Name = Prion Diseases (TSEs)
ICD10 = A81
ICD9 = ICD9|046
A prion (IPAEng|ˈpriːɒn [OED|Prion] Audio|Pronunciation prion.ogg|listen) is thought to be an infectious agent that, according to current scientific consensus, is comprised entirely of a propagated, mis-folded
protein. [cite journal |author=Aguzzi A |title=Unraveling prion strains with cell biology and organic chemistry |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=105 |issue=1 |pages=11–2 |year=2008 |month=January |pmid=18172195 |pmc=2224168 |doi=10.1073/pnas.0710824105 |url=] The mis-folded form of the prion protein has been implicated in a number of diseases in a variety of mammals, including bovine spongiform encephalopathy(BSE, also known as "mad cow disease") in cattleand Creutzfeldt-Jakob disease(CJD) in humans. All hypothesized prion diseases affect the structure of the brainor other neural tissue, and all are currently untreatable and are always fatal. [cite journal |author=Prusiner SB |title=Prions |journal=Proc. Natl. Acad. Sci. USA |volume=95 |issue=23 |pages=13363–83 |year=1998 |doi=10.1073/pnas.95.23.13363 |pmid=9811807] In general usage, prion refers to the theoretical unit of infection. Scientifically speaking, PrPC refers to the endogenous prion protein, which is found in a multitude of tissues, while PrPSC refers to the misfolded form of PrPC, and is responsible for the formation of amyloid plaques that lead to neurodegeneration.
Prions are hypothesized to infect and propagate by refolding abnormally into a structure which is able to convert normal
molecules of the protein into the abnormally structured form. All known prions induce the formation of an amyloidfold, in which the protein polymerises into an aggregate consisting of tightly packed beta sheets. This altered structure is extremely stable and accumulates in infected tissue, causing cell death and tissue damage. [cite journal |author=Dobson CM |title=The structural basis of protein folding and its links with human disease |journal=Philos Trans R Soc Lond B Biol Sci |volume=356 |issue=1406 |pages=133–145 |year=2001 |doi=10.1098/rstb.2000.0758
pmid=11260793] This stability means that prions are resistant to denaturation by chemical and physical agents, making disposal and containment of these particles difficult.
Proteins showing prion-type behavior are also found in some fungi and this has been quite important in helping to understand mammalian prions. However,
fungal prionsdo not appear to cause disease in their hosts and may even confer an evolutionary advantage through a form of protein-based inheritance. [cite journal |author=Lindquist S, Krobitsch S, Li L and Sondheimer N |title=Investigating protein conformation-based inheritance and disease in yeast |journal=Philos Trans R Soc Lond B Biol Sci |volume=356 |issue=1406 |pages=169–176 |year=2001 |doi=10.1098/rstb.2000.0762
The radiation biologist
Tikvah Alperand the mathematician John Stanley Griffithdeveloped the hypothesis during the 1960s that some transmissible spongiform encephalopathies are caused by an infectious agent consisting solely of proteins. [cite journal |author=Alper T, Cramp W, Haig D, Clarke M |title=Does the agent of scrapie replicate without nucleic acid? |journal=Nature |volume=214 |issue=5090 |pages=764–6 |year=1967 |doi=10.1038/214764a0 |pmid=4963878] [cite journal |author=Griffith J |title=Self-replication and scrapie |journal=Nature |volume=215 |issue=5105 |pages=1043–4 |year=1967 |doi=10.1038/2151043a0 | pmid= 4964084] This theory was developed to explain the discovery that the mysterious infectious agent causing the diseases scrapieand Creutzfeldt-Jakob Disease resisted ultravioletradiation (UV radiation causes direct DNA damageby exciting individual molecules in the DNA polymer, which causes errors to be introduced into base pairsequence). Francis Crickrecognized the potential importance of the Griffith protein-only hypothesis for scrapie propagation in the second edition of his famous " Central dogma of molecular biology". [cite journal |author=Crick F |title=Central dogma of molecular biology |journal=Nature |volume=227 |issue=5258 |pages=561–3 |year=1970 |pmid=4913914| doi = 10.1038/227561a0 ] While asserting that the flow of sequence information from protein to protein, or from protein to RNA and DNA was "precluded" by this dogma, he noted that Griffith's hypothesis was a potential contradiction to this dogma (although it was not so promoted by Griffith). Since the revised "dogma" was formulated, in part, to accommodate the then-recent discovery of reverse transcriptionby Howard Teminand David Baltimore(who won the Nobel Prize in 1975), proof of the protein-only hypothesis might be seen as a "sure bet" for a future Nobel Prize. Stanley B. Prusinerof the University of California, San Franciscoannounced in 1982 that his team had purified the hypothetical infectious prion, and that the infectious agent consisted mainly of a specific protein- though they did not manage to satisfactorily isolate the protein until two years after Prusiner's announcement. [Citation |last=Taubes| first= Gary | authorlink=Gary Taubes |title=The game of name is fame. But is it science? |journal=Discover |volume=7 |issue=12 |pages= 28–41 |date=December 1986 |year= 1986] Prusiner coined the word "prion" as a name for the infectious agent, by combining the first two syllables of the words "proteinaceous" and "infectious" (-on by analogy to virion).cite journal | author=Prusiner, SB| authorlink=Stanley Prusiner| title=Novel proteinaceous infectious particles cause scrapie| journal=Science| year=1982| volume=216| issue=4542| pages=136–144 |doi=10.1126/science.278.5336.245 |pmid= 6801762] While the infectious agent was named a prion, the specific protein that the prion was made of was named PrP, an abbreviation for "protease resistant protein". Prusiner was awarded the Nobel Prize in Physiology or Medicinein 1997 for his research into prions.Cite web|url=http://nobelprize.org/nobel_prizes/medicine/laureates/1997/|title=The Nobel Prize in Physiology or Medicine 1997|accessdate=2007-05-11|publisher=NobelPrize.org]
The protein that prions are made of is found throughout the body, even in healthy people and animals. However, the prion protein found in infectious material has a different folding pattern and is resistant to
proteases, the enzymes in the body that can normally break down proteins. The normal form of the protein is called PrPC, while the infectious form is called PrPSc — the "C" refers to 'cellular' or 'common' PrP, while the "Sc" refers to ' scrapie', a prion disease occurring in sheep.cite journal
last=Priola | first=Suzette A.
coauthors=Chesebro, Bruce; Caughey, Byron
title=A View from the Top--Prion Diseases from 10,000 Feet
journal=Science | year=2003 | volume=300
issue=5621 | pages=917–919
pmid=12738843] While PrPC is structurally well-defined, PrPSc is certainly
polydisperseand defined at a relatively poor level. PrP can be induced to fold into other more-or-less well-defined isoforms in vitro, and their relationship to the form(s) that are pathogenic in vivo is not yet clear.
PrPC is a normal protein found on the membranes of cells. It has 209
amino acids (in humans), one disulfide bond, a molecular weight of 35-36kDa and a mainly alpha-helical structure. Several topological forms exist; one cell surface form anchored via glycolipidand two transmembraneforms. [cite journal | author=Hegde RS, Mastrianni JA, Scott MR, Defea KA, Tremblay P, Torchia M, DeArmond SJ, Prusiner SB, Lingappa VR| title=A transmembrane form of the prion protein in neurodegenerative disease| journal=Science| year=1998| volume=276| pages=827–834 |pmid=9452375 |doi=10.1126/science.279.5352.827] Its function has not been fully resolved. PrPC binds copper(II) ions with high affinity. [cite journal | author=Hornshaw MP, McDermott JR, Candy JM| title=Copper binding to the N-terminal tandem repeat regions of mammalian and avian prion protein| journal=Biochem Biophys Res Commun| year=1995| volume=207| pages=621–629 |pmid=7864852 |doi=10.1006/bbrc.1995.1233] The significance of this is not clear, but it presumably relates to PrP structure or function. PrPC is readily digested by proteinase Kand can be liberated from the cell surface in vitro by the enzyme phosphoinositide phospholipase C (PI-PLC), which cleaves the glycophosphatidylinositol(GPI) glycolipid anchor.cite journal | author=Weissmann, C| title=The State of the Prion| journal=Nature Reviews Microbiology| year=2004| volume=2| pages=861–871 |pmid=15494743 |doi=10.1038/nrmicro1025]
isoformof PrPC, known as PrPSc, is able to convert normal PrPC proteins into the infectious isoform by changing their conformation.Although the exact 3D structure of PrPSc is not known, there is increased β-sheet content in the diseased form of the molecule, replacing normal areas of α-helix. [cite journal|title=Conversion of alpha-helices into beta-sheets features in the formation of scrapie prion protein|journal=Pnas USA|date=1993 December 1|volume=90|issue=23|pages=10962–6|url=http://www.pubmedcentral.gov/articlerender.fcgi?tool=pubmed&pubmedid=7902575|pmid= 7902575] Aggregations of these abnormal isoforms may form highly structured amyloidfibers. The end of a fiber acts as a template for the free protein molecules, causing the fiber to grow. Small differences in the amino acid sequence of prion-forming regions lead to distinct structural features on the surface of prion fibers. As a result, only free protein molecules that are identical in amino acid sequence to the prion protein can be recruited into the growing fiber.
It has now been conclusively proven that the prion protein's normal cellular role is as a copper dependent
antioxidant. [cite journal |author=Brown DR, Wong BS, Hafiz F, Clive C, Haswell S, Jones IM |title=Normal prion protein has an activity like that of superoxide dismutase |journal=Biochem J |volume=344 |issue=1 |pages=1–5 |year=1999 |pmid= 10548526 | doi = 10.1042/0264-6021:3440001 ] While a small number of researchers in the field pursue other possibilities, the majority of evidence from many researchers supports this finding.
PrP and long-term memory
There is evidence that PrP may have a normal function in maintenance of
long term memory. [cite journal |author=Shorter J, Lindquist S |title=Prions as adaptive conduits of memory and inheritance |journal=Nat Rev Genet |volume=6 |issue=6 |pages=435–50 |year=2005 |pmid= 15931169 |doi=10.1038/nrg1616] Maglio and colleagues have shown that mice without the genes for normal cellular PrP protein have altered hippocampal LTP. [cite journal |author=Maglio L, Perez M, Martins V, Brentani R, Ramirez O |title=Hippocampal synaptic plasticity in mice devoid of cellular prion protein |journal=Brain Res Mol Brain Res |volume=131 |issue=1-2 |pages=58–64 |year=2004 |pmid= 15530652 |doi=10.1016/j.molbrainres.2004.08.004]
PrP and stem cell renewal
A 2006 article from the Whitehead Institute for Biomedical Research indicates that PrP expression on stem cells is necessary for an organism's self-renewal of
bone marrow. The study showed that all long-term hematopoietic stem cells expressed PrP on their cell membrane and that hematopoietic tissues with such PrP-null stem cells exhibited increased sensitivity to cell depletion. [cite journal |author=Zhang CC, Steele AD, Lindquist S, Lodish HF |title=Prion protein is expressed on long-term repopulating hematopoietic stem cells and is important for their self-renewal |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=103 |issue=7 |pages=2184–9 |year=2006 |month=February |pmid=16467153 |pmc=1413720 |doi=10.1073/pnas.0510577103 |url=]
Prions cause neurodegenerative disease by aggregating extracellularly within the
central nervous systemto form plaques known as amyloids, which disrupt the normal tissue structure. This disruption is characterized by "holes" in the tissue with resultant spongy architecture due to the vacuoleformation in the neurons.cite book | title=Robbins Pathologic Basis of Disease| last=Cotran| coauthors=Kumar, Collins| publisher=W.B Saunders Company| location=Philadelphia| isbn=0-7216-7335-X] Other histological changes include astrogliosisand the absence of an inflammatory reaction.cite journal | author=Belay E.| title=Transmissible Spongiform Encephalopathies in Humans| journal=Annu. Rev. Microbiol.| year=1999| volume=53| pages=283–314 |pmid=10547693 |doi=10.1146/annurev.micro.53.1.283] While the incubation periodfor prion diseases is generally quite long, once symptoms appear the disease progresses rapidly, leading to brain damage and death.Cite web|url=http://www.cdc.gov/ncidod/dvrd/prions/|title=Prion Diseases|accessdate = 2007-05-13|publisher=US Centers for Disease Control] Neurodegenerative symptoms can include convulsions, dementia, ataxia(balance and coordination dysfunction), and behavioural or personality changes.
All known prion diseases, collectively called "transmissible spongiform encephalopathies" (TSEs), are untreatable and fatal.cite journal | author=Gilch, Sabine, "et al."| title=Intracellular re-routing of prion protein prevents propagation of PrPSc and delays onset of prion disease| journal=The EMBO Journal| year=2001 |volume=20 | issue=15| pages=3957–3966 |pmid=11483499 |doi=10.1093/emboj/20.15.3957] However, a vaccine has been developed in mice that may provide insight into providing a vaccine in humans to resist prion infections. [cite web | author = New York University Medical Center and School of Medicine | title = Active Vaccine Prevents Mice From Developing Prion Disease| work = Science Daily | url = http://www.sciencedaily.com/releases/2005/05/050514111648.htm |date=2005-05-14 | accessdate = 2007-05-08 ] Additionally, in 2006 scientists announced that they had genetically engineered cattle lacking a necessary gene for prion production - thus theoretically making them immune to BSE, [cite news |first= Rick|last=Weiss |title=Scientists Announce Mad Cow Breakthrough. |url=http://www.washingtonpost.com/wp-dyn/content/article/2006/12/31/AR2006123100672.html|publisher=The
Washington Post|date= 2007-01-01|quote=Scientists said yesterday that they have used genetic engineering techniques to produce the first cattle that may be biologically incapable of getting mad cow disease. |accessdate=2007-01-01] building on research indicating that mice lacking normally-occurring prion protein are resistant to infection by scrapie prion protein. [cite journal |author=Büeler H, Aguzzi A, Sailer A, Greiner R, Autenried P, Aguet M, Weissmann C |title=Mice devoid of PrP are resistant to scrapie |journal=Cell |volume=73 |issue=7 |pages=1339–47 |year=1993 |pmid= 8100741 |doi=10.1016/0092-8674(93)90360-3]
Many different mammalian species can be affected by prion diseases, as the prion protein (PrP) is very similar in all mammals. [cite journal |author=Collinge J |title=Prion diseases of humans and animals: their causes and molecular basis |journal=Annu Rev Neurosci |volume=24 |issue= |pages=519–50 |year=2001 |pmid = 11283320 |doi=10.1146/annurev.neuro.24.1.519] Due to small differences in PrP between different species, it is unusual for a prion disease to be transmitted from one species to another (but recent laboratory experiments show that this is possible). [cite web|url=http://www.nature.com/news/2008/080904/full/news.2008.1080.html|title=2008-09-04, Prions jump species barrier] However, the human prion disease "variant Creutzfeldt-Jakob disease" is believed to be caused by a prion which typically infects cattle and is transmitted through infected meat.cite journal | author=Ironside, JW| title=Variant Creutzfeldt-Jakob disease: risk of transmission by blood transfusion and blood therapies| journal=Haemophilia| year=2006| volume=12| issue=s1| pages=8–15 |pmid=16445812 |doi=10.1111/j.1365-2516.2006.01195.x]
Some researchers have suggested that metal ion interactions with prion proteins might be relevant to the progression of prion-mediated disease, based on epidemiological studies of clusters of prion disease in locales with low soil concentrations of copper. [cite web|url=http://www.bseinquiry.gov.uk/files/ws/s638.pdf|title=2000-09-22, Normal Function of Prions, Statement to the BSE Inquiry|format=PDF]
The following diseases are believed to be caused by prions.
* In animals:
Scrapiein sheepand goats [http://www.ncbi.nlm.nih.gov/ICTVdb/Ictv/fs_prion.htm "90. Prions - ICTVdB Index of Viruses."] (Website.) U.S. National Institutes of Health website. Retrieved on 2007- 09-27.]
Bovine spongiform encephalopathy(BSE) in cattle(known as "mad cow disease")
Transmissible mink encephalopathy(TME) in mink
Chronic wasting disease(CWD) in white-tailed deer, elkand mule deer
Feline spongiform encephalopathyin cats
Exotic ungulate encephalopathy(EUE) in nyala, oryxand greater kudu
** Spongiform encephalopathy of the
ostrichHussein, Mansour F. and Saud I. Al-Mufarrej. (2004.) [http://www.kfu.edu.sa/sjournal/eng/pdffiles/b526.pdf "Prion Diseases: A Review; II. Prion Diseases in Man and Animals."] "Scientific Journal of King Faisal University (Basic and Applied Sciences)", vol. 5, no. 2 1425, p. 139. Retrieved on 2007- 09-27.]
* In humans:
Creutzfeldt-Jakob disease(CJD) and its varieties: iatrogenic Creutzfeldt-Jakob disease (iCJD), variant Creutzfeldt-Jakob disease (vCJD), familial Creutzfeldt-Jakob disease (fCJD), and sporadic Creutzfeldt-Jakob disease (sCJD)
Fatal familial insomnia(sFI) [( 1999- 05-28.) [http://news.bbc.co.uk/2/hi/health/355297.stm "BSE proteins may cause fatal insomnia."] (News website.) "BBC News". Retrieved on 2007- 09-27.]
Although the identity and general properties of prions are now well understood, the mechanism of prion infection and propagation remains mysterious. It is often assumed that the diseased form directly interacts with the normal form to make it rearrange its structure. One idea, the "Protein X" hypothesis, is that an as-yet unidentified cellular protein (Protein X) enables the conversion of PrPC to PrPSc by bringing a molecule of each of the two together into a complex. [cite journal |author=Telling G, Scott M, Mastrianni J, Gabizon R, Torchia M, Cohen F, DeArmond S, Prusiner S |title=Prion propagation in mice expressing human and chimeric PrP transgenes implicates the interaction of cellular PrP with another protein |journal=Cell |volume=83 |issue=1 | pages = e93 |year=1995 |pmid= 7553876 | doi = 10.1016/0092-8674(95)90236-8 ]
Current research suggests that the primary method of infection in animals is through ingestion. It is thought that prions may be deposited in the environment through the remains of dead animals and via urine, saliva, and other body fluids. They may then linger in the soil by binding to clay and other minerals. [cite journal |author=Johnson C, Pedersen, Chappell R, McKenzie D, Aiken J |title=Oral Transmissibility of Prion Disease is Enhanced by Binding to Soil Particles |journal=PLoS Pathogens |volume=3 |issue=7 |year=2007 |pmid=17616973 |doi=10.1371/journal.ppat.0030093 |pages=e93]
Infectious particles possessing nucleic acid are dependent upon it to direct their continued replication. Prions however, are infectious by their effect on normal versions of the protein. Therefore, sterilizing prions involves the denaturation of the protein to a state where the molecule is no longer able to induce the abnormal folding of normal proteins. However, prions are generally quite resistant to denaturation by
proteases, heat, radiation, and formalintreatments, [cite journal |author=Qin K, O'Donnell M, Zhao R |title=Doppel: more rival than double to prion |journal=Neuroscience |volume=141 |issue=1 |pages=1–8 |year=2006 |doi=10.1016/j.neuroscience.2006.04.057 |link=http://linkinghub.elsevier.com/retrieve/pii/S0306-4522(06)00510-0 | pmid = 16781817] although their infectivity can be reduced by such treatments.
Prions can be denatured by subjecting them to a temperatures of 134 degrees Celsius (274 degrees Fahrenheit) for 18 minutes in a pressurised steam
autoclave. [cite journal |author=Collins SJ, Lawson VA, Masters CL |title=Transmissible spongiform encephalopathies |journal=Lancet |volume=363 |issue=9402 |pages=51–61 |year=2004 |pmid=14723996 |doi=10.1016/S0140-6736(03)15171-9] Ozone sterilization is currently being studied as a potential method for prion deactivation. [ [http://www.hpa.org.uk/hpa/news/articles/press_releases/2005/050414_ozone_sterilizer.htm Ozone Sterilization] - UK Health Protection Agency] Renaturation of a completely denatured prion to infectious status has not yet been achieved, however partially denatured prions can be renatured to an infective status under certain artificial conditions. [cite journal |author=Weissmann C, Enari M, Klöhn PC, Rossi D, Flechsig E |title=Transmission of prions |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=99 Suppl 4 |issue= |pages=16378–83 |year=2002 |doi=10.1073/pnas.172403799 |pmid=12181490]
World Health Organizationrecommends any of the following three procedures for the sterilization of all heat-resistant surgical instruments that are potentially contaminated with prions:
# Immerse in a pan containing 1N NaOH and heat in a gravity-displacement autoclave at 121°C for 30 minutes; clean; rinse in water; and then subject to routine sterilization.
# Immerse in 1N NaOH or sodium hypochlorite (20,000 parts per million available chlorine) for 1 hour; transfer instruments to water; heat in a gravity-displacement autoclave at 121°C for 1 hour; clean; and then subject to routine sterilization
# Immerse in 1N NaOH or sodium hypochlorite (20,000 parts per million available chlorine) for 1 hour; remove and rinse in water, then transfer to an open pan and heat in a gravity-displacement (121°C) or in a porous-load (134°C) autoclave for 1 hour; clean; and then subject to routine sterilization [cite journal| author=Sutton JM, Dickinson J, Walker JT and Raven NDH |title=Methods to Minimize the Risks of Creutzfeldt-Jakob Disease by Surgical Procedures: Where to Set the Standard? |journal=Clinical Infectious Diseases |volume=43 |year=2006 |pages=757–64 |pmid=16912952 |doi=10.1086/507030]
One method that will decompose any organic material to its basic constituents uses cold (non-equilibrium) oxygen ion plasmas. [This converts the organic materials into carbon dioxide, water, nitrogen gas, nitrogen oxides, phosphorous oxides, sulfur dioxide, etc.] Even basal graphite can be converted to carbon dioxide using this method. Another way uses chromerge (Cr2O6) in concentrated sulfuric acid. This is a common method to clean glassware used in organic and analytical chemistry.
Another method for decomposing and disposing of any organic compound is burning it at high temperatures in an oxygen-rich atmosphere. This method is used for the disposal of deadly
chemical weaponssuch as nerve gasses and mustard gas. This reduces it all to simple gaseous compounds, including water vapor, that are safe to release into the environment.
Whether prions are the agent which causes disease or merely a symptom caused by a different agent is still under debate. The following sections describe several contending hypotheses.
Prior to the discovery of prions, it was thought that all
pathogens used nucleic acids to direct their replication. The "protein-only hypothesis" states that a protein structure can replicate without the use of nucleic acid. This was initially controversial as it contradicts the so-called " central dogma of molecular biology," which describes nucleic acid as the central form of replicative information.
Evidence in favor of a protein-only hypothesis include:
*No virus particles, bacteria, or fungi have been conclusively associated with prion diseases
*No nucleic acid has been conclusively associated with infectivity; agent is resistant to degradation by
*No immune response to infection
*PrPSc experimentally transmitted between one species and another results in PrPSc with the amino-acid sequence of the recipient species, suggesting that replication of the donor agent does not occur
*Level of infectivity is associated with levels of PrPSc
*PrPSc and PrPC do not differ in amino-acid sequence, therefore a "PrPSc-specific" nucleic acid is a redundant concept
*Familial prion disease occurs in families with a mutation in the PrP gene, and mice with PrP mutations develop prion disease despite controlled conditions where transmission is prevented
In 2007, biochemist Surachai Supattapone and his colleagues at
Dartmouth Collegeproduced purified infectious prions "de novo" from defined components (PrPC, co-purified lipids, and a synthetic polyanionic molecule) [cite journal |author=Deleault NR, Harris BT, Rees JR, Supattapone S |title=Formation of native prions from minimal components in vitro |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=104 |issue=23 |pages=9741–6 |year=2007 |month=June |pmid=17535913 |pmc=1887554 |doi=10.1073/pnas.0702662104 |url=] . These researchers also showed that the polyanionic molecule required for prion formation was selectively incorporated into high-affinity complexes with PrP molecules, leading them to hypothesize that infectious prions may be composed of multiple host components, including PrP, lipid, and polyanionic molecules, rather than PrPSc alone [cite journal |author=Geoghegan JC, Valdes PA, Orem NR, "et al" |title=Selective incorporation of polyanionic molecules into hamster prions |journal=J. Biol. Chem. |volume=282 |issue=50 |pages=36341–53 |year=2007 |month=December |pmid=17940287 |doi=10.1074/jbc.M704447200 |url=] .
The protein-only hypothesis has been criticised by those who feel that the simplest explanation of the evidence to datecite journal |author=Manuelidis L |title=A 25 nm virion is the likely cause of transmissible spongiform encephalopathies |journal=J. Cell. Biochem. |volume=100 |issue=4 |pages=897–915 |year=2007 |month=March |pmid=17044041 |doi=10.1002/jcb.21090 |url=] is viral. For more than a decade,
Yale Universityneuropathologist Laura Manuelidishas been proposing that prion diseases are caused instead by an unidentified "slow" virus. In January 2007, she and her colleagues published an article in the " Proceedings of the National Academy of Science" reporting to have found the virusin 10%, or less, of their scrapie-infected cells in culture.cite news | url=http://www.yale.edu/opa/newsr/07-01-30-02.all.html | title=Pathogenic Virus Found in Mad Cow Cells | publisher=Yale | date= February 2 2007| accessdate=2007-02-02] cite journal | url=http://www.pnas.org/cgi/content/full/104/6/1965 | title=Cells infected with scrapie and Creutzfeldt–Jakob disease agents produce intracellular 25-nm virus-like particles | author=Laura Manuelidis, Zhoa-Xue Yu, Nuria Barquero, and Brian Mullins | doi=10.1073/pnas.0610999104 |date=February 6, 2007 | volume=104 | issue=6 | pages=1965–1970 | journal=Proceedings of the National Academy of Sciences of the United States of America | pmid=17267596]
The virion hypothesis states that TSEs are caused by a replicable informational molecule (which is likely to be a nucleic acid) bound to PrP. Many TSEs, including scrapie and BSE, show strains with specific and distinct biological properties, a feature which supporters of the virion hypothesis feel is not explained by prions. The presence of a nucleic acid bound to the protein would explain the strains observed. It has also been shown that TSEs including BSE retain their host-specific properties after passage through many different species. cite journal |title=Straining the prion hypothesis |author=Farquhar C, Somerville R and Bruce M |date =1998 |volume=391 |pages=345–346 |journal=Nature |pmid=9450747 |doi=10.1038/34818]
Evidence in favor of a viral hypothesis include:cite book | title=Prion Disease| last=Baker & Ridley| publisher=Humana Press | year=1996 | location=New Jersey| isbn=0-89603-342-2]
*No bacteria or other living organisms have been found in prion-affected organisms.
*Differences in prion infectivity, incubation, symptomology and progression among species resembles the "strain variation" seen between viruses, especially
*The long incubation and rapid onset of symptoms resembles some viral infections, such as
*A number of other properties may match the virion hypothesis more closely than the prion hypothesis, including the size of TSE agents (on which there are conflicting findings), noninfectivity induced by the disruption of what may be the agent's nucleic acid-protein structure, route of dissemination in the body (if by white blood cells, as concluded by some studies), and capacities of TSE agents similar to
*Viral-like particles that do not appear to be composed of PrP have been found in some of the cells of scrapie- or CJD-infected cell lines. ]
Heavy metal poisoning hypothesis
Mark Purdey and Dr. David R. Brown have suggested that common prion is a beneficial molecule when bound to copper ions and that loss of this activity could cause disease. They have hypothesised that abnormal amounts of copper and manganese in the environment or animal feed could precipitate this. [cite web url=http://www.bseinquiry.gov.uk/files/ws/s638.pdftitle=Normal Function of Prions, Statement to the BSE Inquiry]
Evidence favouring a pollutant cause:
*Manganese present increases the percentage of helical protein, while Copper decreases it.cite journal
author = Zhu F, Davies P, Thompsett AR, "et al"
title = Raman optical activity and circular dichroism reveal dramatic differences in the influence of divalent copper and manganese ions on prion protein folding
volume = 47
issue = 8
pages = 2510–7
year = 2008
month = February
pmid = 18205409
doi = 10.1021/bi7022893
quote = In contrast, when the protein is refolded in the presence of divalent manganese ions, Raman Optical Activity indicates the alpha-helix is reinforced, with UV CD revealing an increase in total alpha-helix content to approximately 30%.]
*Alzheimer's disease has similar symptoms, and has been attributed to excessive Aluminum at various times.
*Copper deficiency and Manganese proficiency have been found in the environment of affected cattle.
*Sporadic occurrences of diseased prion rule out genetics.
genefor the normal protein has been isolated: the " PRNP" gene. [cite journal |author=Oesch B, Westaway D, Wälchli M, McKinley M, Kent S, Aebersold R, Barry R, Tempst P, Teplow D, Hood L |title=A cellular gene encodes scrapie PrP 27-30 protein |journal=Cell |volume=40 |issue=4 |pages=735–46 |year=1985 |pmid= 2859120 | doi = 10.1016/0092-8674(85)90333-2 ] Some prion diseases can be inherited, and in all inherited cases there is a mutationin the "PRNP" gene. Many different "PRNP" mutations have been identified and it is thought that the mutations somehow make PrPC more likely to spontaneously change into the abnormal PrPSc form. While these mutations can occur throughout the gene encoding the prion protein the most notable code for the five octopeptide repeats found near the signal peptide of the protein, e.g. if the number of octopeptide repeats is increased to thirteen it can result in Gerstmann-Straussler Syndrome(GSS). Other mutations that have previously identified as a possible cause of genetically induced prion diseases occur at positions 102, 117 & 198 (GSS), 178, 200, 210 & 232 (CJD) and 178 Fatal Familial Insomnia (FFI). Prion diseases are the only known diseases that can be , genetic, or infectious.
Prions in yeast and other fungi
Prion proteins were discovered in the yeast Saccharomyces cerevisiae by
Reed Wicknerin the early 1990's. Subsequently, a prion has also been found in the fungus Podospora anserina. These prions behave similarly to PrP, but are generally non-toxic to their hosts. Susan Lindquist's group at the Whitehead Institutehas argued that some of the fungal prions are not associated with any disease state, but may have a useful role; however, researchers at the NIH have also provided strong arguments demonstrating that fungal prions should be considered a diseased state.
Research into fungal prions has given strong support to the protein-only hypothesis for mammalian prions, since it has been demonstrated that purified protein extracted from cells with the prion state can convert the normal form of the protein into the infectious form "
in vitro", and in the process, preserve the information corresponding to different strains of the prion state. It has also shed some light on prion domains, which are regions in a protein that promote the conversion into a prion. Fungal prions have helped to suggest mechanisms of conversion that may apply to all prions.
Transmissible spongiform encephalopathy
"Deadly Feasts: The "Prion" Controversy and the Public's Health" ["Deadly Feasts: The "Prion" Controversy and the Public's Health", Richard Rhodes, 1998, Touchstone, ISBN: 0684844257] , by
Richard Rhodesoffers a history of research into Kuru, CJD, Mad Cow Disease, Scrapie and related disorders through 1998. The Touchstone paperback edition includes an Afterword that reviews the viral and virion hypotheses. "Deadly Feasts" extensively covers public policy debates on food safety standards.
"The Pathological Protein: Mad Cow, Chronic Wasting, and Other Deadly Prion Diseases" covers the science of TSE diseases in greater depth than "Deadly Feasts" but is not so thorough on policy issues. ["The Pathological Protein: Mad Cow, Chronic Wasting, and Other Deadly Prion Diseases", Phillip Yam, 2003, Springer, ISBN-10: 0387955089] "The Family That Couldn't Sleep" by D. T. Max provides a history of prion diseases for a popular audience.
* [http://nobelprize.org/nobel_prizes/medicine/laureates/1997/prusiner-autobio.html Biography of Dr Prusiner]
* [http://www.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/90.001.0.01.htm Mammalian prion classification] International Committee on Taxonomy of Viruses -
* [http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=176640 Online Mendelian Inheritance in Man: Prion protein] - PrP, inherited prion disease and transgenic animal models.
* [http://www.bseinquiry.gov.uk/ The UK BSE Inquiry] - Report of the UK public inquiry into BSE and variant CJD
* [http://www.seac.gov.uk/ UK Spongiform Encephalopathy Advisory Committee (SEAC)]
* [http://www.cjdsupport.net/ CJD Support Network]
* [http://www.who.int/zoonoses/diseases/prion_diseases/en/ World Health Organisation] - WHO information on prion diseases
* [http://www.cdc.gov/ncidod/dvrd/prions/ CDC] - USA Centers for Disease Control and Prevention - information on prion diseases
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