.1099/0022-1317-83-10-2607] [Citation(s) in RCA: 116] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Placentas from scrapie-affected ewes are known to be infectious. Nevertheless, placenta infectivity in such ewes is not systematic. Maternal transmission to lambs is highly suspected but contamination of the foetus in utero has not been demonstrated. Using ewes from a naturally scrapie-infected flock, it was demonstrated that abnormal prion protein (PrP(Sc)) accumulation in the placenta (i) is controlled by polymorphisms at codons 136, 154 and 171 of the foetal PrP gene and (ii) is restricted mainly to placentome foetal trophoblastic cells. In order to go deeper into the role of the placenta in scrapie transmission, the pattern of PrP(Sc) dissemination was established in susceptible lambs (genotype VRQ/VRQ) sampled from 140 days post-insemination to the age of 4 months from either VRQ/VRQ ewes with PrP(Sc)-positive placentas or ARR/VRQ ewes with PrP(Sc)-negative placentas. In both VRQ/VRQ lamb groups, PrP(Sc) spatial and temporal accumulation patterns were similar, suggesting post-natal rather than in utero contamination.
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Affiliation(s)
- Olivier Andréoletti
- UMR 959 INRA-ENVT, Physiopathologie Infectieuse et Parasitaire des Ruminants, Ecole Nationale Vétérinaire, 23 Chemin des Capelles, 31076 Toulouse Cedex 3, France1
| | - Caroline Lacroux
- UMR 959 INRA-ENVT, Physiopathologie Infectieuse et Parasitaire des Ruminants, Ecole Nationale Vétérinaire, 23 Chemin des Capelles, 31076 Toulouse Cedex 3, France1
| | - Armelle Chabert
- UMR 959 INRA-ENVT, Physiopathologie Infectieuse et Parasitaire des Ruminants, Ecole Nationale Vétérinaire, 23 Chemin des Capelles, 31076 Toulouse Cedex 3, France1
| | - Laurent Monnereau
- UMR 959 INRA-ENVT, Physiopathologie Infectieuse et Parasitaire des Ruminants, Ecole Nationale Vétérinaire, 23 Chemin des Capelles, 31076 Toulouse Cedex 3, France1
| | - Guillaume Tabouret
- UMR 959 INRA-ENVT, Physiopathologie Infectieuse et Parasitaire des Ruminants, Ecole Nationale Vétérinaire, 23 Chemin des Capelles, 31076 Toulouse Cedex 3, France1
| | - Frédéric Lantier
- INRA, Laboratoire de Pathologie Infectieuse et Immunologie, Nouzilly, France2
| | - Patricia Berthon
- INRA, Laboratoire de Pathologie Infectieuse et Immunologie, Nouzilly, France2
| | | | | | - Jean-Michel Elsen
- INRA, Station d'Amélioration Génétique des Animaux, Auzeville, France5
| | - François Schelcher
- UMR 959 INRA-ENVT, Physiopathologie Infectieuse et Parasitaire des Ruminants, Ecole Nationale Vétérinaire, 23 Chemin des Capelles, 31076 Toulouse Cedex 3, France1
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14
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Cervenakova L, Brown P, Hammond DJ, Lee CA, Saenko EL. Factor VIII and transmissible spongiform encephalopathy: the case for safety. Haemophilia 2002; 8:63-75. [PMID: 11952840 DOI: 10.1046/j.1365-2516.2002.00617.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Haemophilia A is the most common inherited bleeding disorder, caused by a deficiency in coagulation factor VIII (FVIII). Current treatment of haemophilia A is based on repeated infusions of plasma-derived FVIII concentrate or of recombinant FVIII, which may be exposed to plasma-derived material of human or animal origin used in its tissue culture production process. We review epidemiological and experimental studies relevant to blood infectivity in the transmissible spongiform encephalopathies (TSEs, or 'prion' diseases), and evaluate the hypothetical risk of TSE transmission through treatment with plasma-derived or recombinant FVIII.
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Affiliation(s)
- L Cervenakova
- J. Holland Laboratory, American Red Cross, Rockville, MD 20855, USA.
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15
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Hérault O, Binet C, Rico A, Degenne M, Bernard MC, Chassaigne M, Sensebe L. Evaluation of performance of white blood cell reduction filters: an original flow cytometric method for detection and quantification of cell-derived membrane fragments. CYTOMETRY 2001; 45:277-84. [PMID: 11746097 DOI: 10.1002/1097-0320(20011201)45:4<277::aid-cyto10017>3.0.co;2-#] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Contamination of blood products by white blood cells leads to a risk of transmission of infectious agents, particularly abnormal prion protein, the probable causative agent of new-variant Creutzfeldt-Jakob disease. Blood product filtration could reduce this risk, but the filtration systems might generate potentially infectious membrane fragments. We developed an original flow cytometric method that allows the detection and quantification of membrane fragments in filtered products and the evaluation of the quantity of destroyed cells. METHODS This method has four technical requirements: cytofluorometric acquisition of forward scatter parameters on a log scale, use of a fluorescent aliphatic reporter molecule (PKH26-GL) to identify membrane fragments, quantification with fluorescent beads, and the drawing up of a standard curve on the basis of cells destroyed by freezing/thawing to generate cell debris (i.e., quantity of membrane fragments measured versus quantity of destroyed cells). RESULTS AND CONCLUSIONS This original method can be used to test new filtration devices and it allows optimization of the filtration process or comparison of different filtration systems. We tested the method with three commercial white cell removal filters. We demonstrated that it is possible to evaluate the filter quality, particularly the likelihood of fragment removal during the filtration process.
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Affiliation(s)
- O Hérault
- UPRES EA-3249, Faculty of Medicine, Tours, France.
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16
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Narang HK. A critical review of atypical cerebellum-type Creutzfeldt-Jakob disease: its relationship to "new variant" CJD and bovine spongiform encephalopathy. Exp Biol Med (Maywood) 2001; 226:629-39. [PMID: 11444099 DOI: 10.1177/153537020222600709] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Shortly after the appearance of bovine spongiform encephalopathy (BSE), Creutzfeldt-Jakob disease (CJD) was identified in young patients with nonclassical presentation such as difficulty in balancing and ataxia. The classical CJD in older patients starts with dementia. To distinguish between the two types, CJD in young persons has been termed "new variant" (nvCJD). The distinguishing features of classical CJD include initial presentation with dementia, confluent spongiform changes are very unusual in the cerebellum, and PrP plaques are rarely observed. For nvCJD, initially, difficulty with balancing and ataxia occurs, confluent spongiform changes are seen in the cerebellum, and a large number of PrP plaques are seen. The icelandic observation of sheep scrapie revealed a predominantly ataxic form of scrapie, termed Type II, rather than the itchy form termed Type I. Both types have been known to exist in Europe. Since the clinical signs of Type II scrapie in sheep with trembling and ataxia are similar to those seen in BSE and nvCJD, this suggests that Type II is the cause of BSE and nvCJD. Over 8 years, from 1989 to 1996, I examined the clinical histories of 33 CJD cases aged between the ages of 18 and 84. Six under the age of 40 and 15 over the age of 40 had leading clinical features such as difficulty in balancing and ataxia similar to those seen in the young cases classified as "nvCJD." Brains were examined from the six of 15 cases over the age of 40, which revealed similar pathology to that seen in young patients classified as "nvCJD." These findings suggest that all age groups are susceptible to the strain of the agent derived from BSE cattle.
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Affiliation(s)
- H K Narang
- Ken Bell International, 22-40 Brentwood Avenue, Newcastle-upon-Tyne NE2 3DH, UK.
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17
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Narang HK. Lingering doubts about spongiform encephalopathy and Creutzfeldt-Jakob disease. Exp Biol Med (Maywood) 2001; 226:640-52. [PMID: 11444100 DOI: 10.1177/153537020222600710] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Bovine spongiform encephalopathy (BSE) is an infectious disease and has been transmitted orally to many other animals, including humans. There is clear evidence of maternal transmission, although disagreement on the source of the BSE agent remains. The current theories link the origin of BSE to common scrapie in sheep. Twenty different strains of the scrapie agent have been isolated from sheep. A search of the literature indicates two distinct clinical syndromes in sheep, both of which have been called scrapie. I have designated these Type I (the common type), which exhibits itchiness and lose their wool, and Type II, which exhibits trembling and ataxia. Sheep inoculated with BSE develop Type II scrapie and they exhibit trembling. When cattle or mink are injected with the Type I strain, only a few will develop a clinical disease. By contrast, no clinical disease has so far been shown in cattle or mink by feeding them with Type I-infected sheep brains. However, either by injecting or feeding with the BSE strain, 100% of calves and mink develop the clinical disease. Evidence suggests that Type II is the cause of BSE. Identical clinical signs of Type II trembling are found in kuru and many of the recent cases of Creutzfeldt-Jakob disease. The BSE agent has caused spongiform encephalopathies (SEs) in domestic cats, tigers, and in some species of ruminants in zoos. The nature of the BSE agent remains unchanged when passaged through a range of species, irrespective of their genetic make up, demonstrating that variations in the host PrP gene are not a major factor in the susceptibility to the BSE agent. Since more than 85 zoo animals of many species have been diagnosed with SEs, from these studies it seems reasonable to conclude that the BSE agent can infect almost all mammalian species, including humans. For eradication of BSE and to reduce the risk of infection to humans, the development of a vaccine against BSE is suggested. Such a possibility should be fully explored.
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Affiliation(s)
- H K Narang
- Ken Bell International, 22-40 Brentwood Avenue, Newcastle Upon Tyne NE2 3DH, UK.
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18
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Barclay GR, Hope J, Birkett CR, Turner ML. Distribution of cell-associated prion protein in normal adult blood determined by flow cytometry. Br J Haematol 1999; 107:804-14. [PMID: 10606888 DOI: 10.1046/j.1365-2141.1999.01789.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Leucocyte subpopulations from normally healthy individuals were identified by recognized combinations of fluorochrome-conjugated antibodies to CD markers and stained by different monoclonal antibodies (MAb) to normal cellular prion protein (PrPC), including the 3F4 MAb. Cell preparations were examined by three-colour flow cytometry. All mononuclear leucocyte subpopulations and platelets expressed PrPC, but polymorphonuclear leucocytes and red blood cells expressed little or no PrPC. The amounts of PrPC expressed by the different cells were calculated by comparison to bead standards. Mononuclear leucocytes expressed 3000-4000 molecules of antibody-reactive PrPC per cell. Resting platelets expressed around 1400 molecules of PrPC per cell, whereas activated platelets expressed around 4800 molecules of PrPC per cell. Extrapolation of these values to the amounts of the various cells in whole blood showed that platelet PrPC accounted for at least 96% of cell-expressed PrPC in blood. The PrPC on mononuclear cells and platelets was sensitive to enzymatic treatment of cells by proteinase k and phosphatidylinositol-specific phospholipase C. Certain anti-PrPC MAbs which showed equivalent intensity of staining to MAb 3F4 on fresh cells showed relative reductions of staining compared to MAb 3F4 on stored cells, indicating possible structural alterations of PrPC under these conditions.
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Affiliation(s)
- G R Barclay
- Edinburgh Regional Blood Transfusion Centre, SNBTS, Edinburgh.
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19
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Abstract
Though considerable circumstantial evidence suggests that the pathogen of prion disease is proteinaceous, it has not yet been conclusively identified. Epidemiological observations indicate that a microbial vector is responsible for the transmission of natural prion disease in sheep and goats and that the real causative agent may correspond to a structural protein of that microorganism. The microbial protein should resemble prion protein (PrP) and may replicate itself in the host by using mammalian DNA. A similar phenomenon was already described with a protein antigen of the ameba Naegleria gruberi. The various serotypes of the microbial protein may account for the existence of scrapie strains. It is proposed that many microbial proteins may be capable of replicating themselves in mammalian cells eliciting and sustaining thereby degenerative and/or autoimmune reactions subsequent to infections with microorganisms.
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Affiliation(s)
- M Füzi
- Budapest Institute of National Public Health and Medical Officer Service, Hungary
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20
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Abstract
Prion diseases are lethal disorders, some of which are transmissible by infectious route. Experimental data concerning neuroinvasion indicate that there is a viremia during the migration of the prion agent to the central nervous system. The possibility of accidental transmission via blood products and therefore potential transfusion risk thus arises. The analysis of experimental and epidemiological data available at present contributes to the following conclusion: the potential and theoretical risk for contamination from blood products is not null but mathematically very low, there is no indisputable experimental proof for that risk via systemic route and no case is definite and the risk is probably linked to leukocytes, and especially B lymphocytes. These conclusions are reassuring but nevertheless justify strict epidemiological survey and a reasonable discussion for each transfusion. Some groups of people have to be excluded from blood donors.
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Affiliation(s)
- P Beauvais
- Service de neuropédiatrie, hôpital Armand-Trousseau, Paris, France
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21
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Abstract
Based on information accumulated to date, it is still difficult to assess the risk of Creutzfeldt-Jakob disease (CJD) and blood transfusion with any degree of confidence. However, it is reasonable to conclude that CJD is produced by a transmittable agent which is probably contained in low titer in the blood of infected people and animals. From the present clinical and epidemiological studies, transmission by blood or blood products appears to be a rare or non-existent cause of current and past cases of CJD in humans. Since blood products are necessary to prevent the immediate risk of death or significant morbidity in many clinical conditions, therapeutic decisions should be made after consideration of the known risk in these situations vs the theoretical long-term risk of the rare occurrence of CJD.
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Affiliation(s)
- B L Evatt
- Hematologic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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22
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Abstract
Improvements in donor selection, testing of donors for markers of infection, and viral inactivation of plasma-derived products have helped reduce the risk of transfusion-associated infections, including hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency viruses (HIV). The potential for transmission of emerging infections is illustrated by current concerns about group O strains of HIV, nonenveloped viruses, newly discovered microbial agents, prions, Chagas' disease, tick-borne infections, and the need to assess the frequency of transfusion reactions associated with bacterial contamination.
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Affiliation(s)
- M Chamberland
- Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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23
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Collins SJ, Cappai R, Masters CL. Recent developments in the transmissible spongiform encephalopathies: Implications for clinical practice. J Clin Neurosci 1996; 3:97-101. [DOI: 10.1016/s0967-5868(96)90000-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dormont D. [Evaluation of transmission of unconventional agents by human albumin]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 1996; 15:560-8. [PMID: 8881498 DOI: 10.1016/0750-7658(96)83220-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Transmissible spongiform encephalopathy agents (TSA) or prions induce neurodegenerative diseases in humans and animals. Their nature is still unknown, even if the main component of infectivity is identified as an abnormal isoform of a host-encoded protein, the prion protein (PrP). Today, no diagnostic test is available routinely for the detection of infected patients. TSA are resistant to most of the physical and chemical procedures that are efficient against other micro-organisms. Iatrogenic transmissions of TSA have been reported in the past: they always involved either brain derivatives or instruments that have been in contact with infected central nervous system. In an infected individual, infectivity is mostly detectable in brain. However, a persistent low-level viremia can be demonstrated in association with the white blood cells; infectivity is never found in plasma, serum or in red blood cells. Epidemiological data do not evidence any relationship between spongiform encephalopathies and blood transfusion. Therefore, in 1995, TSA transmission trough albumin is only a theoretical risk.
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Affiliation(s)
- D Dormont
- Département de recherche médicale, Commissariat à l'énergie atomique, centre de recherches du service de Santé des Armées, Fontenay-aux-Roses, France
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Ridley RM, Baker HF. The myth of maternal transmission of spongiform encephalopathy. BMJ (CLINICAL RESEARCH ED.) 1995; 311:1071-5; discussion 1075-6. [PMID: 7580668 PMCID: PMC2551372 DOI: 10.1136/bmj.311.7012.1071] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
It has long been accepted that the pattern of occurrence of scrapie--the form of spongiform encephalopathy associated with sheep--is determined mainly by maternal transmission, and this view has had a profound influence on policy decisions in the control of bovine spongiform encephalopathy and on public concern over the risk to human health form this disease. The occurrence of maternal transmission is, however, not predicted by modern knowledge of the aetiology of spongiform encephalopathy, and even though claims of maternal transmission have been reiterated frequently in the literature, re-examination of the source data reveals that these data are extremely scanty, unreplicated, and probably subject to ascertainment bias. The probability of maternal transmission of spongiform encephalopathy in any species should be viewed with the greatest scepticism.
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Affiliation(s)
- R M Ridley
- Department of Experimental Psychology, Cambridge University
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26
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Créange A, Gray F, Cesaro P, Adle-Biassette H, Duvoux C, Cherqui D, Bell J, Parchi P, Gambetti P, Degos JD. Creutzfeldt-Jakob disease after liver transplantation. Ann Neurol 1995; 38:269-72. [PMID: 7654078 DOI: 10.1002/ana.410380223] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We report a 57-year-old woman who died from Creutzfeldt-Jakob disease 2 years after a liver transplantation. The liver donor had no history of neurological disease. In one albumin donor, possible Creutzfeldt-Jakob disease developed 3 years later. The patient initially had cerebellar symptoms. Neuropathology included "Kuru-type" plaques and prion protein (PrP) deposits involving the cerebellum predominantly. The patient was homozygote valine at codon 129 of the PrP gene while the liver was homozygote methionine. This observation raises the possibility of transmission of Creutzfeldt-Jakob disease by the graft itself or the associated albumin transfusions and, on a wider extent, by nonneural tissue.
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Affiliation(s)
- A Créange
- Departement de Neurosciences, Centre Hospitalier Universitaire Henri Mondor, Créteil, France
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de Backere AC. Euro Skin Bank: large scale skin-banking in Europe based on glycerol-preservation of donor skin. Burns 1994; 20 Suppl 1:S4-9. [PMID: 8198742 DOI: 10.1016/0305-4179(94)90080-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Although skin banking has been well developed through the years as a means of providing sufficient skin which is instantly accessible to the burn patient, the methods of preservation and the scale on which various institutions bank skin vary considerably. In 1984, the Dutch National Skin Bank started using glycerol as a preservant for skin allografts. Since then there has been a marked increase in both the volume of glycerol skin grafts applied and the area over which these have been distributed. The procedure and organizational aspects of the Euro Skin Bank, as our own institution is now called, and its current method of skin preservation are described.
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Healy DL, Evans J. Creutzfeldt-Jakob disease after pituitary gonadotrophins. BMJ (CLINICAL RESEARCH ED.) 1993; 307:517-8. [PMID: 8400968 PMCID: PMC1678637 DOI: 10.1136/bmj.307.6903.517] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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