Rapid diagnosis of human prion disease using streptomycin with tonsil and brain tissues

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The use of streptomycin in the pathological prion protein (PrPsc) detection procedures represents a new and attractive way for diagnostic purpose. With this agent, western blot readily detected PrPsc in 263K scrapie hamster and C57Bl/6 wild-type mice challenged with C506M3 scrapie strain. Our aim was to evaluate this new diagnosis procedure in the field of human transmissible spongiform encephalopathies (TSEs). First, we had confirmed the ability of streptomycin to precipitate PrPres from human brain of Creutzfeldt–Jakob disease (CJD) patient. Second, we compared the detection of PrPres with streptomycin against three other protocols using other precipitations. Then we assessed PrPres detection with streptomycin in 98 brain tissue samples from various aetiologies of human TSEs and 52 brain samples from other dementia. Finally, we applied this protocol for tonsils examination of five patients suspected of variant CJD (v-CJD). Sensitivity and specificity obtained with the streptomycin protocol were both 100% on brain tissue. For tonsil tissues, PrPres was clearly identified in the two post-mortem confirmed v-CJD cases, whereas no characteristic three-band pattern was seen in the three confirmed non-v-CJD samples. In this study, streptomycin demonstrated its efficiency to detect PrPres both in the central nervous system and in the lymphoid tissue without practical difficulty and with rapid preparation. Because of its ability to act as a good agent for PrPsc examination in different tissues, recovery of PrPsc in biological fluids using streptomycin should open further perspectives of applications in CJD diagnostics. Streptomycin effects in vivo might thus also be questioned.