NR APHM
AU Glatzel,M.; Abela,E.; Maissen,M.; Aguzzi,A.
TI Extraneural pathologic prion protein in sporadic Creutzfeldt-Jakob disease
QU The New England Journal of Medicine 2003 Nov 6; 349(19): 1812-20
PT journal article
AB BACKGROUND: In patients with sporadic Creutzfeldt-Jakob disease, pathologic disease-associated prion protein (PrPsc) has been identified only in the central nervous system and olfactory-nerve tissue. Understanding the distribution of PrPsc in Creutzfeldt-Jakob disease is important for classification and diagnosis and perhaps even for prevention. METHODS: We used a highly sensitive method of detection - involving the concentration of PrPsc by differential precipitation with sodium phosphotungstic acid, which increased the sensitivity of Western blot analysis by up to three orders of magnitude - to search for PrPsc in extraneural organs of 36 patients with sporadic Creutzfeldt-Jakob disease who died between 1996 and 2002. RESULTS: PrPsc was present in the brain tissue of all patients. In addition, we found PrPsc in 10 of 28 spleen specimens and in 8 of 32 skeletal-muscle samples. Three patients had PrPsc in both spleen and muscle specimens. Patients with extraneural PrPsc had a significantly longer duration of disease and were more likely to have uncommon molecular variants of sporadic Creutzfeldt-Jakob disease than were patients without extraneural PrPsc. CONCLUSIONS: Using sensitive techniques, we identified extraneural deposition of PrPsc in spleen and muscle samples from approximately one third of patients who died with sporadic Creutzfeldt-Jakob disease. Extraneural PrPsc appears to correlate with a long duration of disease.
IN Durch einen vorgeschalteten Fällungsschritt mit Phosphorwolframsäure (engl. phosphotungstic acid, Summenformel: H3[P(W3O10)4]*xH2O) konnten die Autoren die Sensitivität ihrer Western blots nach eigenen Angaben um bis zu 3 Größenordnungen steigern und fanden damit auch außerhalb des Zentralnervensystems bei Fällen von sporadischer Creutzfeldt-Jakob-Krankheit PrPsc in verschiedenen Geweben. Die Autoren wiesen PrPsc bei 10 von 28 Patienten auch in der Milz und bei 8 von 32 Patienten auch in Proben von Skelettmuskeln nach. Bei 3 Patienten fand man PrPsc in Milz und Muskeln. Im Durchschnitt hatten die Patienten mit in nicht neuronalem Gewebe nachweisbarem PrPsc eine längere Krankheitsphase und mit erhöhter Wahrscheinlichkeit eine seltene molekulare Variante des PrPsc.
MH Blotting, Western; Brain/metabolism/pathology; Creutzfeldt-Jakob Syndrome/*metabolism/pathology; Human; Muscle, Skeletal/*metabolism/pathology; PrPsc Proteins/*metabolism; Prions/genetics; Spleen/*metabolism/pathology; Support, Non-U.S. Gov't
AD Institute of Neuropathology and National Reference Center for Prion Diseases, University Hospital of Zürich, Zürich, Switzerland.
SP englisch
PO USA
ZF Zusammenfassung des Abstracts von Roland Heynkes