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Prion 2022 Conference abstracts: pushing the boundaries Prion 2022会议摘要:突破界限
IF 2.3 3区 生物学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2022-09-11 DOI: 10.1080/19336896.2022.2091286
Inga Zerr
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引用次数: 3
Cellular prion protein distribution in the vomeronasal organ, parotid, and scent glands of white-tailed deer and mule deer 细胞朊病毒蛋白在白尾鹿和骡鹿犁鼻器官、腮腺和气味腺中的分布
IF 2.3 3区 生物学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2022-05-29 DOI: 10.1080/19336896.2022.2079888
A. Ness, Aradhana Jacob, Kelsey Saboraki, Alicia Otero, Danielle Gushue, Diana Martinez Moreno, Melanie de Peña, Xinli Tang, J. Aiken, Susan Lingle, Debbie McKenzie
ABSTRACT Chronic wasting disease (CWD) is a contagious and fatal transmissible spongiform encephalopathy affecting species of the cervidae family. CWD has an expanding geographic range and complex, poorly understood transmission mechanics. CWD is disproportionately prevalent in wild male mule deer and male white-tailed deer. Sex and species influences on CWD prevalence have been hypothesized to be related to animal behaviours that involve deer facial and body exocrine glands. Understanding CWD transmission potential requires a foundational knowledge of the cellular prion protein (PrPC) in glands associated with cervid behaviours. In this study, we characterized the presence and distribution of PrPC in six integumentary and two non-integumentary tissues of hunter-harvested mule deer (Odocoileus hemionus) and white-tailed deer (O. virginianus). We report that white-tailed deer expressed significantly more PrPC than their mule deer in the parotid, metatarsal, and interdigital glands. Females expressed more PrPC than males in the forehead and preorbital glands. The distribution of PrPC within the integumentary exocrine glands of the face and legs were localized to glandular cells, hair follicles, epidermis, and immune cell infiltrates. All tissues examined expressed sufficient quantities of PrPC to serve as possible sites of prion initial infection, propagation, and shedding.
慢性消耗性疾病(CWD)是一种传染性和致命性的海绵状脑病,影响子宫颈科的物种。CWD具有不断扩大的地理范围和复杂的、鲜为人知的传输机制。CWD在野生雄性骡鹿和雄性白尾鹿中尤为普遍。性别和物种对CWD患病率的影响被假设与涉及鹿面部和身体外分泌腺的动物行为有关。了解CWD传播潜力需要了解与宫颈行为相关的腺体中的细胞朊蛋白(PrPC)的基础知识。在本研究中,我们鉴定了PrPC在采食的骡鹿(Odocoileus hemionus)和白尾鹿(O. virginianus)的6个被皮组织和2个非被皮组织中的存在和分布。我们报道了白尾鹿在腮腺、跖骨和指间腺中的PrPC表达明显高于骡鹿。雌性比雄性在前额和眶前腺表达更多的PrPC。PrPC在面部和腿部表皮外分泌腺的分布局限于腺细胞、毛囊、表皮和免疫细胞浸润。所有被检测的组织都表达了足够数量的PrPC,作为朊病毒初始感染、繁殖和脱落的可能位点。
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引用次数: 4
The expanding scope of amyloid signalling. 淀粉样蛋白信号传导范围的扩大。
IF 2.3 3区 生物学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2021-12-01 DOI: 10.1080/19336896.2021.1874791
Asen Daskalov, Sven J Saupe

Formation of higher-order supramolecular complexes has emerged as a common principle underlying activity of a number of immune and regulated cell-death signalling pathways in animals, plants and fungi. Some of these signalosomes employ functional amyloid motifs in their assembly process. The description of such systems in fungi finds its origin in earlier studies on a fungal prion termed [Het-s], originally identified as a non-Mendelian cytoplasmic infectious element. Janine Beisson has been a key contributor to such early studies. Recent work on this and related systems offers a more integrated view framing this prion in a broader picture including related signalling systems described in animals. We propose here an auto-commentary centred on three recent studies on amyloid signalling in microbes. Collectively, these studies increase our understanding of fold conservation in functional amyloids and the structural basis of seeding, highlight the relation of fungal amyloid motifs to mammalian RHIM (RIP homotypic interaction motif) and expand the concept of Nod-like receptor-based amyloid signalosomes to the prokaryote reign.

高阶超分子复合物的形成已成为动物、植物和真菌中许多免疫和受调节的细胞死亡信号通路活动的共同原理。其中一些信号体在其组装过程中使用功能性淀粉样蛋白基序。真菌中这种系统的描述起源于早期对一种称为[Het-s]的真菌朊病毒的研究,最初被确定为一种非孟德尔细胞质感染元素。珍妮·贝松(Janine Beisson)是此类早期研究的关键贡献者。最近对这一系统和相关系统的研究提供了一个更综合的观点,将这种朊病毒纳入更广泛的视野,包括动物中描述的相关信号系统。我们在这里提出一个自动评论集中在三个最近的研究淀粉样蛋白信号在微生物。总的来说,这些研究增加了我们对功能性淀粉样蛋白的折叠保护和播种的结构基础的理解,突出了真菌淀粉样蛋白基序与哺乳动物RHIM (RIP同型相互作用基序)的关系,并将基于nod样受体的淀粉样蛋白信号体的概念扩展到原核生物领域。
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引用次数: 3
Exploration of genetic factors resulting in abnormal disease in cattle experimentally challenged with bovine spongiform encephalopathy. 探索导致牛海绵状脑病实验挑战牛异常疾病的遗传因素。
IF 2.3 3区 生物学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2021-12-01 DOI: 10.1080/19336896.2020.1869495
Sandor Dudas, Renee Anderson, Antanas Staskevicus, Gordon Mitchell, James C Cross, Stefanie Czub

Since the discovery of bovine spongiform encephalopathy (BSE), researchers have orally challenged cattle with infected brain material to study various aspects of disease pathogenesis. Unlike most other pathogens, oral BSE challenge does not always result in the expected clinical presentation and pathology. In a recent study, steers were challenged orally with BSE and all developed clinical signs and were sacrificed and tested. However, despite a similar incubation and clinical presentation, one of the steers did not have detectable PrPSc in its brain. Samples from this animal were analysed for genetic differences as well as for the presence of in vitro PrPSc seeding activity or infectivity to determine the BSE status of this animal and the potential reasons that it was different. Seeding activity was detected in the brainstem of the abnormal steer but it was approximately one million times less than that found in the normal BSE positive steers. Intra-cranial challenge of bovinized transgenic mice resulted in no transmission of disease. The abnormal steer had different genetic sequences in non-coding regions of the PRNP gene but detection of similar genotypes in Canadian BSE field cases, that showed the expected brain pathology, suggested these differences may not be the primary cause of the abnormal result. Breed composition analysis showed a higher Hereford content in the abnormal steer as well as in two Canadian atypical BSE field cases and several additional abnormal experimental animals. This study could point towards a possible impact of breed composition on BSE pathogenesis.

自从发现牛海绵状脑病(BSE)以来,研究人员用受感染的脑物质对牛进行了口头挑战,以研究疾病发病机制的各个方面。与大多数其他病原体不同,口腔疯牛病感染并不总是导致预期的临床表现和病理。在最近的一项研究中,牛被口头感染了疯牛病,所有的牛都出现了临床症状,并被处死并进行了测试。然而,尽管有类似的孵化和临床表现,其中一只公牛的大脑中没有检测到PrPSc。对该动物的样本进行遗传差异以及体外PrPSc播种活性或感染性分析,以确定该动物的疯牛病状态及其差异的潜在原因。在异常牛的脑干中检测到种子活性,但其含量约为正常牛的100万倍。牛化转基因小鼠的颅内攻击没有导致疾病传播。异常公牛在PRNP基因的非编码区具有不同的基因序列,但在加拿大疯牛病现场病例中检测到相似的基因型,显示了预期的脑部病理,表明这些差异可能不是异常结果的主要原因。品种组成分析表明,在异常阉牛、2例加拿大非典型疯牛病现场病例和另外几例异常实验动物中存在较高的赫里福德含量。该研究可能指出品种组成对疯牛病发病机制的可能影响。
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引用次数: 3
Decoding the role of coiled-coil motifs in human prion-like proteins. 解码盘绕盘绕基序在人类朊病毒样蛋白中的作用。
IF 2.3 3区 生物学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2021-12-01 DOI: 10.1080/19336896.2021.1961569
Molood Behbahanipour, Javier García-Pardo, Salvador Ventura

Prions are self-propagating proteins that cause fatal neurodegenerative diseases in humans. However, increasing evidence suggests that eukaryotic cells exploit prion conformational conversion for functional purposes. A recent study delineated a group of twenty prion-like proteins in humans, characterized by the presence of low-complexity glutamine-rich sequences with overlapping coiled-coil (CCs) motifs. This is the case of Mediator complex subunit 15 (MED15), which is overexpressed in a wide range of human cancers. Biophysical studies demonstrated that the prion-like domain (PrLD) of MED15 forms homodimers in solution, sustained by CCs interactions. Furthermore, the same coiled-coil (CC) region plays a crucial role in the PrLD structural transition to a transmissible β-sheet amyloid state. In this review, we discuss the role of CCs motifs and their contribution to amyloid transitions in human prion-like domains (PrLDs), while providing a comprehensive overview of six predicted human prion-like proteins involved in transcription, gene expression, or DNA damage response and associated with human disease, whose PrLDs contain or overlap with CCs sequences. Finally, we try to rationalize how these molecular signatures might relate to both their function and involvement in disease.

朊病毒是一种自我繁殖的蛋白质,可导致人类致命的神经退行性疾病。然而,越来越多的证据表明,真核细胞利用朊病毒构象转换达到功能目的。最近的一项研究描绘了一组20种人类朊病毒样蛋白,其特征是存在具有重叠卷曲螺旋(CC)基序的低复杂性富含谷氨酰胺的序列。这就是介导复合体亚基15(MED15)的情况,它在广泛的人类癌症中过表达。生物物理研究表明,MED15的朊病毒样结构域(PrLD)在溶液中形成同源二聚体,由CCs相互作用维持。此外,相同的卷曲螺旋(CC)区域在PrLD结构向可传递的β-淀粉样蛋白状态的转变中起着至关重要的作用。在这篇综述中,我们讨论了人类朊病毒样结构域(PrLD)中CCs基序的作用及其对淀粉样蛋白转变的贡献,同时全面概述了六种预测的参与转录、基因表达或DNA损伤反应并与人类疾病相关的人朊病毒样蛋白,其PrLD包含CCs序列或与CCs序列重叠。最后,我们试图合理化这些分子特征与它们的功能和疾病的关系。
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引用次数: 3
Prion protein polymorphisms in Michigan white-tailed deer (Odocoileus virginianus). 密歇根白尾鹿Prion蛋白多态性。
IF 2.3 3区 生物学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2021-12-01 DOI: 10.1080/19336896.2021.1990628
Caitlin N Ott-Conn, Julie A Blanchong, Wes A Larson

Chronic Wasting Disease (CWD), a well-described transmissible spongiform encephalopathy of the Cervidae family, is associated with the aggregation of an abnormal isoform (PrPCWD) of the naturally occurring host prion protein (PrPC). Variations in the PrP gene (PRNP) have been associated with CWD rate of infection and disease progression. We analysed 568 free-ranging white-tailed deer (Odocoileus virginianus) from 9 CWD-positive Michigan counties for PRNP polymorphisms. Sampling included 185 CWD-positive, 332 CWD non-detected, and an additional 51 CWD non-detected paired to CWD-positives by sex, age, and harvest location. We found 12 polymorphic sites of which 5 were non-synonymous and resulted in a change in amino acid composition. Thirteen haplotypes were predicted, of which 11 have previously been described. Using logistic regression, consistent with other studies, we found haplotypes C (OR = 0.488, 95% CI = 0.321-0.730, P < 0.001) and F (OR = 0.122, 95% CI = 0.007-0.612, P < 0.05) and diplotype BC (OR = 0.340, 95% CI = 0.154-0.709, P < 0.01) were less likely to be found in deer infected with CWD. As has also been documented in other studies, the presence of a serine at amino acid 96 was less likely to be found in deer infected with CWD (P < 0.001, OR = 0.360 and 95% CI = 0.227-0.556). Identification of PRNP polymorphisms associated with reduced vulnerability to CWD in Michigan deer and their spatial distribution can help managers design surveillance programmesand identify and prioritize areas for CWD management.

慢性消耗性疾病(CWD)是一种描述良好的Cervidae家族的传染性海绵状脑病,与自然发生的宿主朊蛋白(PrPC)的异常亚型(PrPCWD)聚集有关。PrP基因(PRNP)的变异与CWD的感染率和疾病进展有关。我们分析了568只自由放养的白尾鹿(Odocoileus virginianus)来自9个cwd阳性的密歇根州县的PRNP多态性。样本包括185例CWD阳性,332例CWD未检测,另外51例CWD未检测,按性别、年龄和采集地点配对为CWD阳性。我们发现了12个多态性位点,其中5个是非同义的,导致氨基酸组成的变化。预测了13个单倍型,其中11个先前已经被描述过。通过与其他研究相一致的逻辑回归,我们发现单倍型C (OR = 0.488, 95% CI = 0.321-0.730)和P PRNP多态性与密歇根鹿CWD易感性降低相关,它们的空间分布可以帮助管理者设计监测方案,确定CWD管理的优先区域。
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引用次数: 0
A Chinese patient with the clinical features of Parkinson's disease contains a single copy of octarepeat deletion in PRNP case report. 1例具有帕金森病临床特征的中国患者在PRNP病例报告中含有单个8重复缺失拷贝。
IF 2.3 3区 生物学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2021-12-01 DOI: 10.1080/19336896.2021.1946376
Qi Shi, Xiao-Jing Shen, Li-Ping Gao, Kang Xiao, Wei Zhou, Yuan Wang, Cao Chen, Xiao-Ping Dong

Insertion or deletion of single copy of octapeptide repeat (OR) in human PrP protein are considered as polymorphism, while of insertions of more numbers of OR and deletion of two copies of OR are associated with genetic prion diseases.Here, we reported a 58-year-old female patient who displayed clinical manifestations of Parkinson's disease (PD) but contained deletion mutation of single copy of OR in one PRNP allele. The patient complained involuntary tremor of left upper limb for 18 months and her symptoms aggravation for 6 months at the time referring to Chinese National CJD surveillance system. The tremor was pronounced at rest, exacerbated by stress and disappear during sleep. Her symptoms were partially relieved after receiving medicament for PD. Neurological examination recorded involuntary movement of left hand and gear-like muscle tension of left upper limb. Coordination movement reported positive of Romberg sign and unstable in heel-keen test. EEG recorded a mild abnormality, but without periodic sharp wave complexes (PSWC). MRI showed a mild write matter demyelination. CSF protein 14-3-3 was negative. PRNP sequencing revealed heterozygosity of single copy deletion on ORs (R1-2-3-4/R1-2-2-3-4).No family history of neurodegenerative disease was recorded. Such case with a single copy of OR deletion in PRNP displaying the feature of PD is rarely reported in Chinese mainland.

人类PrP蛋白的八肽重复序列(octapeptide repeat, or)单拷贝的插入或缺失被认为是多态性,而or数量较多的插入和两拷贝的缺失与遗传性朊病毒疾病有关。在这里,我们报告了一位58岁的女性患者,她表现出帕金森病(PD)的临床表现,但在一个PRNP等位基因中含有单个拷贝的OR缺失突变。患者主诉左上肢不自主震颤18个月,参照中国国家CJD监测系统时症状加重6个月。这种震颤在休息时明显,在压力下加剧,在睡眠时消失。接受PD药物治疗后症状部分缓解。神经学检查记录左手不随意运动和左上肢齿轮样肌张力。协调运动Romberg征阳性,足跟试验不稳定。脑电图显示轻度异常,但未见周期性尖锐波复合体。MRI显示轻度书写性脱髓鞘。脑脊液蛋白14-3-3阴性。PRNP测序结果显示,ORs上存在单拷贝缺失杂合性(R1-2-3-4/ R1-2-3-4)。无神经退行性疾病家族史。这种PRNP单拷贝或缺失表现PD特征的病例在中国大陆很少报道。
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引用次数: 3
The role of microglia in prion diseases and possible therapeutic targets: a literature review. 小胶质细胞在朊病毒疾病中的作用和可能的治疗靶点:文献综述。
IF 2.3 3区 生物学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2021-12-01 DOI: 10.1080/19336896.2021.1991771
Ananda Sampaio Lamenha Falcão de Melo, Juliana Louise Dias Lima, Maria Carolina Silva Malta, Natália França Marroquim, Álvaro Rivelli Moreira, Isabelle de Almeida Ladeia, Fabrizio Dos Santos Cardoso, Daniel Buzaglo Gonçalves, Bruna Guimarães Dutra, Júlio César Claudino Dos Santos

Creutzfeldt-Jakob disease (CJD) is a rare and fatal condition that leads to progressive neurodegeneration due to gliosis, vacuolation of central nervous system tissue, and loss of neurons. Microglia play a crucial role in maintaining Central Nervous System (CNS) homoeostasis, both in health and disease, through phagocytosis and cytokine production. In the context of CJD, the immunomodulatory function of microglia turns it into a cell of particular interest. Microglia would be activated by infectious prion proteins, initially acquiring a phagocytic and anti-inflammatory profile (M2), and producing cytokines such as IL-4, IL-10, and TGF-β. Therefore, microglia are seen as a key target for the development of new treatment approaches, with many emerging strategies to guide it towards a beneficial role upon neuroinflammation, by manipulating its metabolic pathways. In such a setting, many cellular targets in microglia that can be involved in phenotype modulation, such as membrane receptors, have been identified and pointed out as possible targets for further experiments and therapeutic approaches. In this article, we review the major findings about the role of microglia in CJD, including its relationship to some risk factors associated with the development of the disease. Furthermore, considering its central role in neural immunity, we explore microglial connection with other elements of the immune system and cell signalling, such as inflammasomes, the complement and purinergic systems, and the latest finding strategies to guide these cells from harmful to beneficial roles.

克雅氏病(CJD)是一种罕见且致命的疾病,由于胶质细胞增生、中枢神经系统组织空泡化和神经元丢失,会导致进行性神经退行性变。小胶质细胞通过吞噬作用和细胞因子的产生,在维持中枢神经系统(CNS)稳态方面发挥着至关重要的作用,无论是在健康还是疾病中。在CJD的背景下,小胶质细胞的免疫调节功能将其转化为一种特别感兴趣的细胞。小胶质细胞会被感染性朊病毒蛋白激活,最初获得吞噬和抗炎特性(M2),并产生细胞因子,如IL-4、IL-10和TGF-β。因此,小胶质细胞被视为开发新治疗方法的关键靶点,许多新兴策略通过操纵其代谢途径,引导其在神经炎症中发挥有益作用。在这样的环境中,小胶质细胞中许多可能参与表型调节的细胞靶标,如膜受体,已被鉴定并指出为进一步实验和治疗方法的可能靶标。在这篇文章中,我们回顾了小胶质细胞在CJD中的作用的主要发现,包括它与一些与疾病发展相关的危险因素的关系。此外,考虑到小胶质细胞在神经免疫中的核心作用,我们探索了小胶质细胞与免疫系统和细胞信号传导的其他元素的联系,如炎症小体、补体和嘌呤能系统,以及引导这些细胞从有害角色变为有益角色的最新发现策略。
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引用次数: 7
System degeneration in an MM1-type sporadic Creutzfeldt-Jakob disease case with an unusually prolonged akinetic mutism state. mm1型散发性克雅氏病伴异常延长的动态缄默状态的系统变性。
IF 2.3 3区 生物学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2021-12-01 DOI: 10.1080/19336896.2020.1868931
Yasushi Iwasaki, Keiko Mori, Masumi Ito, Yoshinari Kawai, Akio Akagi, Yuichi Riku, Hiroaki Miyahara, Atsushi Kobayashi, Tetsuyuki Kitamoto, Mari Yoshida

Methionine/methionine type 1 (MM1-type) sporadic Creutzfeldt-Jakob disease (sCJD), known as the 'classic type,' shows typical clinicopathological sCJD findings. In general, patients reach an akinetic mutism state within a few months of disease onset and die soon after if supportive therapies are not administered. Here, we describe remarkable neuropathologic observations of MM1-type sCJD in a 48-year-old, Japanese man with an unusually prolonged akinetic mutism state. In the early disease stages, the patient exhibited abnormal behaviour with gait disturbance and rapidly progressive cognitive dysfunction. Diffusion-weighted magnetic resonance imaging revealed extensive cerebral cortical hyperintensity. Prion protein (PrP) gene analysis revealed no mutations, and the polymorphic codon 129 exhibited methionine homozygosity. Although the patient remained stable with tube feeding for more than 2 years after reaching the akinetic mutism state, he died because of central respiratory failure 30 months after disease onset. Neuropathologic investigation showed extensive devastating lesions, such as status spongiosus, and typical spongiform changes could no longer be observed in the cerebral neocortex. Conspicuous pyramidal tract degeneration was observed. However, the regions commonly preserved in MM1-type sCJD pathology were still relatively preserved. Immunostaining revealed extensive diffuse synaptic-type PrP deposition in the grey matter. The pathological findings suggested that sCJD is a neurodegenerative disease that shows system degeneration; there are primary and secondary degenerative regions and distinct preserved regions, even in cases with prolonged disease duration. In addition, it is considered that there is a limited survival period for MM1-type sCJD, even if active symptomatic treatment is provided.

蛋氨酸/蛋氨酸1型(mm1型)散发性克雅氏病(sCJD),被称为“经典型”,表现出典型的sCJD临床病理表现。一般来说,患者在发病后几个月内达到动态缄默状态,如果不给予支持性治疗,患者很快就会死亡。在这里,我们描述了一名48岁的日本男性的mm1型sCJD的显著神经病理学观察,他患有异常延长的动态缄默症。在疾病早期,患者表现出异常行为,步态障碍和快速进行性认知功能障碍。弥散加权磁共振成像显示广泛的大脑皮质高信号。PrP基因分析未发现突变,多态性密码子129表现为蛋氨酸纯合性。患者在达到不动性缄默状态后,经管饲维持稳定2年多,但发病30个月后因中枢性呼吸衰竭死亡。神经病理学检查显示广泛的破坏性病变,如海绵状状态,在大脑新皮层中不再观察到典型的海绵状改变。可见明显的锥体束变性。然而,在mm1型sCJD病理中通常保存的区域仍然相对保存。免疫染色显示灰质中广泛弥漫性突触型PrP沉积。病理结果提示sCJD是一种表现为系统变性的神经退行性疾病;有原发性和继发性退行性区域和明显的保留区域,即使在病例病程延长。此外,即使提供积极的对症治疗,也认为mm1型sCJD的生存期有限。
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引用次数: 0
Long-term preservation of pharyngeal swallowing function in MM2-cortical-type sporadic Creutzfeldt-Jakob disease. mm2皮质型散发性克雅氏病咽部吞咽功能的长期保存。
IF 2.3 3区 生物学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2021-12-01 DOI: 10.1080/19336896.2021.1930851
Yuichi Hayashi, Kenjiro Kunieda, Takuya Kudo, Akio Kimura, Ichiro Fujishima, Takayoshi Shimohata

Swallowing function in long-term survivors of Creutzfeldt-Jakob disease (CJD) has not been elucidated. Herein, we report a patient with MM2-cortical-type sporadic CJD (MM2C-type sCJD) with long-term preservation of pharyngeal swallowing function using videofluoroscopic (VF) examination of swallowing. A 55-year-old woman was admitted to hospital because of dyscalculia and memory disturbance 3 years after the onset of these symptoms. Neurological examination revealed dementia, extrapyramidal signs, and delusion. Diffusion-weighted MRI revealed bilateral hyperintensity in the basal ganglia and frontal, temporal, and parietal cortices. No mutation with the methionine homozygote at codon 129 was found on PRNP gene analysis. VF was performed 68 months after the onset. Although bolus transport from the oral cavity to the pharynx worsened, the pharyngeal swallowing function was preserved even 68 months after onset. Serial MRI examinations revealed no apparent atrophy of the brainstem. Single photon emission computed tomography revealed that the regional cerebral blood flow in the brainstem was preserved. These findings suggest that pseudobulbar palsy is the pathophysiology underlying dysphagia in long-term survivors of MM2C-type sCJD, probably owing to preserved brainstem function even in a state of akinetic mutism.

克雅氏病(CJD)长期幸存者的吞咽功能尚未阐明。在此,我们报告了一例mm2 -皮质型散发性CJD (mm2c型sCJD)患者,通过视频x线镜(VF)检查咽部吞咽功能长期保存。一名55岁妇女在出现这些症状3年后因计算障碍和记忆障碍入院。神经学检查显示痴呆、锥体外系征象和妄想。弥散加权MRI显示双侧基底节区、额叶、颞叶和顶叶皮质高强度。PRNP基因分析未发现129密码子的蛋氨酸纯合子突变。发病68个月后行VF。虽然从口腔到咽部的药物转运恶化,但咽部吞咽功能在发病68个月后仍得以保留。连续MRI检查未见脑干明显萎缩。单光子发射计算机断层扫描显示脑干局部脑血流被保留。这些发现表明,假性球麻痹是mm2c型sCJD长期存活患者吞咽困难的病理生理学基础,可能是由于即使在动态缄默症状态下脑干功能仍保留。
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