Prion Propagation

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Prions are unique infectious agents that consist only of a protein, and are not replicated via nucleic acid. The wild type protein PrPC (Prion-related Protein) consists of approximately 209 amino acids (split evenly between an N-terminal domain and a C-terminal domain) in primarily alpha-helix secondary structures with one disulfide bond. The prion protein is expressed throughout the body, including fibroblasts and keratinocytes in the skin, though at highest levels in the central nervous system. The function is unknown, although it is a cell surface protein held in place by a glycolipid anchor. However, due to a mutation in the PRNP gene sequence, the amino acid sequence, or error in posttranslational protein folding, the PrPC protein is misfolded into an isoform PrPSc, which consists of mainly beta-sheet fibrillar secondary structures that tend to aggregate, also known as a form of amyloid. This alteration in secondary structure leads to accumulation of PrPSc, formation of plaques, and prion diseases such as Creutzfeldt-Jakob disease (CJD), Gerstmann-Straussler-Scheinker disease, kuru, Bovine Spongiform Encephalopathy (BSE or "mad cow" disease), scrapie, and Familial Fatal Insomnia (FFI). Since the aggregates are formed from native protein sequences, no immune response is raised, and since the plaques assume a non-standard conformation, they are semi-resistant to proteinase K (PK) degradation. The normal half-life of a PrPC is approximately 3-6 hours, but proteinase K resistance increases this time. Polysaccharides have also been shown to play a role in PrPSc structure, and sphingolipids and cholesterol have even been found in purified preparations of prion rods in scrapie (a prion disease found in sheep).

A. The normal isoform of PrPC. B. The misfolded isoform, PrPSc.

The Prion Hypothesis


The prion hypothesis, which states that prions propagate themselves without nucleic acid involvement, is controversial because it contradicts the fundamental tenet of molecular biology: proteins are translated from RNA which is transcribed from DNA. However, while the precise mechanism of prion propagation is unclear, there is much evidence to support the theory that PrPsc is the primary, if not sole agent responsible for propagation of more PrPsc, not the least of which is a lack of identification of nucleic acid involvement after over two decades of research. Different hypotheses of this interaction exist, most of which involve the PrPsc protein acting as a template to induce misfolding of PrPc, or a mysterious as-yet unidentified “protein X”, which binds one unit of PrPc and one unit of PrPsc together in a complex. Three known classes of prion propagation have been identified as distinct, including sporadic (85% of cases), acquired (5%), and inherited (10%) PrPsc accumulation.

Attempts by researchers to recreate PrPSc using PrPSc from a donor organism of the same species have been well documented, and result in about a 50% successful transmission rate. One of the most supporting pieces of evidence in favor of the protein-only hypothesis is that when mutant PrPSc from a donor organism is inoculated into a recipient organism of the same species, the PrPSc that results has the amino acid sequence of the recipient organism's PrPC, not the donor organism's PrPSc.

Attempts by researchers to recreate PrPSc formation de novo have been conducted, though perhaps raise more questions than they answer. PrPSc formation has been shown to be induced by polyanionic structures such as RNA and polysaccharides in brain homogenates. Attempts to induce PrPSc from mutations in PrPC via an increase in PK-resistant and beta-rich sequences resulted in a number of different isoforms, also indicating that PrPSc formation can depend on intracellular conditions such as solvent concentration and the presence of anionic cofactors. Fibrillar aggregates were induced from PrPC using SDS, certain lipids, and other denaturing agents. However, the initially low infectivity and increasing infectivity corresponding to successive inoculations of these synthetically made prions have led to two hypotheses: the 'maturation' hypothesis, which states that perhaps the amyloid fibrils generated de novo were semi-infectious intermediates between PrPC and PrPSc formation, and the 'adaptation' hypothesis, which states that because the synthetic PrPSc is conformationally different from the PrPC produced in vivo, a 'transmission barrier' develops, which prohibits the propagation of a strain of PrPSc until it adapts enough of the correct conformational modifications of different isoforms of synthetic PrPSc to allow for natural conformational alteration of wild type PrPC. The 'adaptation' model may be supported by evidence that PrPSc aggregates tend to accumulate mutations over their extremely long life-span, resulting from oxidative damage, deamidation, and enzymatic modifications. Some researchers remain convinced that a virus or virion particle is responsible for all classified prion diseases, despite a lack of evidence in support of this theory.

Sporadic Propagation: Creutzfeldt-Jakob disease


CJD is classified as a neuropathological disorder cause by sporadic prion propagation, although there is evidence for a new form, variant-CJD or vCJD, that is hereditary. CJD cannot be absolutely diagnosed until a post mortem autopsy, but symptoms may begin as late in life as 60, and spinal taps and EEGs can rule out other forms of treatable dementia. Symptoms include progressively worsening dementia, loss of memory and muscle functions, myoclonus (muscle jerks), and even blindness, leading into a comatose state which is often accompanied by a form of pneumonia. Patients usually die within a single year of onset of symptoms. There is no cure or treatment for the disease as of 2009.

The sporadic mutation of the PRNP gene results in about 1 case of CJD per million individuals, consistent with random mutation statistical analysis. This prion disease, caused by rare genetic event or somatic mutation, seems to be focused on amino acid 129. Several different classifications of the PrPSc have been primarily identified by differential cleavage patterns by proteinase K. These types have been additionally separated based on amino acid sequence with respect to a valine or methionine at position 129 in the PrPSc protein, and then by location and formation of plaques in different regions of the brain. Type 1 PrPSc is characterized by homozygous methionine (MM) at codon 129, and synaptic plaque formation primarily in the cerebral cortex and occipital lobe. Type 2 PrPSc can be homozygous methionine, valine (VV), or heterozygous (MV), and causes mainly perivacuolar plaque formation in the basal ganglia and cerebellum in addition to the cerebral cortex. Type 3 PrPSc is characterized by MV or VV at codon 129, and show linear plaque formation similar to that of the kuru prion, located mainly in the basal ganglia and cerebellum. Type 4 PrPSc (MM)was associated mainly with the vCJD prion, which evidence points toward hereditary transmission of the isoform mutation. Incubation periods of different prion strains also differ, with Types 1 and 3 PrpSc having the shortest disease length (around 3-10 months). Homozygosity seems to correspond to shorter duration of illness, but the age of onset of symptoms is unrelated.

Prion strains 1-4 can also be identified by differential glycosylation patterns upon partial digestion by proteinase K. Types 1 and 2 showed similar percentages of unglycosylated, monoglycosylated, and diglycosylated substrate, while types 3 MM, 3 MV, 3 VV and type 4 MM showed very distinct patterns. Additionally, the ability of the N-terminal region of PrPSc to bind copper ions may play a role in differential classifications between types 1 and 2 PrPSc.

Glycoform ratios of di-, mono- and unglycosylated PrPSc fragments expressed as the mean with 6 SEM (represented by vertical bars). The values for 6 are the mean values of two separately scanned western blots.

Acquired Propagation: Kuru


Kuru is an acquired prion disease symptomatically divergent from all forms of CJD. In documented kuru cases, severe dementia did not become apparent until much later after onset of the disease. Instead, it is characterized by radical behavioral changes (alternating bouts of depression and inappropriate laughter), joint pain, and loss of muscle function. Kuru is prevalent in the Fore linguistic group of the Eastern Highlands in Papua New Guinea. Members of these societies classically participated in ceremonies in which practically the entire body of deceased relatives would be feasted upon as a sign of honor and respect. Records of these ceremonies indicate that while men took choice cuts of the human flesh, mainly women and children ate the internal organs such as the brain, which is consistent with a statistically higher proportion of the 2700 documented cases of kuru being found in women and grown children. Although prion disease cannot be transmitted ordinarily through contact with skin or even blood, contact with brain tissue or spinal fluid does effectively transmit the disease. Dura mater grafts, corneal transplants, or surgical implantation of non-sterile electrodes in the brain can also transmit prion disease. It is not known how much abnormal PrpSc it is necessary to have ingested or injected to cause kuru or other acquired prion disease.

Once the source of the kuru disease was discovered in 1959 after anthropologically raised questions, ritual endocannabalism ceased, and incidences of kuru have all but disappeared. Remarkably, the incubation of the prion PrpSc lasted from a minimum of 4 years to well over 40 years, the onset seeming to be more age-dependent than linked to any other factor.

PrPSc strain types in human prion disease. Immunoblots of proteinase K digested brain homogenates from patients with human prion disease. Disease aetiology of each brain sample is designated above each lane and the PrPSc type and PRNP codon 129 genotype of the patient (M, methionine; V, valine) are designated below.


Inherited Propagation: Fatal Familial Insomnia


Fatal Familial Insomnia is an autosomal dominant disease caused by mutation of the PRNP gene. Early symptoms include insomnia, bizarre phobias, headaches, panic attacks, and hallucinations, followed by recurrence of fetal reflexes, weight loss, apathy, breathing disorders, myoclonus, and eventually coma and death. Studies of the PrpSc found in FFI patients show a methionine at codon 129, as well as an asparagine mutation at codon 178.

Cross-species Transmission of Prions


Although normally transmission of prions between species is impossible due to differing amino acid sequences of the PrPC and PrPSc protein, there are several documented instances of just such occurrences. One of the main pieces of evidence for the protein-only hypothesis is that when a mutated PrPSc is inoculated into a wild-type member of the same species, the PrPSc that forms in the recipient organism has the same amino acid sequence as the PrPC in the recipient organism, not the PrPSc in the donor organism. However, if homology is close enough for PrPSc to retain activity and reconfigure wild type PrPC in the recipient species, that strain of PrPSc can cross the transmission barrier.

This has been documented in yeast, in a 2005 study where researchers used a synthetic form of the S. cerevisiae prion Sup35 to infect a distantly phylogenetically related and highly divergent species of yeast, C. albicans. The introduction of Sup35 into the recipient yeast resulted in an conformationally adapted unique conformation of prion, which was then removed and inoculated back into the donor yeast re-cross the species transmission barrier. These findings not only support the 'adaptation' hypothesis of prion formation, but support the theory that conformation is the primary determinant in cross-species prion transmission, while amino acid sequence affects the specificity by allowing and prohibiting differential amyloid conformations.

An area of recent interest was the hypothetical transmission of BSE, or 'mad cow' disease, to humans through consumption of beef from infected cattle.

In addition to infectious prion transmission from one species to another, the theory that prions may be carried between members of the same species by a vector has been an important subject of research. PrPSc present in the skin in keratinocytes and fibroblasts may be ingested by ectoparasties, and homogeneates of these prion-infected ectoparasites, such as Diptera (flies whose larvae burrow beneath mammalian skin in an invasion known as myiasis) and the mites Lepidoglyphus destructor and Acarus farris have been shown to be able to spread scrapie in sheep and mice.[10]

Conclusion


What importance does prion propagation have to the field of microbiology?

Microbes are defined as living organisms that require a microscope to be seen; however, the jury is still out on whether even viruses are classified as living organisms, despite their classification as microbes. Other microbes include microscopic eukaryotes, bacteria, and archaea. Can prions, viroid-like particles with no other molecular parts, protective coats, or nucleic acids be classified as microbes? They represent an even smaller, simpler form of pathogenic material, that can propagate itself, perhaps without the aid of any other proteins, enzymes, or cofactors.

References

Andrew F. Hill, Susan Joiner, Jonathan D. F. Wadsworth, Katie C. L. Sidle, Jeanne E. Bell, Herbert Budka, James W. Ironside and John Collinge, "Molecular classification of sporadic Creutzfeldt-Jakob disease". Brain. 2003. Volume 126. p. 1333-1346.

Ilia V. Baskakov, Leonid Breydo, "Converting the prion protein: What makes the protein infectious". "BBA - Molecular Basis of Disease", Volume 1772, issue 6 (June, 2007), p. 692-703.

[http://journals.ohiolink.edu/ejc/pdf.cgi/Wadsworth_Jonathan_D.F._.pdf?issn=09628436&issue=v363i1510&article=3747_rtootpkmabst Jonathan D. F. Wadsworth, Susan Joiner, Jacqueline M. Linehan, Emmanuel A. Asante, Sebastian Brandner and John Collinge, "The origin of the prion agent of kuru: molecular and biological strain typing". "Philosophical Transactions of the Royal Society B". 2008. Volume 363, p. 3747–3753.]

Will, Robert G. "Acquired prion disease: iatrogenic CJD, variant CJD, kuru". British Medical Bulletin, Volume 66, issue 1. (June 2003). p. 255-265.

Fiorino, Anthony S. "Sleep, genes and death: fatal familial insomnia". "Brain Research Reviews". Volume 22, issue 3. (October, 1996). p. 258-264.

Krasnianski, Anna; Bart, Mario; Sanchez Juan, Pascual J.; Heinemann, Uta; Meissner, Bettina; Varges, Daniela; Schulze-Sturm, Ulf; Kretzschmar, Haus A.; Schulz-Schaeffer, Walter J.; Zerr, Inga1. "Fatal familial insomnia: Clinical features and early identification". "Annals of Neurology". Volume 63, issue 5. (May 2008). p. 658 - 661.

[http://journals.ohiolink.edu/ejc/pdf.cgi/Tanaka_Motomasa.pdf?issn=00928674&issue=v121i0001&article=49_mocpt Tanaka, Motomasa; Chien, Peter; Yonekura, Koji; Weissman, Jonathan S. "Mechanism of Cross-Species Prion Transmission: An Infectious Conformation Compatible withTwo Highly Divergent Yeast Prion Proteins". "Cell". Volume 121, issue 1. (April 8, 2005). p. 49-62.]

R. Clarke, Graham S. Jackson, John Collinge, Anthony. "The molecular biology of prion propagation". "Philosophical Transactions: Biological Sciences". Volume 356, issue 1406. (February 28, 2001). p. 185-195.

Omar Lupi. "Could ectoparasites act as vectors for prion diseases?" "International Journal of Dermatology". Volume 42, issue 6. (June 2003). p. 425-429

Edited by student of Joan Slonczewski for BIOL 238 Microbiology, 2009, Kenyon College.