7 Prions
‘Rogue protein’ pathogenesis
Prions are unique infectious agents
• small size (< 100 nm, therefore filterable)
• lack of a nucleic acid genome
• extreme resistance to heat, disinfectants and irradiation (but susceptible to high concentrations of phenol, periodate, sodium hydroxide, sodium hypochlorite)
• slow replication – typically diseases have a long incubation period and usually appear late in life. Incubation periods of up to 35 years have been recorded in humans, but variant CJD can produce symptoms much more rapidly
Prions are host-derived molecules
Studies on scrapie gave some insight into the nature of prions and their role in disease. The infectious agent is a host-derived 30–35 kDa glycoprotein (termed PrPSc, prion protein scrapie) that is associated with the characteristic intracellular fibrils seen in diseased tissue. PrPSc is derived from a naturally occurring cellular prion protein (PrPc), expressed predominantly on the surface of nerve cells and coded by a single copy gene of unknown function (located on chromosome 20 in humans). Mice with the PrPc gene disrupted are resistant to scrapie, and they show no gross abnormalities. The two proteins have a similar sequence, but differ in structure and protease resistance; PrPSc is globular and enzyme resistant; PrPc is linear and enzyme susceptible. The association of PrPSc with PrPc results in conversion of the latter into the abnormal form, the change being largely conformational, from alpha helices to beta-pleated sheets. Affected cells produce more PrPc and the process is then repeated, the accumulating PrPSc aggregating into amyloid fibrils and plaques (Fig. 7.1). Replication can lead to very high titres of infectious particles and up to 108–109/g of brain tissue have been recorded.
• Scrapie infectivity in material co-purifies with PrPSc.
• Purified PrPSc confers greater scrapie activity.
• Mice lacking the PrPc gene do not develop disease when injected with prions.
• Introduction of a PrP transgene from a prion donor species (e.g. hamster) into a recipient species (e.g. mouse) facilitates cross-species transmission, suggesting that homology between the PrP genes of donor and recipient is the main molecular determinant of such transmission.
• In vitro, PrPSc can convert PrPc into PrPSc, with the transfer of biochemical characteristics.