Abstract

Prion diseases are transmissible, progressive and invariably fatal neurodegenerative conditions associated with misfolding and aggregation of a host-encoded cellular prion protein, PrPC. They have occurred in a wide range of mammalian species including human. Human prion diseases can arise sporadically, be hereditary or be acquired. Sporadic human prion diseases include Cruetzfeldt-Jacob disease (CJD), fatal insomnia and variably protease-sensitive prionopathy. Genetic or familial prion diseases are caused by autosomal dominantly inherited mutations in the gene encoding for PrPC and include familial or genetic CJD, fatal familial insomnia and Gerstmann-Sträussler-Scheinker syndrome. Acquired human prion diseases account for only 5% of cases of human prion disease. They include kuru, iatrogenic CJD and a new variant form of CJD that was transmitted to humans from affected cattle via meat consumption especially brain. This review presents information on the epidemiology, etiology, clinical assessment, neuropathology and public health concerns of human prion diseases. The role of the PrP encoding gene (PRNP) in conferring susceptibility to human prion diseases is also discussed.

Highlights

  • Prion diseases are transmissible protein misfolding disorders in which misfolding of a host-encoded prion protein (PrP) occurs

  • PrP may exist in two forms: a normal cellular prion protein designated as Cellular isoform of prion protein (PrPC) and a pathogenic misfolded conformer designated as Scrapie isoform of prion protein (PrPSc)

  • Both PrPC and PrPSc conformers are encoded from the same sequence of the 16 kb single copy Prion protein gene (PRNP) gene that is positioned on the short (p) arm of human chromosome 20 (20p13), from base pairs 4,666,796-4,682,233

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Summary

Background

Prion diseases are transmissible protein misfolding disorders in which misfolding of a host-encoded prion protein (PrP) occurs. The mean age at onset of symptoms is 29 years, and the progression or total duration of the disease spans 18 months in average, which is similar to that is reported for kuru and iCJD linked to treatment with hGH [28,29,60]. Very soon after the report on 10 vCJD cases, epidemiological studies, experimental transmission of the disease to cynomologous macaques and mice (wild as well as transgenic) and biochemical strain typing linked the etiology of vCJD to infection from BSE prions [60]. At least 4 pathologically confirmed cases including 1 with subclinical or potentially preclinical infection have been associated with the secondary vCJD transmission via blood transfusion [76] These reports on secondary iatrogenic transmission and the possibility of vCJD occurrence with long incubation periods in individuals with 129 MV and 129 VV PrP genotypes have raised serious public health concerns [71,72,77,78]. The PRNP genotype 129 MM appears protective against the development of VPSPr [42]

Conclusion
20. Kirschbaum WR
29. Brandel JP
41. Brandner S
60. Will RG
69. Beekes M
Findings
83. Norrby E
Full Text
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