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Kim DY, Shim KH, Bagyinszky E, An SSA. Prion Mutations in Republic of Republic of Korea, China, and Japan. Int J Mol Sci 2022; 24:ijms24010625. [PMID: 36614069 PMCID: PMC9820783 DOI: 10.3390/ijms24010625] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022] Open
Abstract
Prion gene (PRNP) mutations are associated with diverse disease phenotypes, including familiar Creutzfeldt-Jakob Disease (CJD), Gerstmann-Sträussler-Scheinker disease (GSS), and fatal familial insomnia (FFI). Interestingly, PRNP mutations have been reported in patients diagnosed with Alzheimer's disease, dementia with Lewy bodies, Parkinson's disease, and frontotemporal dementia. In this review, we describe prion mutations in Asian countries, including Republic of Republic of Korea, China, and Japan. Clinical phenotypes and imaging data related to these mutations have also been introduced in detail. Several prion mutations are specific to Asians and have rarely been reported in countries outside Asia. For example, PRNP V180I and M232R, which are rare in other countries, are frequently detected in Republic of Korea and Japan. PRNP T188K is common in China, and E200K is significantly more common among Libyan Jews in Israel. The A117V mutation has not been detected in any Asian population, although it is commonly reported among European GSS patients. In addition, V210I or octapeptide insertion is common among European CJD patients, but relatively rare among Asian patients. The reason for these differences may be geographical or ethical isolation. In terms of clinical phenotypes, V180I, P102L, and E200K present diverse clinical symptoms with disease duration, which could be due to other genetic and environmental influences. For example, rs189305274 in the ACO1 gene may be associated with neuroprotective effects in cases of V180I mutation, leading to longer disease survival. Additional neuroprotective variants may be possible in cases featuring the E200K mutation, such as KLKB1, KARS, NRXN2, LAMA3, or CYP4X1. E219K has been suggested to modify the disease course in cases featuring the P102L mutation, as it may result in the absence of prion protein-positive plaques in tissue stained with Congo red. However, these studies analyzed only a few patients and may be too preliminary. The findings need to be verified in studies with larger sample sizes or in other populations. It would be interesting to probe additional genetic factors that cause disease progression or act as neuroprotective factors. Further studies are needed on genetic modifiers working with prions and alterations from mutations.
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Affiliation(s)
- Dan Yeong Kim
- Department of Bionano Technology, Gachon University, Seongnam 13120, Republic of Korea
| | - Kyu Hwan Shim
- Department of Bionano Technology, Gachon University, Seongnam 13120, Republic of Korea
| | - Eva Bagyinszky
- Department of Industrial and Environmental Engineering, Graduate School of Environment, Gachon University, Seongnam 13120, Republic of Korea
- Correspondence: (E.B.); (S.S.A.A.)
| | - Seong Soo A. An
- Department of Bionano Technology, Gachon University, Seongnam 13120, Republic of Korea
- Correspondence: (E.B.); (S.S.A.A.)
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Matsubayashi T, Sanjo N. Systematic Review of Clinical and Pathophysiological Features of Genetic Creutzfeldt-Jakob Disease Caused by a Val-to-Ile Mutation at Codon 180 in the Prion Protein Gene. Int J Mol Sci 2022; 23:15172. [PMID: 36499498 PMCID: PMC9737045 DOI: 10.3390/ijms232315172] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/28/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
Genetic Creutzfeldt-Jakob disease (gCJD) is a subtype of genetic prion diseases (gPrDs) caused by the accumulation of mutated pathological prion proteins (PrPSc). gCJD has a phenotypic similarity with sporadic CJD (sCJD). In Japan, gCJD with a Val to Ile substitution at codon 180 (V180I-gCJD) is the most frequent gPrD, while the mutation is extremely rare in countries other than Japan and Korea. In this article, we aim to review previously elucidated clinical and biochemical features of V180I-gCJD, expecting to advance the understanding of this unique subtype in gCJD. Compared to classical sCJD, specific clinical features of V180I-gCJD include older age at onset, a relatively slow progression of dementia, and a lower positivity for developing myoclonus, cerebellar, pyramidal signs, and visual disturbance. Diffuse edematous ribboning hyperintensity of the cerebral cortex, without occipital lobes in diffusion-weighted magnetic resonance imaging, is also specific. Laboratory data reveal the low positivity of PrPSc in the cerebrospinal fluid and periodic sharp wave complexes on an electroencephalogram. Most patients with V180I-gCJD have been reported to have no family history, probably due to the older age at onset, and clinical and biochemical features indicate the specific phenotype associated with the prion protein gene mutation.
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Affiliation(s)
| | - Nobuo Sanjo
- Department of Neurology and Neurological Science, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8510, Japan
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Kunieda K, Hayashi Y, Yamada M, Waza M, Yaguchi T, Fujishima I, Shimohata T. Serial evaluation of swallowing function in a long-term survivor of V180I genetic Creutzfeldt-Jakob disease. Prion 2021; 14:180-184. [PMID: 32627665 PMCID: PMC7518740 DOI: 10.1080/19336896.2020.1787090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Swallowing function in long-term survivors with Creutzfeldt-Jakob disease (CJD) remains unknown. Herein, we demonstrated serial evaluation of swallowing function in a case with V180I genetic CJD (gCJD) using videofluoroscopic examination of swallowing (VF). A 69-year-old woman was admitted to our hospital because of bradykinesia and memory disturbances 4 months after the onset of symptoms. Neurological examination revealed dementia, bradykinesia and frontal signs. Diffusion-weighted MRI revealed bilateral cortical hyperintensity in the frontal, temporal, and parietal cortices, and PRNP gene analysis indicated a V180I mutation. Her dysphagia gradually progressed, and she received percutaneous gastrostomy 42 months after the onset. VF was performed at 27, 31, 39, and 79 months after the onset. Although bolus transport from oral cavity to pharynx gradually worsened and initiation of the pharyngeal swallow was gradually delayed, the pharyngeal swallowing function was preserved even at 72 months after onset. MRI revealed no apparent atrophy of brainstem, and single photon emission computed tomography showed preserved regional cerebral blood flow in the brainstem. These findings suggest that the pathophysiology of dysphagia in a long-term survivor of V180I gCJD is that of pseudobulbar palsy, likely owing to preserved brainstem function even in the akinetic mutism state.
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Affiliation(s)
- Kenjiro Kunieda
- Department of Neurology, Gifu University Graduate School of Medicine , Gifu, Japan.,Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital , Shizuoka, Japan
| | - Yuichi Hayashi
- Department of Neurology, Gifu University Graduate School of Medicine , Gifu, Japan
| | - Megumi Yamada
- Department of Neurology, Gifu University Graduate School of Medicine , Gifu, Japan
| | - Masahiro Waza
- Department of Neurology, Kakamigahara Rehabilitation Hospital , Kakamigahara, Japan
| | - Tomonori Yaguchi
- Department of Neurology, Gifu University Graduate School of Medicine , Gifu, Japan
| | - Ichiro Fujishima
- Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital , Shizuoka, Japan
| | - Takayoshi Shimohata
- Department of Neurology, Gifu University Graduate School of Medicine , Gifu, Japan
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Nomura T, Iwata I, Naganuma R, Matsushima M, Satoh K, Kitamoto T, Yabe I. A patient with spastic paralysis finally diagnosed as V180I genetic Creutzfeldt-Jakob disease 9 years after onset. Prion 2020; 14:226-231. [PMID: 32938301 PMCID: PMC7518757 DOI: 10.1080/19336896.2020.1823179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/21/2020] [Accepted: 08/31/2020] [Indexed: 12/03/2022] Open
Abstract
Genetic Creutzfeldt-Jakob disease (gCJD) with a mutation in codon 180 of the prion protein gene (V180I gCJD) is the most common form of gCJD in Japan, but only a few cases have been reported in Europe and the United States. It is clinically characterized by occurring in the elderly and presenting as slowly progressive dementia, although it generally shows less cerebellar and pyramidal symptoms than sporadic CJD. Here, we report a patient with V180I gCJD who initially presented with slowly progressive spastic paralysis with neither cerebrospinal fluid (CSF) nor magnetic resonance imaging (MRI) abnormalities. His symptoms progressed gradually, and after 9 years, he displayed features more typical of CJD. Diffusion-weighted MRI revealed high-intensity signals in the cortical gyrus, and there was a marked increase of 14-3-3 protein and total tau protein in the CSF, but he was negative for the real-time quaking-induced conversion assay. Although the time course was more consistent with Gerstmann-Sträussler-Scheinker disease than CJD, genetic testing revealed V180I gCJD. This is the first report of a patient with V180I gCJD who initially presented with spastic paralysis, and also the first to reveal that it took 9 years from disease onset for cortical dysfunction to develop and for MRI and CSF abnormalities to be detectable. In conclusion, we should screen for V180I gCJD in elderly patients presenting with slowly progressive spastic paralysis.
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Affiliation(s)
- Taichi Nomura
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Ikuko Iwata
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Ryoji Naganuma
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Masaaki Matsushima
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Katsuya Satoh
- Department of Molecular Microbiology and Immunology, Graduate School of Biomedical Sciences Nagasaki University, Nagasaki, Japan
| | - Tetsuyuki Kitamoto
- Center for Prion Diseases, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Ichiro Yabe
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
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Bagyinszky E, Yang Y, Giau VV, Youn YC, An SSA, Kim S. Novel prion mutation (p.Tyr225Cys) in a Korean patient with atypical Creutzfeldt-Jakob disease. Clin Interv Aging 2019; 14:1387-1397. [PMID: 31447551 PMCID: PMC6683949 DOI: 10.2147/cia.s210909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/04/2019] [Indexed: 02/06/2023] Open
Abstract
Background: A novel prion variant, PRNP p.Tyr225Cys (c.674A>G; p.Y225C), was identified in an atypical Creutzfeldt–Jakob disease (CJD) patient. The patient had a 5-year history of progressive cognitive impairment with speech and gait disturbances. From the basic neurological examination at his first hospital visit, rigidity and myoclonic jerks in all limbs were observed without focal weakness. Electroencephalogram showed the diffuse slow continuous delta activity in the bilateral cerebral hemisphere. Magnetic resonance imaging revealed abnormalities in the brain, such as cortical signal changes and edema in the frontotemporoparietal lobes and the basal ganglia. Cerebrospinal fluid 14–3-3 protein analysis showed a weakly positive signal. Family history remained unclear, but the patient’s mother and sister were diagnosed with cognitive impairment but both refused genetic testing. Methods: Targeted next generation sequencing (NGS) was performed on 50 genes, involved in different neurodegeneratives diseases, such as Alzheimer's, Parkinson's, frontotemporal dementia or prion diseases. In silico analyses and structure predictions were performed on the potential patohgenic mutations. Results: NGS and standard sequencing revealed the novel PRNP p.Tyr225Cys mutation in the patient. Structure predictions revealed that this may make the helix more flexible. In addition, the extra cysteine residue in TM-III of prion protein may result in disturbances of natural disulfide bond. Conclusion: Hence, the pathogenicity of PRNP p.Tyr225Cys was not fully confirmed at present, and its penetrance was suggested to be low. However, its possible pathogenic nature in prion diseases cannot be ignored, since Tyr/Cys exchange could disturb the helix dynamics and contribute to conformational alteration and disease progression.
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Affiliation(s)
- Eva Bagyinszky
- Department of Bionano Technology, Gachon University, Sungnam, Korea
| | - YoungSoon Yang
- Department of Neurology, Veteran Health Service Medical Center, Seoul, Korea
| | - Vo Van Giau
- Department of Bionano Technology, Gachon University, Sungnam, Korea
| | - Young Chul Youn
- Department of Neurology, Chungang University Hospital, Chungang University, Seoul, Korea
| | - Seong Soo A An
- Department of Bionano Technology, Gachon University, Sungnam, Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine Seoul National University Bundang Hospital, Sungnam, Korea
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Shi Q, Shen XJ, Zhou W, Xiao K, Zhang XM, Zhang BY, Dong XP. Rare V180I mutation in PRNP gene of a Chinese patient with Creutzfeldt-Jakob disease. Prion 2015; 8:411-4. [PMID: 25482600 DOI: 10.4161/19336896.2014.967040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract Here, we reported a Chinese case of Creutzfeldt-Jakob disease (CJD) with a rare mutation in the prion protein gene (PRNP) leading to an exchange of amino acid from valine (V) to isoleucine (I) at codon 180 (V180I). The 72 year-old Chinese women started with gradual memory loss. On admission, she did not present special abnormality during clinical examinations except bradykinesia in her lower extremities. Myoclonic jerks and increased muscle tone were noticed 3 months after the onset. No periodic activity was recorded at electroencephalography (EEG) and 14-3-3 protein was negative in the cerebrospinal fluid (CSF) sample. Brain diffusion weighted images (DWI) demonstrated high signal intensities in bilateral frontal, parietal, temporal and occipital cortices, especially on the left hemisphere, and high signal intensities were also seen in the left caudate nucleus and the putamen. The patient had no family history of similar symptoms. Her general condition was gradually deteriorative, but the patient was still alive when we performed the follow-up 12 months after onset.
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Affiliation(s)
- Qi Shi
- a State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center Diagnosis and Treatment of Infectious Diseases (Zhejiang University, Hangzhou); National Institute for Viral Disease Control and Prevention; Chinese Center for Disease Control and Prevention ; Beijing , China
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Caverzasi E, Mandelli ML, DeArmond SJ, Hess CP, Vitali P, Papinutto N, Oehler A, Miller BL, Lobach IV, Bastianello S, Geschwind MD, Henry RG. White matter involvement in sporadic Creutzfeldt-Jakob disease. ACTA ACUST UNITED AC 2014; 137:3339-54. [PMID: 25367029 PMCID: PMC4240303 DOI: 10.1093/brain/awu298] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Sporadic Creutzfeldt-Jakob disease is considered primarily a disease of grey matter, although the extent of white matter involvement has not been well described. We used diffusion tensor imaging to study the white matter in sporadic Creutzfeldt-Jakob disease compared to healthy control subjects and to correlated magnetic resonance imaging findings with histopathology. Twenty-six patients with sporadic Creutzfeldt-Jakob disease and nine age- and gender-matched healthy control subjects underwent volumetric T1-weighted and diffusion tensor imaging. Six patients had post-mortem brain analysis available for assessment of neuropathological findings associated with prion disease. Parcellation of the subcortical white matter was performed on 3D T1-weighted volumes using Freesurfer. Diffusion tensor imaging maps were calculated and transformed to the 3D-T1 space; the average value for each diffusion metric was calculated in the total white matter and in regional volumes of interest. Tract-based spatial statistics analysis was also performed to investigate the deeper white matter tracts. There was a significant reduction of mean (P = 0.002), axial (P = 0.0003) and radial (P = 0.0134) diffusivities in the total white matter in sporadic Creutzfeldt-Jakob disease. Mean diffusivity was significantly lower in most white matter volumes of interest (P < 0.05, corrected for multiple comparisons), with a generally symmetric pattern of involvement in sporadic Creutzfeldt-Jakob disease. Mean diffusivity reduction reflected concomitant decrease of both axial and radial diffusivity, without appreciable changes in white matter anisotropy. Tract-based spatial statistics analysis showed significant reductions of mean diffusivity within the white matter of patients with sporadic Creutzfeldt-Jakob disease, mainly in the left hemisphere, with a strong trend (P = 0.06) towards reduced mean diffusivity in most of the white matter bilaterally. In contrast, by visual assessment there was no white matter abnormality either on T2-weighted or diffusion-weighted images. Widespread reduction in white matter mean diffusivity, however, was apparent visibly on the quantitative attenuation coefficient maps compared to healthy control subjects. Neuropathological analysis showed diffuse astrocytic gliosis and activated microglia in the white matter, rare prion deposition and subtle subcortical microvacuolization, and patchy foci of demyelination with no evident white matter axonal degeneration. Decreased mean diffusivity on attenuation coefficient maps might be associated with astrocytic gliosis. We show for the first time significant global reduced mean diffusivity within the white matter in sporadic Creutzfeldt-Jakob disease, suggesting possible primary involvement of the white matter, rather than changes secondary to neuronal degeneration/loss. Sporadic Creutzfeldt-Jakob disease (sCJD) is considered primarily a disease of grey matter. However, Caverzasi et al. now show a global decrease in mean diffusivity in white matter. The changes appear to be associated with reactive astrocytic gliosis and activated microglia, and suggest primary involvement of the white matter in sCJD.
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Affiliation(s)
- Eduardo Caverzasi
- 1 Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA 2 Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Maria Luisa Mandelli
- 2 Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Stephen J DeArmond
- 3 Department of Pathology, University of California San Francisco, San Francisco, CA 94143, USA 4 Institute for Neurodegenerative Diseases, University of California San Francisco, San Francisco, CA 94143, USA
| | - Christopher P Hess
- 5 Neuroradiology Division, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
| | - Paolo Vitali
- 6 Brain MRI 3T Mondino Research Center, C. Mondino National Neurological Institute, Pavia 27100, Italy
| | - Nico Papinutto
- 1 Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Abby Oehler
- 3 Department of Pathology, University of California San Francisco, San Francisco, CA 94143, USA 4 Institute for Neurodegenerative Diseases, University of California San Francisco, San Francisco, CA 94143, USA
| | - Bruce L Miller
- 2 Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Irina V Lobach
- 1 Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Stefano Bastianello
- 7 Department of Brain and Behavioral Sciences, University of Pavia, Pavia 27100, Italy
| | - Michael D Geschwind
- 2 Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94143, USA
| | - Roland G Henry
- 1 Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA 8 Bioengineering Graduate Group, University of California San Francisco, San Francisco, CA 94143, USA 9 Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
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Shi Q, Shen X, Zhou W, Xiao K, Zhang X, Zhang BY, Dong XP. Rare V180I mutation in PRNP gene of a Chinese patient with Creutzfeldt-Jacob disease. Prion 2014. [DOI: 10.4161/pri.32080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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