Prion disease Flashcards
What is a prion?
A protein with pathogenic infectious properties in the brain. They have no nucleic acids.
Properties of prion diseases
Rare, fatal, neurodegenerative (creates holes (vacuolation)), cause gliosis (brain inflammation / scarring), long incubation period, no adaptive immune response, resistant to most forms of chemical / physical inactivation, glial (brain immune cell) activation.
What is another term for prion diseases?
Transmissible spongiform encephalopathies (TSEs)
What organisms do prion diseases effect?
Humans and animals (agricultural, captive and wild)
Which animal would you find scrapie in?
Sheep and goats
Which animal would you find bovine spongiform encephalopathy (BSE) in?
Cattle - aka mad cow disease
Which animal would you find transmissible mink encephalopathy (TME) in?
Mink
Which animal would you find chronic wasting (CWD) disease in?
Deer and elk
What does aetiology mean?
Cause
Which prion disease are we most concerned will infect humans?
CWD
How do prion diseases develop?
Prion proteins are post-translationally converted to an infectious form (high beta sheet content) where they are able to form aggregates in the brain.
What are symptoms of prion disease?
Dementia, ataxia (poor muscle control), myoclonus (quick jerking movement), sometimes visual abnormalities
When in a patient does Creutzfeldt-Jakob disease usually develop?
In their 70s
How are prion diseases transmitted?
- Between individuals of a species
- Between species (zoonotic)
How big are prion proteins?
Sub-viral size
What are prion proteins resistant to?
Conventional sterilisation and decontamination methods (autoclave), UV (ionising) radiation, formalin / disinfectants
Normal prion protein notation
PrP^c
Infectious prion protein notation
PrP^Sc
Can infectious prions pass on their pathogenic properties to the next generation / organism?
Yes, despite having no DNA.
Differences between prion strains:
- Clinical and pathological features
- Rates of disease progression
- Histology
- Incubation period
- PrPSc build up
- Anatomical distribution of brain lesions
How can we define a prion strain?
The prions are stable when inoculated into an animal, and when they are passed to another animal ie they adapt to new species / organisms. They have a stable biological phenotype. Biochemical phenotype can also be taken into account.
Sporadic prion disease examples
- Sporadic Creutzfeldt-Jakob disease (sCJD)
- Sporadic fatal insomnia (sFI)
- Variably protease sensitive prionopathy (VPSPr)
What could cause sporadic prion disease?
We don’t know but maybe:
- Somatic mutation
- Chance conversion of PrPc to PrPSc
Genetic prion disease examples
- Gerstmann-Straussler-Sheinker disease (GSS)
- Fatal familial insomnia (FFI)
- Familial Creutzfeldt-Jakob disease (fCJD)
What causes genetic prion disease?
Mutations in the prion protein gene. Each disease a different mutation. They destabilise PrPc
Acquired / infectious prion disease examples:
- Kuru
- Iatrogenic Creutzfeldt-Jakob disease (iCJD)
- Variant Creutzfeldt-Jakob disease (vCJD)
What causes acquired prion disease?
Eating infected tissue, contaminated surgical equipment
Normal prion protein structure:
- 253 amino acids
- 22 aa ER signal peptide
- N-terminus largely unstructured but contains Cu2+ binding region
- N-terminal glycans allowing movement to golgi and ER
- 23 aa C-terminal GPI (in membrane) anchor sequence
- C-terminus globular domain with 3 alpha helices and 2 beta sheets.
Where is prion protein expressed?
Cell surface of neuronal cells - attached by GPI anchor.
Prion protein gene (PRNP) properties:
- Single copy gene
- Human chromosome 20
- Mammalian, avian and amphibian orthologues
What affects prion disease susceptibility / phenotype?
PRNP polymorphisms
Why is there no immune response to prion disease?
The same protein is present (not foreign), it is just misfolded.
How does misfolding change PRNP?
- Increased beta sheet composition (3 to 43%)
- Becomes aggregated instead of monomeric
- Becomes insoluble instead of soluble
- Becomes protease resistant instead of sensitive.
How do we do biological strain typing?
- Measure incubation periods
- Map lesion profile ( distribution of how strain targets the brain)
THERE CAN STILL BE OTHER PHENOTYPIC VARIATION PRESENT THOUGH.
Theory of BSE origin:
Sheep carcasses with scrapie were not properly rendered when creating cattle meal and bone meal (food). Therefore the prion disease passed to cows and other animals.
How do we prevent further BSE spread?
Stop using animal based MBM for all livestock.
What are florid plaques?
Prion aggregates associated with vCJD.
Differences between sCJD and vCJD:
- shorter life expectancy for vCJD
- shorter illness duration for sCJD
- psychiatric features in vCJD
- rapid dementia in sCJD
- sensory symptoms in vCJD
Which polymorphism at codon 129 predisposes someone to prion disease?
MM
What other codon 129 polymorphisms are possible with sCJD?
MV and VV (but less common than MM).