Animal prion diseases: A review of intraspecies transmission.

Animal prion diseases are a group of neurodegenerative, transmissible, and fatal disorders that affect several animal species. The causative agent, prion, is a misfolded isoform of normal cellular prion protein, which is found in cells with higher concentration in the central nervous system. This review explored the sources of infection and different natural transmission routes of animal prion diseases in susceptible populations. Chronic wasting disease in cervids and scrapie in small ruminants are prion diseases capable of maintaining themselves in susceptible populations through horizontal and vertical transmission. The other prion animal diseases can only be transmitted through food contaminated with prions. Bovine spongiform encephalopathy (BSE) is the only animal prion disease considered zoonotic. However, due to its inability to transmit within a population, it could be controlled. The emergence of atypical cases of scrapie and BSE, even the recent report of prion disease in camels, demonstrates the importance of understanding the transmission routes of prion diseases to take measures to control them and to assess the risks to human and animal health.

Enfermedad de Creutzfeldt-Jakob. Presentación de un caso y revisión de la literatura / Creutzfeldt-Jakob Disease. Case Report and Literature Review / Doença de Creutzfeldt-Jakob. Apresentação de caso e revisão da literatura

Resumen: La enfermedad de Creutzfeldt-Jakob (ECJ) es una patología neurodegenerativa transmisible, producida por una proteína anómala infectante denominada prion. Junto con el kuru, el insomnio familiar fatal y el síndrome de Gerstmann-Stráussler-Scheinker, configura el grupo de las llamadas encefalopatías espongiformes. La ECJ es la forma más común en el ser humano: se calcula que afecta a una persona por cada millón, a nivel mundial, y la mayoría de los pacientes presenta síntomas clásicos de demencia y mioclonías, asociadas a cambios específicos en el electroencefalograma (EEG). Conforme la enfermedad progresa, el cuadro demencial empeora y pueden presentarse síntomas visuales, cerebelosos, piramidales y extrapiramidales. El diagnóstico definitivo se logra demostrando la degeneración espongiforme de las neuronas en histopatología. La ECJ siempre es mortal y no tiene tratamiento específico: cerca del 90% de los pacientes fallece dentro del primer año después del diagnóstico. En este artículo, se reporta el caso de un paciente con ECJ esporádica probable, de acuerdo con los criterios diagnósticos actuales de la OMS y se da a conocer una revisión de la literatura.

Abstract: Creutzfeldt-Jakob disease (CJD) is a transmissible neurodegenerative pathology produced by an infecting abnormal protein called prion. Together with kuru, fatal familial insomnia, and Gerstmann-Stráussler-Scheinker syndrome, it forms the group of so-called spongiform encephalopathies. CJD is the most common form in humans: it is estimated to affect one person per million worldwide and most patients have classic symptoms of dementia and myoclonus, associated with specific changes in the electroencephalogram (EEG). As the disease progresses, the dementia condition worsens and visual, cerebellar, pyramidal, and extrapyramidal symptoms may develop. The final diagnosis is achieved by proving the spongiform degeneration of neurons in the histopathology. CJD is always fatal and has no specific treatment: about 90 % of patients die within the first year of diagnosis. This article reports the case of a patient with probable sporadic CJD, following current who diagnostic criteria, and provides a literature review.

Resumo: A doença de Creutzfeldt-Jakob (DCJ) é uma doença patologia neurodegenerativa transmissível, produzida por uma proteína anormal infectante denominada prion. Juntamente com o kuru, a Insónia familiar fatal e a síndrome de Gerstmann-Stráussler-Scheinker, forma o grupo das chamadas encefalopatias espongiformes. A DCJ é a forma mais comum em humanos: estima-se que ela afete uma em cada um milhão de pessoas em todo o mundo, e a maioria dos pacientes apresenta sintomas clássicos de demência e mioclonia, associados a alterações específicas no eletroencefalograma (EEG). À medida que a doença progride, o quadro de demência piora e podem surgir sintomas visuais, ce-rebelares, piramidais e extrapiramidais. O diagnóstico definitivo é obtido por meio da demonstração da degeneração espongiforme dos neurónios na histopatologia. A dcj é sempre fatal e não possui tratamento específico: cerca de 90% dos pacientes morrem no primeiro ano após o diagnóstico. Neste artigo, é relatado o caso de um paciente com dcj esporádica provável, de acordo com os atuais critérios de diagnóstico da oms, e é apresentada uma revisão da literatura.

Oxidative stress and mitochondrial dysfunction-linked neurodegenerative disorders.

Reactive species play an important role in physiological functions. Overproduction of reactive species, notably reactive oxygen (ROS) and nitrogen (RNS) species along with the failure of balance by the body's antioxidant enzyme systems results in destruction of cellular structures, lipids, proteins, and genetic materials such as DNA and RNA. Moreover, the effects of reactive species on mitochondria and their metabolic processes eventually cause a rise in ROS/RNS levels, leading to oxidation of mitochondrial proteins, lipids, and DNA. Oxidative stress has been considered to be linked to the etiology of many diseases, including neurodegenerative diseases (NDDs) such as Alzheimer diseases, Amyotrophic lateral sclerosis, Friedreich's ataxia, Huntington's disease, Multiple sclerosis, and Parkinson's diseases. In addition, oxidative stress causing protein misfold may turn to other NDDs include Creutzfeldt-Jakob disease, Bovine Spongiform Encephalopathy, Kuru, Gerstmann-Straussler-Scheinker syndrome, and Fatal Familial Insomnia. An overview of the oxidative stress and mitochondrial dysfunction-linked NDDs has been summarized in this review.

Aspergillosis of the central nervous system in a previously healthy patient that simulated Creutzfeldt-Jakob disease.

BACKGROUND: The presence of Aspergillus in the central nervous system (CNS) is rare in immunocompetent patients but not in immunocompromised patients who may have a more common infection. This article describes a case of an adult immunocompetent patient with a diagnosis of cerebral aspergillosis and with a clinical process of rapidly progressive dementia which simulated a Creutzfeldt-Jakob syndrome. CASE DESCRIPTION: A 34-year-old adult was previously healthy and had no medical history of any significance. The patient had suffered only facial trauma 8 months before admission. One month prior to admission, he showed rapidly progressing changes in his behavior and higher mental functions. He was admitted to the emergency room with an occipital headache with 2 months of history. By the time he arrived, he suffered from total disability and was prostrate. He was diagnosed with meningeal and demential syndrome in the process of being studied. After starting the diagnostic approach by investigating cerebrospinal fluid, a magnetic resonance of the skull, an electroencephalogram, a brain biopsy was indicated. The histopathological study reported the presence of the hyphae characteristics of Aspergillus. The patient died 7 days after the diagnosis. CONCLUSION: Cerebral aspergillosis is a common aggressive disease in immunosuppressed patients. However, the disease is rare in individuals with respected immunity and in individuals with neurological impairment and a rapid and progressive deterioration of mental functions. The suspected diagnosis should always be considered given its poor prognosis and the encouraging efficacy of antifungal treatment administered in a timely manner.

Polymorphisms in the Prion Protein Gene of cattle breeds from Brazil / Polimorfismos no gene da proteína priônica em bovinos no Brasil

One of the alterations that occur in the PRNP gene in bovines is the insertion/deletion (indel) of base sequences in specific regions, such as indels of 12-base pairs (bp) in intron 1 and of 23- bp in the promoter region. The deletion allele of 23 bp is associated with susceptibility to bovine spongiform encephalopathy (BSE) as well as the presence of the deletion allele of 12 bp. In the present study, the variability of nucleotides in the promoter region and intron 1 of the PRNP gene was genotyped for the Angus, Canchim, Nellore and Simmental bovine breeds to identify the genotype profiles of resistance and/or susceptibility to BSE in each animal. Genomic DNA was extracted for amplification of the target regions of the PRNP gene using polymerase chain reaction (PCR) and specific primers. The PCR products were submitted to electrophoresis in agarose gel 3% and sequencing for genotyping. With the exception of the Angus breed, most breeds exhibited a higher frequency of deletion alleles for 12 bp and 23 bp in comparison to their respective insertion alleles for both regions. These results represent an important contribution to understanding the formation process of the Brazilian herd in relation to bovine PRNP gene polymorphisms.(AU)

Uma das mudanças que ocorrem no gene PRNP em bovinos é a inserção e/ou deleção (indels) de sequências de bases, em determinadas regiões como, por exemplo, as indels de 12 pares de bases (pb) no íntron 1 e 23pb na região promotora. O alelo de deleção de 23pb está relacionado com a suscetibilidade à Encefalopatia Espongiforme Bovina (EEB), assim como a presença do alelo de deleção de 12pb. Neste estudo foi genotipada a variabilidade de nucleotídeos da região promotora e íntron 1 do gene PRNP em bovinos das raças Angus, Canchim, Nelore e Simental, para identificar os perfis genotípicos de resistência e/ou suscetibilidade à EEB de cada animal. Foi realizada a extração de DNA genômico para amplificação das regiões alvo do gene PRNP, por meio da reação em cadeia de polimerase (PCR) utilizando-se primers específicos. Os produtos da PCR foram submetidos à eletroforese em gel de agarose a 3%, e sequenciamento para a realização da genotipagem. Com exceção da raça Angus, a maioria das raças apresentaram maiores frequências do alelo de deleção tanto para 12pb como 23pb, em comparação com seus respectivos alelos de inserção, para as duas regiões. Esses resultados abrem caminhos para o conhecimento de como o rebanho brasileiro está sendo formado com relação aos polimorfismos do gene PRNP bovino.(AU)

Efficient edition of the bovine PRNP prion gene in somatic cells and IVF embryos using the CRISPR/Cas9 system.

The recently developed engineered nucleases, such as zinc-finger nucleases, transcription activator-like effector nucleases, and clustered regularly interspaced short palindromic repeat (CRISPR)/CRISPR-associated nuclease (Cas) 9, provide new opportunities for gene editing in a straightforward manner. However, few reports are available regarding CRISPR application and efficiency in cattle. Here, the CRISPR/Cas9 system was used with the aim of inducing knockout and knock-in alleles of the bovine PRNP gene, responsible for mad cow disease, both in bovine fetal fibroblasts and in IVF embryos. Five single-guide RNAs were designed to target 875 bp of PRNP exon 3, and all five were codelivered with Cas9. The feasibility of inducing homologous recombination (HR) was evaluated with a reporter vector carrying EGFP flanked by 1 kbp PRNP regions (pHRegfp). For somatic cells, plasmids coding for Cas9 and for each of the five single-guide RNAs (pCMVCas9 and pSPgRNAs) were transfected under two different conditions (1X and 2X). For IVF zygotes, cytoplasmic injection was conducted with either plasmids or mRNA. For plasmid injection groups, 1 pg pCMVCas9 + 0.1 pg of each pSPgRNA (DNA2X) was used per zygote. In the case of RNA, two amounts (RNA1X and RNA2X) were compared. To assess the occurrence of HR, a group additionally cotransfected or coinjected with pHRegfp plasmid was included. Somatic cell lysates were analyzed by polymerase chain reaction and surveyor assay. In the case of embryos, the in vitro development and the genotype of blastocysts were evaluated by polymerase chain reaction and sequencing. In somatic cells, 2X transfection resulted in indels and large deletions of the targeted PRNP region. Regarding embryo injection, higher blastocyst rates were obtained for RNA injected groups (46/103 [44.6%] and 55/116 [47.4%] for RNA1X and RNA2X) than for the DNA2X group (26/140 [18.6%], P < 0.05). In 46% (26/56) of the total sequenced blastocysts, specific gene editing was detected. The total number of genetic modifications (29) was higher than the total number of gene-edited embryos, as three blastocysts from the group RNA2X reported more than one type of modification. The modifications included indels (10/56; 17.9%) and large deletions (19/56; 33.9%). Moreover, it was possible to detect HR in 1/8 (12.5%) embryos treated with RNA2X. These results report that the CRISPR/Cas9 system can be applied for site-specific edition of the bovine genome, which could have a great impact on the development of large animals resistant to important zoonotic diseases.

Polymorphisms in the Prion Protein Gene of cattle breeds from Brazil / Polimorfismos no gene da proteína priônica em bovinos no Brasil

One of the alterations that occur in the PRNP gene in bovines is the insertion/deletion (indel) of base sequences in specific regions, such as indels of 12-base pairs (bp) in intron 1 and of 23- bp in the promoter region. The deletion allele of 23 bp is associated with susceptibility to bovine spongiform encephalopathy (BSE) as well as the presence of the deletion allele of 12 bp. In the present study, the variability of nucleotides in the promoter region and intron 1 of the PRNP gene was genotyped for the Angus, Canchim, Nellore and Simmental bovine breeds to identify the genotype profiles of resistance and/or susceptibility to BSE in each animal. Genomic DNA was extracted for amplification of the target regions of the PRNP gene using polymerase chain reaction (PCR) and specific primers. The PCR products were submitted to electrophoresis in agarose gel 3% and sequencing for genotyping. With the exception of the Angus breed, most breeds exhibited a higher frequency of deletion alleles for 12 bp and 23 bp in comparison to their respective insertion alleles for both regions. These results represent an important contribution to understanding the formation process of the Brazilian herd in relation to bovine PRNP gene polymorphisms.(AU)

Uma das mudanças que ocorrem no gene PRNP em bovinos é a inserção e/ou deleção (indels) de sequências de bases, em determinadas regiões como, por exemplo, as indels de 12 pares de bases (pb) no íntron 1 e 23pb na região promotora. O alelo de deleção de 23pb está relacionado com a suscetibilidade à Encefalopatia Espongiforme Bovina (EEB), assim como a presença do alelo de deleção de 12pb. Neste estudo foi genotipada a variabilidade de nucleotídeos da região promotora e íntron 1 do gene PRNP em bovinos das raças Angus, Canchim, Nelore e Simental, para identificar os perfis genotípicos de resistência e/ou suscetibilidade à EEB de cada animal. Foi realizada a extração de DNA genômico para amplificação das regiões alvo do gene PRNP, por meio da reação em cadeia de polimerase (PCR) utilizando-se primers específicos. Os produtos da PCR foram submetidos à eletroforese em gel de agarose a 3%, e sequenciamento para a realização da genotipagem. Com exceção da raça Angus, a maioria das raças apresentaram maiores frequências do alelo de deleção tanto para 12pb como 23pb, em comparação com seus respectivos alelos de inserção, para as duas regiões. Esses resultados abrem caminhos para o conhecimento de como o rebanho brasileiro está sendo formado com relação aos polimorfismos do gene PRNP bovino.(AU)

Doenças de ovinos diagnosticadas no Laboratório de Anatomia Patológica Animal da Universidade Federal de Mato Grosso do Sul (1996-2010) / Sheep diseases diagnosed at the Laboratory of Animal Pathology, Federal University of Mato Grosso do Sul, Brazil (1996-2010)

Nas últimas décadas a pecuária ovina cresceu significativamente no Brasil. Concomitantemente, grupos de pesquisas e laboratórios de diagnósticos realizam estudos retrospectivos com a finalidade de fornecer subsídios técnico-científicos para os médicos veterinários. Desta forma, realizou-se um estudo de prevalência nos arquivos do Laboratório de Anatomia Patológica Animal (LAP) da Universidade Federal de Mato Grosso do Sul (UFMS) no período de Janeiro de 1996 a Dezembro de 2010. O Laboratório de Bacteriologia da UFMS e o Setor de Patologia Veterinária da Universidade Federal do Rio Grande do Sul forneceram apoio diagnóstico nos casos de mannheimiose pulmonar e scrapie, respectivamente. Os laudos da espécie ovina foram revisados e agrupados em conclusivos e inconclusivos, dos quais foram excluídos os casos experimentais e de outros estados e países. Os casos conclusivos foram classificados de acordo com a etiologia da doença. Os exames da espécie ovina somaram 331 laudos (3,97 %) de um total de 8.333 casos diagnosticados no período. Destes, foram excluídos sessenta e quatro (19,3%) casos experimentais e materiais oriundos de outros estados ou países. Dos 267 casos remanescentes, 87 (32,6%) foram inconclusivos e 180 (67,4%) considerados conclusivos, sendo 60 (33,3%) doenças infecciosas e parasitárias; 45 (25%) intoxicações e toxi-infecções; 41 (22,8%) "lesões sem causa definida"; 22 (12,2%) doenças metabólicas e nutricionais; 10 (5,6%) foram classificadas como "outros distúrbios" e 2 (1,1%) neoplasmas. A hemoncose, intoxicação por Brachiaria spp., pleuropneumonias, broncopneumonias, pneumonias fibrinonecrosante ou fibrinossupurativa sem causa definida e a intoxicação por cobre foram as doenças mais prevalentes no período estudado. Dois casos de scrapie foram diagnosticados no período.

Sheep farming has increased significantly in Brazil during the last decades. Concurrently, research groups and diagnostic laboratories compile data and perform retrospective studies to provide important insight for professionals. A prevalence study from January 1996 to December 2010 was carried out in the archives of Laboratório de Anatomia Patológica Animal (LAP), Universidade Federal de Mato Grosso do Sul (UFMS). Laboratório de Bacteriologia, UFMS, and Setor de Patologia Veterinária at Universidade Federal do Rio Grande do Sul helped on the diagnostic of pulmonary mannheimiosis and scrapie respectively. The reports for sheep were reviewed and grouped into conclusive and inconclusive ones. The conclusive cases were classified according to the etiology of the disease. In the period, 331 exams (3.97%) were done. Sixty-four experimental cases and materials from other states or countries (19.3%) were excluded. Remaining cases (267), eighty-seven (32.6%) were inconclusive and 180 (67.4%) were considered conclusive reports, were classified according to the etiology: 60 (33.3%) infectious and parasitary diseases; 45 (25%) were poisonings and toxi-infections; 41 (22.8%) were summarized as "injuries without apparent cause"; 22 (12.2%) cases of metabolic and nutritional diseases; 10 (5.6%) were classified as "other disorders" and 2 (1.1%) case of neoplasms. Haemonchosis, fibrinonecrotic or fibrinopurulent pleuropneumonia, bronchopneumonia and pneumonia, poisonings by Brachiaria spp. and copper poisoning were the most prevalent diseases in sheep. Two cases of scrapie have been diagnosed in this period.

Doenças de ovinos diagnosticadas no Laboratório de Anatomia Patológica Animal da Universidade Federal de Mato Grosso do Sul (1996-2010) / Sheep diseases diagnosed at the Laboratory of Animal Pathology, Federal University of Mato Grosso do Sul, Brazil (1996-2010)

Nas últimas décadas a pecuária ovina cresceu significativamente no Brasil. Concomitantemente, grupos de pesquisas e laboratórios de diagnósticos realizam estudos retrospectivos com a finalidade de fornecer subsídios técnico-científicos para os médicos veterinários. Desta forma, realizou-se um estudo de prevalência nos arquivos do Laboratório de Anatomia Patológica Animal (LAP) da Universidade Federal de Mato Grosso do Sul (UFMS) no período de Janeiro de 1996 a Dezembro de 2010. O Laboratório de Bacteriologia da UFMS e o Setor de Patologia Veterinária da Universidade Federal do Rio Grande do Sul forneceram apoio diagnóstico nos casos de mannheimiose pulmonar e scrapie, respectivamente. Os laudos da espécie ovina foram revisados e agrupados em conclusivos e inconclusivos, dos quais foram excluídos os casos experimentais e de outros estados e países. Os casos conclusivos foram classificados de acordo com a etiologia da doença. Os exames da espécie ovina somaram 331 laudos (3,97 %) de um total de 8.333 casos diagnosticados no período. Destes, foram excluídos sessenta e quatro (19,3%) casos experimentais e materiais oriundos de outros estados ou países. Dos 267 casos remanescentes, 87 (32,6%) foram inconclusivos e 180 (67,4%) considerados conclusivos, sendo 60 (33,3%) doenças infecciosas e parasitárias; 45 (25%) intoxicações e toxi-infecções; 41 (22,8%) "lesões sem causa definida"; 22 (12,2%) doenças metabólicas e nutricionais; 10 (5,6%) foram classificadas como "outros distúrbios" e 2 (1,1%) neoplasmas. A hemoncose, intoxicação por Brachiaria spp., pleuropneumonias, broncopneumonias, pneumonias fibrinonecrosante ou fibrinossupurativa sem causa definida e a intoxicação por cobre foram as doenças mais prevalentes no período estudado. Dois casos de scrapie foram diagnosticados no período.(AU)

Sheep farming has increased significantly in Brazil during the last decades. Concurrently, research groups and diagnostic laboratories compile data and perform retrospective studies to provide important insight for professionals. A prevalence study from January 1996 to December 2010 was carried out in the archives of Laboratório de Anatomia Patológica Animal (LAP), Universidade Federal de Mato Grosso do Sul (UFMS). Laboratório de Bacteriologia, UFMS, and Setor de Patologia Veterinária at Universidade Federal do Rio Grande do Sul helped on the diagnostic of pulmonary mannheimiosis and scrapie respectively. The reports for sheep were reviewed and grouped into conclusive and inconclusive ones. The conclusive cases were classified according to the etiology of the disease. In the period, 331 exams (3.97%) were done. Sixty-four experimental cases and materials from other states or countries (19.3%) were excluded. Remaining cases (267), eighty-seven (32.6%) were inconclusive and 180 (67.4%) were considered conclusive reports, were classified according to the etiology: 60 (33.3%) infectious and parasitary diseases; 45 (25%) were poisonings and toxi-infections; 41 (22.8%) were summarized as "injuries without apparent cause"; 22 (12.2%) cases of metabolic and nutritional diseases; 10 (5.6%) were classified as "other disorders" and 2 (1.1%) case of neoplasms. Haemonchosis, fibrinonecrotic or fibrinopurulent pleuropneumonia, bronchopneumonia and pneumonia, poisonings by Brachiaria spp. and copper poisoning were the most prevalent diseases in sheep. Two cases of scrapie have been diagnosed in this period.(AU)

What is an atypical BSE?

The number of cases of Bovine Spongiform Encephalopathy (BSE) in the United Kingdom (UK) and Europe has decreased during the last years. The disease is designated as Classical BSE (C-BSE) once the prion protein involved is very constant and has genetic identity. On the other hand, atypical cases have occurred in several countries, apparently without any relationship with contaminated feeding. Atypical cases, H or L-BSE can have involvement with the etiology of the known C-BSE, first diagnosed in the UK. With the control of C-BSE based on rigid control of feeding, the occurrence of atypical BSE may predominate in the future. In this hypothesis atypical BSE, probably a spontaneous encephalopathy of cattle, will be considered as Sporadic BSE in contrast with the C-BSE that could be nominated UK-BSE.

What is an atypical BSE?

The number of cases of Bovine Spongiform Encephalopathy (BSE) in the United Kingdom (UK) and Europe has decreased during the last years. The disease is designated as Classical BSE (C-BSE) once the prion protein involved is very constant and has genetic identity. On the other hand, atypical cases have occurred in several countries, apparently without any relationship with contaminated feeding. Atypical cases, H or L-BSE can have involvement with the etiology of the known C-BSE, first diagnosed in the UK. With the control of C-BSE based on rigid control of feeding, the occurrence of atypical BSE may predominate in the future. In this hypothesis atypical BSE, probably a spontaneous encephalopathy of cattle, will be considered as Sporadic BSE in contrast with the C-BSE that could be nominated UK-BSE.(AU)

Enfermedad de Creutzfeldt-Jakob: reporte de dos casos / Creutzfeldt- Jakob disease: report of two cases

INTRODUCCIÓN: La enfermedad de Creutzfeldt-Jakob (ECJ) es una enfermedad priónica neurodegenerativa que afecta el Sistema Nervioso Central (SNC), invariablemente mortal. Clasificada en esporádica, familiar e iatrogénica, se manifiesta por cuadro demencial subagudo, síntomas motores, visuales, y mioclonías. Presenta electroencefalograma (EEG) con actividad espicular pseudoperiódica; resonancia agnética (RM) con hiperintesidad de núcleos estriados y áreas de corteza cerebral; y líquido céfalo raquídeo (LCR) con aumento de proteína 14-3-3. Finalmente, un estudio histopatológico del cerebro establece la encefalopatía espongiforme. PRESENTACIÓN DEL CASO: Se exponen dos casos de ECJ. Ambas mujeres, 44 y 67 años, con alteración de la marcha, deterioro cognitivo y mioclonías, cuadro rápidamente progresivo hasta la dependencia absoluta. EEG en ambos casos compatible con ECJ, además de imágenes que revelan hiperintensidad en núcleos estriados y/o zonas de la corteza. Ambas cursaron con infecciones durante su hospitalización y se les realizó gastrostomía por presentar trastorno deglutorio severo. DISCUSIÓN: El diagnóstico de ECJ se sospecha con la clínica, y se fundamenta con hallazgos característicos en RM, EEG y análisis de LCR. Ante la sospecha de la forma familiar se sugiere estudio genético, sin embargo, en el Hospital Clínico Herminda Martin (HCHM) no se realiza. Al ser una enfermedad invariablemente mortal y sin tratamiento, dificulta la decisión entre realización de estudios e intervenciones, contra el manejo expectante.

INTRODUCTION: Creutzfeldt-Jakob disease (CJD) is a neurodegenerativedisease caused by prions that affect the central nervous system. It’s invariably fatal. It can be classified as sporadic, familial and iatrogenic. It’s clinical features are subacute dementia, associated with motor and visual symptoms, as well as myoclonus. Electroencephalogram (EEG) shows pseudoperiodic spicular activity. Magnetic Resonance Imaging (MRI) presents with hyperintense signals in both striated corpus and some cerebral cortex areas. Cerebrospinal fluid (CSF) shows an increased level of 14-3-3 protein. Finally, histopathological study of brain states spongiform encephalopathy. CASE REPORT: We report two cases of CJD. Two women who started at ages 44 and 67 years old with abnormal gait, cognitive impairment and myoclonus, with rapid progression of symptoms to absolute dependence. EEG was compatible with the disease and imaging tests showed hyperintense signals in striatum and / or some areas of the cortex. Both patients coursed with infections during their hospitalization period and both underwent gastrostomy due to the presence of a severe swallowing disorder. DISCUSSION: The diagnosis of CJD is suspected based on the clinical findings and it is supported by characteristic features on MRI, EEG and CSF analysis. If the familial form of CJD is suspected, a genetic study is suggested however, in Herminda Martin Clinical Hospital (HCHM) this is not available. CJD is an invariably fatal disease and it doesn’t have any treatment. This makes difficult to choose between executing tests and interventions, and having an expectant management.

Polimorfismos de nucleotídeos únicos em 15 códons do gene da proteína priônica em um rebanho Suffolk afetado com scrapie no Brasil / Single nucleotide polymorphisms at 15 codons of the prion protein gene from a scrapie-affected herd of Suffolk sheep in Brazil

Scrapie is a transmissible spongiform encephalopathy of sheeps and goats, associated with the deposition of a isoform of the prion protein (PrPsc). This isoform presents an altered conformation that leads to aggregation in the host's central nervous and lymphoreticular systems. Predisposition to the prion agent infection can be influenced by specific genotypes related to mutations in amino acids of the PrPsc gene. The most characterized mutations occur at codons 136, 154 and 171, with genotypes VRQ being the most susceptible and ARR the most resistant. In this study we have analyzed polymorphisms in 15 different codons of the PrPsc gene in sheeps from a Suffolk herd from Brazil affected by an outbreak of classical scrapie. Amplicons from the PrPsc gene, encompassing the most relevant altered codons in the protein, were sequenced in order to determine each animal's genotype. We have found polymorphisms at 3 of the 15 analyzed codons (136, 143 and 171). The most variable codon was 171, where all described alleles were identified. A rare polymorphism was found at the 143 codon in 4 percent of the samples analyzed, which has been described as increasing scrapie resistance in otherwise susceptible animals. No other polymorphisms were detected in the remaining 12 analyzed codons, all of them corresponding to the wild-type prion protein. Regarding the risk degree of developing scrapie, most of the animals (96 percent) had genotypes corresponding to risk groups 1 to 3 (very low to moderate), with only 4 percent in the higher risks group. Our data is discussed in relation to preventive measures involving genotyping and positive selection to control the disease.

Scrapie é uma encefalopatia espongiforme transmissível de ovinos e caprinos, associado a deposição da isoforma da proteína priônica (PrPsc). Essa isoforma apresenta uma alteração conformacional que leva ao acúmulo da proteína no sistema nervoso central e linforeticular do hospedeiro. A predisposição a infecção pelo agente priônico pode ser influenciado por genótipos específicos relacionados a mutações na sequência de aminoácidos do gene PrPsc. As principais mutações caracterizadas ocorrem nos códons 136, 154 e 171, sendo o genótipo VRQ o mais suscetível e o genótipo ARR o mais resistente. Nesse estudo nós analisamos os polimorfismos de 15 códons diferentes da gene PrPsc em ovinos de um rebanho da raça Suffolk no Brasil afetado com scrapie clássico. Os amplicons do gene da PrPsc, que contem os códons mais frequentemente encontrados foram sequenciados para determinar o genótipo de cada animal. Nós encontramos 3 polimorfismos do 15 códons analisados (136, 143 e 171). O códon que mais teve variações foi o códon 171, onde todos os alelos foram identificados. Um polimorfismo raro foi encontrado no códon 143, em 4 por cento das amostras analisadas, o qual tem sido descrito por aumentar a resistência a scrapie em animais suscetíveis. Nenhum outro polimorfismo foi detectado nos 12 códons restantes, todos então, correspondendo à proteína priônica selvagem. De acordo com a grau de risco a desenvolver scrapie, a maioria dos animais (96 por cento) tiveram genótipo correspondentes aos grupos de risco 1 a 3 (muito baixo a moderado), e somente 4 por cento no grupo de risco alto. Nossos dados discutem a relação das medidas de prevenção envolvendo a genotipagem e a seleção positiva para o controle da doença.

Polimorfismos de nucleotídeos únicos em 15 códons do gene da proteína priônica em um rebanho Suffolk afetado com scrapie no Brasil / Single nucleotide polymorphisms at 15 codons of the prion protein gene from a scrapie-affected herd of Suffolk sheep in Brazil

Scrapie is a transmissible spongiform encephalopathy of sheeps and goats, associated with the deposition of a isoform of the prion protein (PrPsc). This isoform presents an altered conformation that leads to aggregation in the host's central nervous and lymphoreticular systems. Predisposition to the prion agent infection can be influenced by specific genotypes related to mutations in amino acids of the PrPsc gene. The most characterized mutations occur at codons 136, 154 and 171, with genotypes VRQ being the most susceptible and ARR the most resistant. In this study we have analyzed polymorphisms in 15 different codons of the PrPsc gene in sheeps from a Suffolk herd from Brazil affected by an outbreak of classical scrapie. Amplicons from the PrPsc gene, encompassing the most relevant altered codons in the protein, were sequenced in order to determine each animal's genotype. We have found polymorphisms at 3 of the 15 analyzed codons (136, 143 and 171). The most variable codon was 171, where all described alleles were identified. A rare polymorphism was found at the 143 codon in 4 percent of the samples analyzed, which has been described as increasing scrapie resistance in otherwise susceptible animals. No other polymorphisms were detected in the remaining 12 analyzed codons, all of them corresponding to the wild-type prion protein. Regarding the risk degree of developing scrapie, most of the animals (96 percent) had genotypes corresponding to risk groups 1 to 3 (very low to moderate), with only 4 percent in the higher risks group. Our data is discussed in relation to preventive measures involving genotyping and positive selection to control the disease.(AU)

Scrapie é uma encefalopatia espongiforme transmissível de ovinos e caprinos, associado a deposição da isoforma da proteína priônica (PrPsc). Essa isoforma apresenta uma alteração conformacional que leva ao acúmulo da proteína no sistema nervoso central e linforeticular do hospedeiro. A predisposição a infecção pelo agente priônico pode ser influenciado por genótipos específicos relacionados a mutações na sequência de aminoácidos do gene PrPsc. As principais mutações caracterizadas ocorrem nos códons 136, 154 e 171, sendo o genótipo VRQ o mais suscetível e o genótipo ARR o mais resistente. Nesse estudo nós analisamos os polimorfismos de 15 códons diferentes da gene PrPsc em ovinos de um rebanho da raça Suffolk no Brasil afetado com scrapie clássico. Os amplicons do gene da PrPsc, que contem os códons mais frequentemente encontrados foram sequenciados para determinar o genótipo de cada animal. Nós encontramos 3 polimorfismos do 15 códons analisados (136, 143 e 171). O códon que mais teve variações foi o códon 171, onde todos os alelos foram identificados. Um polimorfismo raro foi encontrado no códon 143, em 4 por cento das amostras analisadas, o qual tem sido descrito por aumentar a resistência a scrapie em animais suscetíveis. Nenhum outro polimorfismo foi detectado nos 12 códons restantes, todos então, correspondendo à proteína priônica selvagem. De acordo com a grau de risco a desenvolver scrapie, a maioria dos animais (96 por cento) tiveram genótipo correspondentes aos grupos de risco 1 a 3 (muito baixo a moderado), e somente 4 por cento no grupo de risco alto. Nossos dados discutem a relação das medidas de prevenção envolvendo a genotipagem e a seleção positiva para o controle da doença.(AU)

Encefalopatías espongiformes transmisibles:biología del prion y estado actual de la vigilanciaepidemiológica en Colombia / Encefalopatias espongiformes transmissíveis: biologia do prião e estado atual davigilância epidemiológica na Colômbia / Transmissible spongiform encephalopathies: biology of the Prion and current state of the epidemiologic surveillance in Colombia

Las Encefalopatías Espongiformes Transmisibles, también llamadas enfermedades priónicas, sonun grupo de enfermedades neurodegenerativas, que afectan una gran variedad de mamíferos. El agenteresponsable de estas patologías se ha identificado como una isoforma anormal de una proteína celular, lacual luego de sufrir un cambio conformacional (prion), adquiere la capacidad de comportarse como unagente infeccioso. Se ha demostrado la capacidad de los priones para cruzar la barrera de especies entreel ganado y los seres humanos; lo cual se ha reflejado en un problema de salud pública que ha afectadogravemente a los países donde se han presentado brotes de estas enfermedades. Las EncefalopatíasEspongiformes Transmisibles se han reportado en una gran cantidad de países y Colombia no ha sido ajenaa la presencia de casos esporádicos humanos, no relacionados con el consumo de material contaminadoprocedente de animales enfermos. Con el presente artículo se pretende dar una visión de la historia y elestado actual de Colombia frente a estas enfermedades, las cuales representan una grave amenaza para lasalud pública y la agrocadena ganadera del país.

Transmissible Spongiform Encephalopaties, also called prion diseases, are a group of neurodegenerativediseases affecting a variety of mammals. The responsible agent consists of an abnormal isoform of a cellularprotein that suffers a conformational change (prion), acquiring the ability of being transmissible. It hasbeen demonstrated prions capacity to cross the species barrier between the cattle and humans; affectingpublic health in countries with reported cases of bovine spongiform encephalopathy. The transmissiblespongiform encephalitis have been reported in a number of countries and Colombia is not the exceptionwith some human sporadic cases, not related with the intake of contaminated material from sick animals.With this manuscript we pretend to give a view of the history and the current state of prion diseases inColombia, which represent a serious threat for the public health and the cattle industry of the country.

As doenças encefalopatias espongiformes transmissíveis, são do grupo de doenças neurodegenerativas,que afetam uma grande variedade de mamíferos. O agente responsável de estas patologias estáidentificado como uma isoforma anormal de uma proteína celular, a qual logo de apresentar umamudança de conformação (prião), adquire a capacidade de comportar-se como um agente infeccioso.Tem-se demonstrado a capacidade que tem o prião para ultrapassar a barreira de espécies entre o gadoe o ser humano; o qual está refletido gravemente aos países onde tem-se apresentado estas doenças.As encefalopatias espongiformes transmissíveis estão reportadas em uma grande quantidade de países.Na Colômbia tem-se apresentado casos esporádicos em humanos, não relacionados com o consumo dematerial contaminado procedente de animais doentes. O presente artigo, busca dar uma visão da historiae o estado atual da Colômbia frente as doenças, as quais representam uma grave ameaça para a saúdepública e da pecuária do pais.

Enfermedad de Creutzfeldt-Jakob: hallazgos clínicos, electroencefalográficos, imagenológicos y de patología / Creutzfeldt-Jakob disease: clinical, electroencephalografic, pathologic, and imaging characteristics

La enfermedad de Creutzfeld-Jakob (ECJ) hace parte de un grupo de enfermedades transmisibles que se caracterizan por la presencia de encefalopatía espongiforme, donde también se encuentran el kuru, el síndrome Gerstmann-Straussler- Scheinker, y el insomnio fatal familiar. De ellas, la más común es la ECJ (representando aproximadamente el 85 por ciento de casos de encefalopatías espongiformes), con una incidencia anual estimada en 1-2 casos por millón en la población general y de 5 casos por millón en personas entre 60 y 74 años. A pesar de que fue descrita hace ya más de 50 años, no hay hasta el momento ningún tratamiento efectivo, por lo cual la enfermedad es siempre fatal. El promedio de sobrevida es de apenas 1 año una vez hecho el diagnóstico. Describimos el caso de una paciente femenina de 62 años, quien ingresó a nuestra institución con un cuadro de 1 año de evolución de cambios en el comportamiento rápidamente progresivos, demencia y posteriormente alteraciones motoras. La enfermedad progresó hasta llevar a la postración e incapacidad de la paciente para entablar comunicación con su entorno, lo cual obligó a sus familiares a consultar a nuestro centro para su estudio. Los hallazgos neuropatológicos, clínicos e imagenológicos fueron compatibles con una enfermedad de Creutzfeldt-Jakob esporádica.

Creutzfeldt-Jakob Disease (CJD) belongs to a group of infectious diseases characterized by spongiform encephalitis, which also includes Kuru, Gerstmann-Straussler- Scheinker syndrome, and fatal familial insomnia. Amongst these, the most common is CJD (responsible for aproximately 85 per cent of all cases of spongiform encephalitis) with an anual incidence of 1-2 cases in the general population and 5 cases in people with ages 60-74 years. Even though it was described more than 50 years ago there is still no effective treatment, being invariably fatal. Life expectancy is only 1 year after diagnosis. We describe the case of a 65 year old female patient, who was seen at our institution with a 1 year history of rapid decline of her mental function, initially manifest as behavioral changes followed by dementia and later by motor disfunction. During the last months she was bedridden and unable to communicate, which led her family to seek help in our institution. Clinical, neuropathological and imaging characteristics were compatible with sporadic Creutzfeldt-Jakob disease.

Prion diseases are undercompulsory notification in Brazil: Surveillance of cases evaluated by biochemicaland/or genetic markers from 2005 to 2007.

The emergence of the new variant of Creutzfeldt-Jakob disease (vCJD) in the United Kingdom has raised concerns over the risks of this prion disease in other parts of the world. Since 2005, human prion diseases have been under compulsory notification in Brazil. It is well known that some polymorphisms within the cellular prion gene (PRNP) have been associated to a higher susceptibility to sporadic CJD (sCJD) and vCJD. OBJECTIVES: To describe the first notified cases and to evaluate the presence of mutations and polymorphisms of the PRNP in these cases. METHODS: Thirty-five notified cases were evaluated by clinical, auxiliary exams and biochemical and/or genetic tests and classified according to the World Health Organization criteria for CJD. A control group (N=202) was included for the purpose of comparing the genetic analyses. RESULTS: Twenty seven cases (74%) were classified as possible sCJD while 51% fulfilled the criteria for probable sCJD. Brain tissue analysis was available in three cases, where two were classified as definite sCJD and one as unconfirmed sCJD. Mutation of the PRNP was not found, and regarding the codon 129 polymorphism, valine in both alleles (Val129Val) was more frequent in patients than in the control group (OR=4.98; 1.55-15.96; p=0.007) when all possible cases were included, but not when only probable cases were considered. CONCLUSIONS: Our data did not show correlation of PRNP polymorphisms with probable sCJD cases. It is necessary to work toward notification of all cases of possible CJD in Brazil and to increase the rate of definitive diagnoses.

O aparecimento da nova variante da doença de Creutzfeldt-Jakob (vDCJ) na Grã-Bretanha causou preocupações quanto aos riscos de doenças por príons em outras partes do globo. Desde 2005, doenças humanas por príons são de notificação compulsória no Brasil. É bem conhecido que alguns polimorfismos do gene da proteína príon celular (PRNP) têm sido associados a maior susceptibilidade a DCJ esporádica (DCJe) e a vDCJ. OBJETIVOS: Descrever os primeiros casos notificados e avaliar a presença de mutações e polimorfismos do PRNP nesses casos. MÉTODOS: 35 casos notificados foram avaliados clinicamente, mediante exames complementares, testes bioquímicos e/ou genéticos e classificados de acordo com os critérios de DCJ da Organização Mundial de Saúde. Grupo controle (N=202) foi incluído para comparação dos dados da análise genética. RESULTADOS: 27 casos (74%) foram classificados como possível DCJe, dos quais 51% preencheram critérios para provável DCJe. Exame neuropatológico do encéfalo foi realizado em apenas 3 casos, dos quais 2 foram classificados como DCJe definida e um como DCJe não confirmada. Mutações do PRNP não foram encontradas e, com respeito ao polimorfismo do códon 129, valina em ambos os alelos (Val129Val) foi mais freqüente em pacientes do que em controles (OR=4,98; 1,55-15,96; p=0,007) quando todos os casos foram investigados, mas não quando apenas casos prováveis foram incluídos. CONCLUSÕES: Nossos dados não mostram correlação dos polimorfismos do PRNP com provável DCJe. É necessário ampliar a notificação de todos os casos de possível DCJ no Brasil e o diagnóstico definitivo.

Bovine Spongiform Encephalopathy: epizootiology, etiology and clinical update / Encefalite Espongiforme Bovina: considerações epizootiológicas, etiológicas e clínicas

A review on bovine spongiform encephalophaty (BSE), that has been occurred since 1985 in Europe mainly in the United  Kingdom, is presented. Topics such as history, etiology, clinical signs, epizootiology and economical implications are described. The control measures to minimize any risk of establishment of BSE in Brazilian cattle are suggested.

Apresentam-se nesta revisão dados e informações básicas para a compreensão da encefalite espongiforme que grassa em bovinos de vários países europeus, em especial do Reino Unido, desde 1985.Descrevem-se de maneira sucinta aspectos ligados ao histórico, etiologia; quadro clínico, epizootiologia e implicações econômicas da referida enfermidade. Também são sugeridas medidas de controle, a serem mantidas ou adotadas, para certificar que a mesma continue a ser uma doença exótica em nosso país.

Bovine Spongiform Encephalopathy: epizootiology, etiology and clinical update / Encefalite Espongiforme Bovina: considerações epizootiológicas, etiológicas e clínicas

A review on bovine spongiform encephalophaty (BSE), that has been occurred since 1985 in Europe mainly in the United  Kingdom, is presented. Topics such as history, etiology, clinical signs, epizootiology and economical implications are described. The control measures to minimize any risk of establishment of BSE in Brazilian cattle are suggested.

Apresentam-se nesta revisão dados e informações básicas para a compreensão da encefalite espongiforme que grassa em bovinos de vários países europeus, em especial do Reino Unido, desde 1985.Descrevem-se de maneira sucinta aspectos ligados ao histórico, etiologia; quadro clínico, epizootiologia e implicações econômicas da referida enfermidade. Também são sugeridas medidas de controle, a serem mantidas ou adotadas, para certificar que a mesma continue a ser uma doença exótica em nosso país.