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      Fatal Prion Disease in a Mouse Model of Genetic E200K Creutzfeldt-Jakob Disease

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          Abstract

          Genetic prion diseases are late onset fatal neurodegenerative disorders linked to pathogenic mutations in the prion protein-encoding gene, PRNP. The most prevalent of these is the substitution of Glutamate for Lysine at codon 200 (E200K), causing genetic Creutzfeldt-Jakob disease (gCJD) in several clusters, including Jews of Libyan origin. Investigating the pathogenesis of genetic CJD, as well as developing prophylactic treatments for young asymptomatic carriers of this and other PrP mutations, may well depend upon the availability of appropriate animal models in which long term treatments can be evaluated for efficacy and toxicity. Here we present the first effective mouse model for E200KCJD, which expresses chimeric mouse/human (TgMHu2M) E199KPrP on both a null and a wt PrP background, as is the case for heterozygous patients and carriers. Mice from both lines suffered from distinct neurological symptoms as early as 5–6 month of age and deteriorated to death several months thereafter. Histopathological examination of the brain and spinal cord revealed early gliosis and age-related intraneuronal deposition of disease-associated PrP similarly to human E200K gCJD. Concomitantly we detected aggregated, proteinase K resistant, truncated and oxidized PrP forms on immunoblots. Inoculation of brain extracts from TgMHu2ME199K mice readily induced, the first time for any mutant prion transgenic model, a distinct fatal prion disease in wt mice. We believe that these mice may serve as an ideal platform for the investigation of the pathogenesis of genetic prion disease and thus for the monitoring of anti-prion treatments.

          Author Summary

          Inherited prion diseases, such as genetic CJD, are dominant disorders linked to mutations in the gene encoding the prion protein, PrP. Since therapeutic intervention in all types of human prion diseases has failed, we propose that therapeutic efforts should be directed mostly to the development of preventive treatments for subjects incubating prion diseases, as is the case for asymptomatic carriers of pathogenic PrP mutations. These subjects will develop disease symptoms at some point in their adult life; therefore they should be treated before clinical deterioration. Candidate treatments will need to be tested for efficacy and safety first in animal models that mimic most properties of genetic CJD. In this work, we describe a new transgenic mouse model for E200K genetic CJD, presenting progressive neurodegenerative disease and age related prion disease pathology and biochemistry, as is the case in the human disease. Brain extracts from these mice also transmitted prion disease to wt mice, as shown before for parallel human samples. We propose that these animals will play a significant role in the development of novel anti-prion prophylactic treatments.

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          Most cited references44

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          Normal development and behaviour of mice lacking the neuronal cell-surface PrP protein.

          PrPC is a host protein anchored to the outer surface of neurons and to a lesser extent of lymphocytes and other cells. The transmissible agent (prion) responsible for scrapie is believed to be a modified form of PrPC. Mice homozygous for disrupted PrP genes have been generated. Surprisingly, they develop and behave normally for at least seven months, and no immunological defects are apparent. It is now feasible to determine whether mice devoid of PrPC can propagate prions and are susceptible to scrapie pathogenesis.
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            Human spongiform encephalopathy: the National Institutes of Health series of 300 cases of experimentally transmitted disease.

            We present a synthesis of clinical, neuropathological, and biological details of the National Institutes of Health series of 300 experimentally transmitted cases of spongiform encephalopathy from among more than 1,000 cases of various neurological disorders inoculated into nonhuman primates during the past 30 years. The series comprises 278 subjects with Creutzfeldt-Jakob disease, of whom 234 had sporadic, 36 familial, and 8 iatrogenic disease; 18 patients with kuru; and 4 patients with Gerstmann-Strüssler-Scheinker syndrome. Sporadic Creutzfeldt-Jakob disease, numerically by far the most important representative, showed an average age at onset of 60 years, with the frequent early appearance of cerebellar and visual/oculomotor signs, and a broad spectrum of clinical features during the subsequent course of illness, which was usually fatal in less than 6 months. Characteristic spongiform neuropathology was present in all but 2 subjects. Microscopically visible kuru-type amyloid plaques were found in 5% of patients with Creutzfeldt-Jakob disease, 75% of those with kuru, and 100% of those with Gerstmann-Sträussler-Scheinker syndrome; brain biopsy was diagnostic in 95% of cases later confirmed at autopsy, and proteinase-resistant amyloid protein was identified in Western blots of brain extracts from 88% of tested subjects. Experimental transmission rates were highest for iatrogenic Creutzfeldt-Jakob disease (100%), kuru (95%), and sporadic Creutzfeldt-Jakob disease (90%), and considerably lower for most familial forms of disease (68%). Incubation periods as well as the durations and character of illness showed great variability, even in animals receiving the same inoculum, mirroring the spectrum of clinical profiles seen in human disease. Infectivity reached average levels of nearly 10(5) median lethal doses/gm of brain tissue, but was only irregularly present (and at much lower levels) in tissues outside the brain, and, except for cerebrospinal fluid, was never detected in bodily secretions or excretions.
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              Prion propagation in mice expressing human and chimeric PrP transgenes implicates the interaction of cellular PrP with another protein.

              Transgenic (Tg) mice expressing human (Hu) and chimeric prion protein (PrP) genes were inoculated with brain extracts from humans with inherited or sporadic prion disease to investigate the mechanism by which PrPC is transformed into PrPSc. Although Tg(HuPrP) mice expressed high levels of HuPrPC, they were resistant to human prions. They became susceptible to human prions upon ablation of the mouse (Mo) PrP gene. In contrast, mice expressing low levels of the chimeric transgene were susceptible to human prions and registered only a modest decrease in incubation times upon MoPrP gene disruption. These and other findings argue that a species-specific macromolecule, provisionally designated protein X, participates in prion formation. While the results demonstrate that PrPSc binds to PrPC in a region delimited by codons 96 to 167, they also suggest that PrPC binds protein X through residues near the C-terminus. Protein X might function as a molecular chaperone in the formation of PrPSc.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS Pathog
                plos
                plospath
                PLoS Pathogens
                Public Library of Science (San Francisco, USA )
                1553-7366
                1553-7374
                November 2011
                November 2011
                3 November 2011
                : 7
                : 11
                : e1002350
                Affiliations
                [1 ]Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Jerusalem, Israel
                [2 ]Institute of Neurology, Medical University Vienna, Austria
                University of Alberta, Canada
                Author notes

                Conceived and designed the experiments: YFL ZM GGK HB DA RG. Performed the experiments: TC KF YFL GGK DA RG. Analyzed the data: GGK HB ZM RG YFL. Contributed reagents/materials/analysis tools: ZM GGK TC. Wrote the paper: YFL GGK RG HB.

                Article
                PPATHOGENS-D-11-01077
                10.1371/journal.ppat.1002350
                3207931
                22072968
                e0377235-7a95-4ba8-ba07-fa0ce1e5556d
                Friedman-Levi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 24 May 2011
                : 18 September 2011
                Page count
                Pages: 14
                Categories
                Research Article
                Biology
                Medicine

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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