Tema 28. Priones
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Tema 28. Priones. Características generales Estructura y ciclo de multiplicación. Patogenia. Inmunidad. Cuadros clínicos. Diagnóstico. Tratamiento. Epidemiología y Profilaxis. (Viroides). Prions and viroids are unconventional infectious agents

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Tema 28. Priones

Características generales

Estructura y ciclo de multiplicación.

Patogenia.

Inmunidad.

Cuadros clínicos.

Diagnóstico.

Tratamiento.

Epidemiología y Profilaxis.

(Viroides)


  • Prions and viroids are unconventional infectious agents

  • Prions—infectious proteins that cause a group of diseases of the brain and nervous system called Transmissible Spongiform Encephalopathies (TSEs)

  • Viroids—small, pathogenic RNAs that cause viruslike diseases in plants


Caracter sticas priones
Características Priones

  • Proteínas modificadas del hospedador que puede transmitir la enfermedad.

  • Prión: pequeña partícula infecciosa proteica. (PrP stands for “proteinaceous infectious particle”)

  • Humanos

  • Kuru

  • Enfermedad de Creutzfeldt-Jakob (ECJ)

  • Animales

  • Encefalopatía espongiforme bovina (vacas locas)


Tertiary structure of prp c and prp res

Estructura y ciclo de multiplicación

Tertiary Structure of PrPc and PrPres

Two Distinct Conformations of the Prion Protein


Prnp gene encodes prp c
PRNP gene encodes PrPC

  • PRNP gene located on chromosome 20 of humans

  • Codes for a 254 AA protein.

  • It is unique (no other proteins of similar homology in the database)

  • PrPC is targeted via a secretory pathway to the cell surface of neurons and other cell types

  • A glycosylinositol phospholipid anchors it into the membrane.



Hypothetical model showing prp c involvement in the secretory pathway of cells
Hypothetical Model showing PrPc Involvement in the Secretory Pathway of Cells


Patogenia
Patogenia

  • Incubation period of TSEs (with the exception of vCJD) is long (20-56 years)

  • South Fore tribe members still getting Kuru some 39-56 years after the cessation of cannibalism


Histological brain changes of tses

Patogenia

Histological/Brain Changes of TSEs

  • Infected brains become spongiform (the brain has vacuoles—clear zones, similar to a sponge)

  • Neuronal loss

  • Astrocystosis (spread of astrocytes to damaged tissues in the brain)

  • Amyloid plaques—formation of PrPres threadlike aggregates


Spongiosis
Spongiosis

Brain tissues showing histopathologic changes found in bovine spongiform encephalopathy.



Brain changes
Brain Changes the Different TSEs

  • Depending upon what region of the brain is affected

    • e.g. memory is affected when the cerebral cortex is infected

  • No inflammation or immune defense against prions exists

    • Natural proteins (body does not recognize as foreign antigens)

    • Prion proteins are only harmful when they are converted to PrPres


PRIONES the Different TSEs

Depósitos de proteínas priónicas


Inmunidad
Inmunidad the Different TSEs

  • None of the TSEs evoke an immune response

  • Prions cause a noninflammatory process that results in vacuolation or spongiosis in the gray matter of the brain


Fore child with symptoms of ambulant stage

Cuadros the Different TSEsClínicos

Fore Child with Symptoms of Ambulant Stage

A Fore child with symptoms of the ambulant stage of Kuru.


Clinical signs and symptoms of variant creutzfeldt jakob disease variant cjd
Clinical Signs and Symptoms of Variant Creutzfeldt-Jakob Disease (Variant CJD)

  • 50% of variant CJD patients die before the age of 30

    • average age of death is 28

  • Patients suffering from classic CJD die at an average of 68 years


Symptoms of variant cjd
Symptoms of Variant CJD Disease (Variant CJD)

  • Anxiety

  • Memory loss

  • Mood changes

  • Depression

  • Neurological signs

    • Twitching

    • Spasms (jerky movements)

    • Posture and gait abnormalities (motor difficulties)


Final symptoms of variant cjd
Final Symptoms of Variant CJD Disease (Variant CJD)

  • Loss of speech

  • Stupor

  • Persistent vegetative state (coma)

  • Death (14 months after symptoms appear)


Diagn stico de cjd
Diagnóstico de CJD Disease (Variant CJD)

  • Most patients referred to a psychiatrist because of behavioral changes

  • Definitive diagnosis—prion positive immunostaining of biopsy material from:

    • Tonsil

    • Spleen

    • Lymph nodes

  • Electroencefalografía—looking for slow or negative brain wave activity

  • Resonancia magnética—looking for brain lesions

  • LCR—looking for elevated levels of neuronal, astrocytic and glial proteins

    • Elevated levels are a consequence of damage to the blood brain barrier


Gold standard of diagnosis is postmortem examination of brain tissues
Gold Standard of Disease (Variant CJD)Diagnosis is Postmortem Examination of Brain Tissues

Detection of PrPres by Western blot analysis.

Samples of human brain tissues from a diseased individual suspected of variant CJD.


Human genetics codon 129
Human Genetics: Codon 129 Disease (Variant CJD)

  • 50 known mutations in the PRNP gene

  • PRNP codon 129 appears to act as a genetic susceptibility factor (codes for methionine or valine at position 129 of the PrPC).

  • All people suffering from vCJD acquired through consuming prion-contaminated beef products were homozygous methionine at codon 129


Steps toward treatment and vaccination
Steps Toward Disease (Variant CJD)Treatment and Vaccination

  • No drug therapies available.

  • Treatment is supportive

  • No vaccine available

    • PrPC antibodies injected into the brains of mice cause neurotoxicity


Epidemiolog a y profilaxis
Epidemiología y Profilaxis Disease (Variant CJD)

Prions are highly resistant to routine methods of decontamination

  • Not inactivated by proteases, organic solvents, alkaline cleaners, ultraviolet radiation, ethanol, formaldehyde or extremely high temperatures (e.g. greater than 100 oC; sterilization for one hour at 121 oC in an autoclave does not kill prions)


Typical decontamination protocol that researchers use
Typical Decontamination Protocol that Researchers Use: Disease (Variant CJD)

  • Tissues, infectious waste, and instruments used in the processing of prion-contaminated samples are decontaminated in:

    • 1 N NaOH or undiluted fresh household bleach followed by autoclaving at 132 oC for 4.5 hours



Transmission
Transmission Disease (Variant CJD)

  • Infection

    • diet, vCJD

    • Iatrogenic means (e.g. surgery)

    • Growth hormone injections

    • Corneal transplants

  • Inherited

    • Genetic CJD

    • Gerstmann-Straussler-Scheinker Disease (GSS)

    • Fatal Familial Insomnia (FFI)

  • Sporadic forms

    • CJD


Transmission Disease (Variant CJD)


Species Barrier Disease (Variant CJD) Bovine Spongiform Encephalopathy (BSE) and Variant Creutzfeldt-Jakob Disease (Variant CJD)

  • Transmissibility among species is easy

  • Transmission can occur between different species

  • Origin of BSE unclear

    • Accepted hypothesis is that BSE came from cattle ingesting scrapie-contaminated bone meal derived from sheep offal fed to young calves


Encefalopat as espongiformes transmisibles
ENCEFALOPATÍAS ESPONGIFORMES TRANSMISIBLES Disease (Variant CJD)

HOMBRE:

  • Kuru.

  • Enfermedad de Creutzfeldt-Jacob (ECJ).

  • Síndrome de Gerstmann-Straussler (ECJ hereditaria).

  • Síndrome de insomnio familiar fatal.

  • Nueva variante de la Enfermedad de Creutzfeldt-Jacob (nv ECJ).

    ANIMALES:

  • Scrapie.

  • Encefalopatía espongiforme bovina (Enfermedad de las vacas locas).


Nvecj
nvECJ Disease (Variant CJD)

  • Consumo de derivados bovinos con EEB: amígdalas, retina, tejido nervioso.

  • Homocigotos met en el codón 129.

  • Diferencias:


Encefalopat as espongiformes subagudas pri n viri n

SIMILITUDES Disease (Variant CJD)

Transmisibles.

Muy pequeños.

Filtrables.

Dependientes de la célula huésped.

Sin capacidad de:

Generar energía.

Síntesis proteica.

DIFERENCIAS

No evidencia de partículas virales.

Ácidos nucleicos no detectables.

Muy resistentes.

No inducen reacción inflamatoria/respuesta inmunitaria.

ENCEFALOPATÍAS ESPONGIFORMES SUBAGUDASPRIÓN-VIRIÓN


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