What are Prions and viroids?
Unconventional infectious agents
Not viruses, bacteria or parasites
What are Prions?
Infectious Proteins that cause a groups of diseases of the brain and nerous system called transmissible spongiform encephalopathies (TSEs)
What are Viroids?
Small, pathogenic RNAs that cause virus like diseases in plants
Do not code for proteins
What are TSEs?
Diseases affecting humans, sheep, goats, mink deer, elk, antelopes, cats
None of the TSEs evoke an immune response.
Prions cause a non-inflammatory process that results in vacuolation or spongiosis in the gray matter of the brain.
What are the “Mad Diseases” Transmissible spongiform encephalopathies (TSEs)
Kuru and bannibalism
Kuru—human TSE
“laughing sickness”
Mysterious disease affecting large numbers of the South Fore people of Papua, New Guinea in the 1950s and 1960s
Investigated by Vin Zigas, Shirley Lindenbaum, and Carleton Gadjusek
<10% of females survived past child-bearing age
Males only had 20% chance of dying of the disease
What are the three distinct stages of symptoms of Kuru?
What is the Fore Tribe practiced endocannibalism?
Practice of eating dead relatives
Began during the 1900s
Sign of love and respect as part of funeral rites
Human flesh was regarded as meat.
The body fat of Fore dead resembled pork and was an excellent source of food.
Bodies were infected with Kuru.
Men ate muscle.
Women and children ate morsels of the brain and other internal organs.
What are two theories to expalin to the cause of kuru?
What is the PrP and the “Protein only” hypothesis?
What are the characteristics of prions?
What are the typical decontamination Protocol that researchers Use:
Tissues, infectious waste, and instruments used in the processing of prion-contaminated samples are decontaminated in:
1 N NaOH or undiluted fresh household bleach followed by autoclaving at 132 oC for 4.5 hours`
What are two distinct conformations of the Prion protein?
What is PRNP gene encodes PrPc?
PRNP gene located on chromosome 20 of humans
Codes for a 254 amino acid protein
It is unique- no other proteins of similar homology in the database
PrPC is targeted via a secretory pathway to the cell surface of neurons and other cell types.
A glycosylinositol phospholipid anchors it into the membrane.
What is PrP c function?
What are three ways that TSEs can arise?
Infection
Inherited
Sporadic forms (most frequent human form)
What is the oral transmission?
Oral transmission of TSEs is very inefficient compared to intracerebral injections.
Infectious dose through ingestion of prion-contaminated food is unknown.
New research suggests infectious prions enter the brain via the hypoglossal nerve of the tongue.
Food products that contain tongue may be a potential source of prion infection for humans.
2005 study: Low doses via diet may be enough to cause a subclinical disease.
What are other routes of transmission?
Such as Iatrogenic disease?
Iatrogenic disease—inadvertently caused by a physician or surgeon by a contaminated medical or surgical instrument or diagnostic procedure
What are the examples of Iatrogenic transmission of CJD?
Corneal grafts from donors who developed CJD
Sharing of contaminated deep EEG electrodes implanted into brain
Contaminated neurosurgical instruments
Receipt of human growth hormone from CJD-infected donors
Patients who received dura mater grafts from donors who developed CJD
What is the bloodbornes transmission?
What is the blood transmission surveillance?
At least 48 individuals who received blood components from 15 donors who later developed variant CJD are being monitored as a precautionary step for their at-risk status.
Hemophiliacs in the U.K. have been notified that they are at risk for developing variant CJD.
What are the clinical signs and symptoms of variant CJD?
50% of variant CJD patients die before the age of 30
Average age at death is 28
Patients suffering from classic CJD die at an average of 68 years of age.
What are the Symptoms of Variant CJD?
What are the final symptoms of Variant CJD?
Loss of speech
Stupor
Persistent vegetative state (coma)
Death (14 months after symptoms appear)
What is the DIagnsosis of Vairant CJD?
Most patients referred to a psychiatrist because of behavioral changes
Definitive diagnosis: prion-positive immunostaining of biopsy material from
Tonsil
Spleen
Lymph nodes
EEG—looking for slow or negative brain wave activity
MRI—looking for brain lesions
CSF—looking for elevated levels of neuronal, astrocytic, and glial proteins
Elevated levels are a consequence of damage to the blood– brain barrier (extensive brain tissue damage)
No detectable immune response means no routine test to diagnose asymptomatic individuals