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Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Acta+Neuropathol 2017 ; 134 (2): 221-240 Nephropedia Template TP
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Amyloid-beta accumulation in the CNS in human growth hormone recipients in the UK #MMPMID28349199
Ritchie DL; Adlard P; Peden AH; Lowrie S; Le Grice M; Burns K; Jackson RJ; Yull H; Keogh MJ; Wei W; Chinnery PF; Head MW; Ironside JW
Acta Neuropathol 2017[Aug]; 134 (2): 221-240 PMID28349199show ga
Human-to-human transmission of Creutzfeldt-Jakob disease (CJD) has occurred through medical procedures resulting in iatrogenic CJD (iCJD). One of the commonest causes of iCJD was the use of human pituitary-derived growth hormone (hGH) to treat primary or secondary growth hormone deficiency. As part of a comprehensive tissue-based analysis of the largest cohort yet collected (35 cases) of UK hGH-iCJD cases, we describe the clinicopathological phenotype of hGH-iCJD in the UK. In the 33/35 hGH-iCJD cases with sufficient paraffin-embedded tissue for full pathological examination, we report the accumulation of the amyloid beta (Abeta) protein associated with Alzheimer's disease (AD) in the brains and cerebral blood vessels in 18/33 hGH-iCJD patients and for the first time in 5/12 hGH recipients who died from causes other than CJD. Abeta accumulation was markedly less prevalent in age-matched patients who died from sporadic CJD and variant CJD. These results are consistent with the hypothesis that Abeta, which can accumulate in the pituitary gland, was present in the inoculated hGH preparations and had a seeding effect in the brains of around 50% of all hGH recipients, producing an AD-like neuropathology and cerebral amyloid angiopathy (CAA), regardless of whether CJD neuropathology had occurred. These findings indicate that Abeta seeding can occur independently and in the absence of the abnormal prion protein in the human brain. Our findings provide further evidence for the prion-like seeding properties of Abeta and give insights into the possibility of iatrogenic transmission of AD and CAA.
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Acta+Neuropathol 2017 ; 134 (2): 221-240
