Prion Pathology (Symptoms, etc.)
The main differences in terms of pathology between the normal prion protein form PrPC and the diseased form PrPSc is that the Scrapie form is resistant to cellular processes that were supposed to break down this protein and remove it from the body. This resulted in having no way to get rid of / recycle this protein and it ended up being accumulated in the brain of patients with a prion disease.
There have been many other terms for these accumulations of prion proteins in the brain. Sometimes theyâve been called amyloid plaques. These amyloid plaques are clumps / aggregates of proteins that are very resistant to breakdown and removal. Other neurodegenerative disease have also identified plaques consisting of misfolded proteins, such as in Alzheimerâs disease, and also in normal aging brains. However these diseases have plaques made from proteins other than the PrP protein. This just means that the PrP protein is probably the first well-studied prion disease but many other proteins in the brain may behave similarly.
When you look at prion diseased tissues through a microscope, there are two distinct forms you could see. The spongiform encephalopathies are clusters of vacuoles that look like a bunch of empty bubbles smushed together. There are also clusters of prions, such as in kuru plaques (kuru is another prion disease). These appear like a bunch of dark dots gathered in one area.
Since prions affect the brain, prion diseases are essentially diseases of the central nervous system. In kuru disease, the symptoms include trembling, difficulty walking, trouble with bodily coordination, dementia, etc. All of these result from faults in the brain which is your area of motor control. The symptoms in Creutzfeld-Jakob Disease (a rare type of human dementia) and Gerstmann-Straussler disease are also attributed to prions.
In sheep infected with Scrapie disease, the sheep scrape their wool against the fences. This disease is also caused by prions like weâve mentioned before. However, as of now, there is not enough research yet to firmly conclude that diseases such as Alzheimerâs with symptoms of dementia, lack of coordination, difficulty walking and other movements resulting in death, is necessarily caused by prions. They are probably involved though. The same goes for Parkinsonâs disease which has symptoms like ganglion cell destruction, neurofibrillary degeneration, and dementia. Another neurodegenerative disease with similar symptoms is Amyotrophic Lateral Sclerosis (ALS), which results from the destruction of motor neurons.
Since these diseases all have similar pathology and clinical signs, it is possible that theyâre all related, or even variants of the same disorder. All the pathological features (disease manifestations) are in the central nervous system, and we know that prion proteins are selective for the central nervous system and accumulate in CNS nerve cells. For PrPSc, it accumulates in the neurophil. This causes astrocyte gliosis (increase in # of astrocytes, which is a star-shaped glial cell), depletion of dendritic spines in neurons (neurons are less interconnected, probably canât receive signals from other neurons as effectively), and the formation of vacuoles in the cerebellar cortex. These vacuoles are essentially empty holes in the brain that we call spongiform encephalopathies. The scrapie prion protein also causes amyloidosis, which is the increase of amyloid in the cerebellar cortex, thalamus, brain stem, and lumen of blood vessels found in the brain. Amyloids are aggregates (groups) of proteins that stick together. These amyloid plaques are eosinophilic, meaning that they can be stained by eosin in experiments and then subsequently visualized. The plaques often have amyloid fibrils radiating out at the sides. The amyloid fibrils are still just collections of proteins but they take on a ore stringy structure instead of being a large chunk. The plaques are subependymal, subpial, and perivascular (the first two mean that the position of these protein plaques in the brain are under the ependyma which is a thing in the brain, and also under the pia mater which is also another part of the brain. Perivascular means that itâs usually found around the blood vessels).
One huge difference between prion disease pathology and virus pathology is that prion diseases do not result in any inflammation of fever! This is very important, because fever and inflammation only occur as a result of the immune system going into action. This means that the immune system is not responding to these prion proteins. This makes sense when you think about it, because diseased prion proteins are derived from normal proteins that result from everybodyâs genome.
The symptoms of prion disease also result from the disease pathology described above. There is a long incubation period of several years, which has been coined a âslow infectionâ. There is also loss of or abnormal function in the cerebellum, resulting in difficulty walking and loss of muscle coordination. Dementia also results later on, which involves loss of memory, diminished intellect, and poor judgment. Patients may also see progressive insomnia with either reduction or loss of the slow-wave and rapid-eye-movement phases in sleep.
Here are some quick examples of prion diseases. Thereâs scrapie which infects sheep and goats, and itâs transmitted from sheep to other genetically susceptible sheep. Transmissible Mink Encephalopathy (TME) infects Mink, and they get it from sheep or cattle with a prion disease. Chronic wasting disease is present in mule, deer, and elk, and right now we donât know how they get it. Bovine Spongiform Encephalopathy (BSE) infects cattle, and they get it through eating prion-contaminated feed (usually bonemeal, i.e. ground bones from infected sheep which are put into their feed in order to give them more protein to grow etc.). In humans, there is kuru disease which is a prion disease that transmits in certain tribes due to them having rituals where they cannibalize deceased relatives and tribe members in order to let them move on in peace. Other human diseases are Creutzfeld-Jakob disease (CJD), Gerstmann-Straussler Syndrome (GSS), and Fatal Familial Insomnia (FFI), which result from a germline mutation in the PrP gene (i.e. passed on genetically). Then thereâs the variant form of Creutzfeld-Jakob Disease (vCJD) in humans which is believed to be transmitted through eating infected beef.