Centre for Prions and Protein Folding Diseases, Edmonton, AB T6G 2R3, Canada.
Department of Medicine, Division of Neurology, University of Alberta, Edmonton, AB T6G 2R3, Canada.
Viruses. 2020 Dec 17;12(12):1454. doi: 10.3390/v12121454.
The majority of human prion diseases are sporadic, but acquired disease can occur, as seen with variant Creutzfeldt-Jakob disease (vCJD) following consumption of bovine spongiform encephalopathy (BSE). With increasing rates of cervid chronic wasting disease (CWD), there is concern that a new form of human prion disease may arise. Currently, there is no evidence of transmission of CWD to humans, suggesting the presence of a strong species barrier; however, in vitro and in vivo studies on the zoonotic potential of CWD have yielded mixed results. The emergence of different CWD strains is also concerning, as different strains can have different abilities to cross species barriers. Given that venison consumption is common in areas where CWD rates are on the rise, increased rates of human exposure are inevitable. If CWD was to infect humans, it is unclear how it would present clinically; in vCJD, it was strain-typing of vCJD prions that proved the causal link to BSE. Therefore, the best way to screen for CWD in humans is to have thorough strain-typing of harvested cervids and human CJD cases so that we will be in a position to detect atypical strains or strain shifts within the human CJD population.
大多数人类朊病毒病是散发性的,但也可发生获得性疾病,如食用牛海绵状脑病(BSE)后出现变异型克雅氏病(vCJD)。随着鹿慢性消耗病(CWD)发病率的增加,人们担心可能会出现一种新形式的人类朊病毒病。目前,尚无证据表明 CWD 会传播给人类,这表明存在很强的物种屏障;然而,关于 CWD 人畜共患潜力的体外和体内研究结果喜忧参半。不同 CWD 毒株的出现也令人担忧,因为不同的毒株可能具有不同的跨越物种屏障的能力。鉴于鹿肉在 CWD 发病率上升的地区很常见,人类接触的风险不可避免会增加。如果 CWD 感染了人类,其临床表现尚不清楚;在 vCJD 中,vCJD 朊病毒的毒株分型证明了与 BSE 的因果关系。因此,筛查人类 CWD 的最佳方法是对收获的鹿和人类 CJD 病例进行彻底的毒株分型,以便我们能够检测到人类 CJD 人群中出现的非典型毒株或毒株变化。