Abstract
Human prion diseases are a group of rare fatal neurodegenerative diseases with sporadic, genetic, and acquired forms. They are neuropathologically characterized by pathological prion protein accumulation, neuronal death, and vacuolation. Classical immunological response has long been known not to play a major in prion diseases; however, gliosis is known to be a common feature although variable in extent and poorly described. In this investigation, astrogliosis and activated microglia in two brain regions were assessed and compared with non-neurologically affected patients in a representative sample across the spectrum of Creutzfeldt–Jakob disease (CJD) forms and subtypes in order to analyze the influence of prion strain on pathological processes. In this report, we choose to focus on features common to all CJD types rather than the diversity among them. Novel pathological changes in both glial cell types were found to be shared by all CJD types. Microglial activation correlated to astrogliosis. Spongiosis, but not pathological prion protein deposition, correlated to both astrogliosis and microgliosis. At the ultrastructural level, astrocytic glial filaments correlated with pathological changes associated with prion disease. These observations confirm that neuroglia play a prominent role in the neurodegenerative process of prion diseases, regardless of the causative prion type.
Highlights
Creutzfeldt–Jakob disease (CJD) is a group of progressive neurodegenerative pathologies characterized by long incubation periods and an inevitable fatal outcome
The severity of spongiform change was highly variable among cases reaching the highest severity in iCJD regardless of the brain region examined (3.08 ± 0.90 in cerebellum and 2.57 ± 0.93 in frontal cortex; Figure 2)
Kuru-like plaques were detected in cerebellum and frontal cortex samples from iCJD (GMT, MV1) and iCJD (GHT, MV1+2), respectively
Summary
Creutzfeldt–Jakob disease (CJD) is a group of progressive neurodegenerative pathologies characterized by long incubation periods and an inevitable fatal outcome. Some authors tend to focus on microglia considering them responsible for the neurodegenerative process characteristic of this group of diseases, in part because microglia are the main immune cell of the central nervous system (CNS) [13–15] Studies of their morphological alterations have suggested a continuum of changes, from resting to an activated state or as consequence of neuropathological states, including different morphologies: Ramified, activated, amoeboid, dystrophic, and rod-like in neurodegenerative disease [16–18]. Evidence indicates that this activated cellular type, besides contributing to the clearance of damaged cellular material and protein aggregates, might induce a neuroinflammatory state, which accelerates the development of neurodegeneration [19]. A definitive view on the role of the activation state of these glial cells in the neurodegeneration process remains elusive
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