Bodemer W, Kaup F-J
Deutsches Primatenzentrum Göttingen, Abt. Infektionspathologie.
Gesundheitswesen. 2004 Feb;66 Suppl 1:S21-5. doi: 10.1055/s-2004-812760.
Prion diseases of animals and man are neurological diseases with amyloidal deposition of the respective proteins. As to prion disease, the cellular prion protein is in its abnormal isoform(s) an essential component of prion protein aggregates found in affected tissue. In contrast to all neurodegenerative diseases like Morbus Alzheimer or Huntington's disease, prion diseases are transmissible. Therefore, prion diseases were designated Transmissible Spongiform Encephalopathies (TSE). The diseases have been well known for decades. Scrapie was first described around 1750, a BSE case was reported in the 1850-ties most likely a misdiagnosis, and in 1920/1930 the human Creutzfeldt-Jakob disease (CJD) had been described. Transmission of CJD i. e. Kuru had been suspected in the early 1950 s and was erroneously classified as slow virus disease. The CJD transmission posed a problem to humans when transplants from CJD cases were used for treatment. Fortunately, these iatrogenic transmissions remained limited. But with the advent of BSE and appearance of variant CJD cases in the UK and some places in Europe scientists suspected that transmission from cattle to man could have happened. From animal models we know of successful transmission via several routes. Species barriers do not completely prevent transmission. Rather, transmission barriers might exist controlling individual susceptibility against prions. Modes of transmission, susceptibility to transmission, identification of receptor molecules as well as molecular mechanisms of the transmission process are being investigated with great intensity. Current knowledge leads us to assume that inapparent stages of prion infection wrongly suggest a (non-existent) species barrier. This inapparent infection precedes overt disease, and, hence, most research focuses on the development of highly sensitive assay systems for detection of minute amounts of pathological prion protein in suspected cases. Inapparence also should warn us to underestimate BSE or human vCJD cases; at present, approx. 145 cases occurred in Europe and one probable case in Hong Kong (June 2003). Whether BSE had spread to other parts of the world by animal nutrition components or meat can neither be excluded nor confirmed at this time. New data on transmission and consequences of BSE for the human population are summarised in this review.
动物和人类的朊病毒病是伴有各自蛋白质淀粉样沉积的神经疾病。就朊病毒病而言,细胞朊蛋白的异常异构体是在受影响组织中发现的朊蛋白聚集体的重要组成部分。与所有神经退行性疾病如阿尔茨海默病或亨廷顿舞蹈症不同,朊病毒病是可传播的。因此,朊病毒病被称为传染性海绵状脑病(TSE)。这些疾病已为人所知数十年。羊瘙痒症最早于1750年左右被描述,19世纪50年代报道了一例牛海绵状脑病病例,很可能是误诊,1920年/1930年人类克雅氏病(CJD)被描述。20世纪50年代初人们怀疑克雅氏病(即库鲁病)具有传染性,并错误地将其归类为慢病毒疾病。当使用来自克雅氏病患者的组织进行移植治疗时,克雅氏病的传播给人类带来了问题。幸运的是,这些医源性传播仍然有限。但随着牛海绵状脑病的出现以及英国和欧洲一些地方出现变异型克雅氏病病例,科学家怀疑可能发生了从牛到人的传播。从动物模型中我们知道可以通过多种途径成功传播。物种屏障并不能完全阻止传播。相反,可能存在控制个体对朊病毒易感性的传播屏障。传播方式、对传播的易感性、受体分子的鉴定以及传播过程的分子机制正在被深入研究。目前的知识使我们认为,朊病毒感染的隐匿阶段错误地暗示了一种(不存在的)物种屏障。这种隐匿性感染先于显性疾病,因此,大多数研究集中在开发用于检测疑似病例中微量病理性朊蛋白的高灵敏度检测系统。隐匿性也应该提醒我们不要低估牛海绵状脑病或人类变异型克雅氏病病例;目前,欧洲大约发生了145例病例,香港有一例可能病例(2003年6月)。目前既不能排除也不能证实牛海绵状脑病是否通过动物营养成分或肉类传播到了世界其他地区。本综述总结了关于牛海绵状脑病传播及其对人类影响的新数据。