Warter J M, Steinmetz G, Mohr M, Tranchant C
Service de Neurologie, Hôpitaux Universitaires, Strasbourg, France.
Rev Neurol (Paris). 2002 Oct;158(10 Pt 1):998-1007.
Creutzfeldt-Jakob disease, kuru, Gerstmann Sträussler Scheinker syndrome and fatal familial insomnia in humans, as well as scrapie and bovine spongiform encephalopathy, in animals, are fatal disorders of the central nervous system that are part of the group of transmissible spongiform encephalopathies, (TSE) or prion diseases. Neuronal intracellular spongiosis and the accumulation of abnormal, protease resistant prion protein in the nervous central system characterize TSE. The conformational change of a host protein, prion protein, into a pathological isoform is the key pathogenetic event in TSE. Despite their relative rarity, prion diseases have a great impact on the scientific community and society in general. There are two major reasons: first, the heretical hypothesis of a disease transmitted by an "infectious protein" in the absence of nucleic acid, the basis of the conformational transmissibility concept; second, the panic originated from the appearance of new variant Creutzfeldt-Jakob disease and the evidence linking it to the exposure of humans to bovine spongiform encephalopathy via food contaminated by affected bovine tissue. Novel therapeutic approaches are examined.
克雅氏病、库鲁病、格斯特曼综合征和人类致死性家族性失眠症,以及动物中的羊瘙痒症和牛海绵状脑病,都是致命的中枢神经系统疾病,属于传染性海绵状脑病(TSE)或朊病毒病。神经元细胞内海绵样变以及异常的、抗蛋白酶的朊病毒蛋白在中枢神经系统中的积累是TSE的特征。宿主蛋白朊病毒蛋白转变为病理异构体的构象变化是TSE发病机制的关键事件。尽管朊病毒病相对罕见,但它们对科学界和整个社会都有很大影响。主要有两个原因:第一,在没有核酸的情况下由“传染性蛋白质”传播疾病的异端假说,这是构象可传播性概念的基础;第二,新变异型克雅氏病的出现引发的恐慌,以及将其与人类通过受感染牛组织污染的食物接触牛海绵状脑病联系起来的证据。文中探讨了新的治疗方法。