Kovacs Gabor G
a Institute of Neurology, Medical University of Vienna , Vienna , Austria.
Prion. 2016 Sep 2;10(5):369-376. doi: 10.1080/19336896.2016.1228507.
Recent studies on iatrogenic Creutzfeldt-Jakob disease (CJD) raised concerns that one of the hallmark lesions of Alzheimer disease (AD), amyloid-β (Aβ), may be transmitted from human-to-human. The neuropathology of AD-related lesions is complex. Therefore, many aspects need to be considered in deciding on this issue. Observations of recent studies can be summarized as follows: 1) The frequency of iatrogenic CJD cases with parencyhmal and vascular Aβ deposits is statistically higher than expected; 2) The morphology and distribution of Aβ deposition may show distinct features; 3) The pituitary and the dura mater themselves may serve as potential sources of Aβ seeds; 4) Cadaveric dura mater from 2 examined cases shows Aβ deposition; and 5) There is a lack of evidence that the clinical phenotype of AD appears following the application of cadaveric pituitary hormone or dura mater transplantation. These studies support the notion that neurodegenerative diseases have common features regarding propagation of disease-associated proteins as seeds. However, until further evidence emerges, prions of transmissible spongiform encephalopathies are the only neurodegenerative disease-related proteins proven to propagate clinicopathological phenotypes.
近期关于医源性克雅氏病(CJD)的研究引发了人们的担忧,即阿尔茨海默病(AD)的标志性病变之一——淀粉样β蛋白(Aβ)可能会在人与人之间传播。AD相关病变的神经病理学很复杂。因此,在决定这个问题时需要考虑很多方面。近期研究的观察结果可总结如下:1)伴有实质和血管Aβ沉积的医源性CJD病例的发生率在统计学上高于预期;2)Aβ沉积的形态和分布可能呈现出不同的特征;3)垂体和硬脑膜本身可能是Aβ种子的潜在来源;4)来自2例受检病例的尸体硬脑膜显示有Aβ沉积;5)缺乏证据表明在应用尸体垂体激素或硬脑膜移植后会出现AD的临床表型。这些研究支持了神经退行性疾病在将疾病相关蛋白作为种子进行传播方面具有共同特征这一观点。然而,在有更多证据出现之前,可传播性海绵状脑病的朊病毒是唯一被证实能传播临床病理表型的神经退行性疾病相关蛋白。