TY  - JOUR
T1  - EValuation of potential infectivity of alzheimer and parkinson disease proteins in recipients of cadaver-derived human growth hormone
AU  - Irwin DJ, Abrams JY, Schonberger LB, et al
Y1  - 2013/04/01
N1  - 10.1001/jamaneurol.2013.1933
JO  - JAMA Neurology
SP  - 462
EP  - 468
VL  - 70
IS  - 4
N2  - Importance 
                  Growing evidence of cell-to-cell transmission of neurodegenerative disease (ND)–associated proteins (NDAPs) (ie, tau, Aβ, and α-synuclein) suggests possible similarities to the infectious prion protein (PrPsc) in spongiform encephalopathies. There are limited data on the potential human-to-human transmission of NDAPs associated with Alzheimer disease (AD) and other non-PrPsc ND.Objective 
                  To examine evidence for human-to-human transmission of AD, Parkinson disease (PD), and related NDAPs in cadaveric human growth hormone (c-hGH) recipients.Design 
                  We conducted a detailed immunohistochemical analysis of pathological NDAPs other than PrPsc in human pituitary glands. We also searched for ND in recipients of pituitary-derived c-hGH by reviewing the National Hormone and Pituitary Program (NHPP) cohort database and medical literature.Setting 
                  University-based academic center and agencies of the US Department of Health and Human Services.Participants 
                  Thirty-four routine autopsy subjects (10 non-ND controls and 24 patients with ND) and a US cohort of c-hGH recipients in the NHPP.Main Outcome Measures 
                  Detectable NDAPs in human pituitary sections and death certificate reports of non-PrPsc ND in the NHPP database.Results 
                  We found mild amounts of pathological tau, Aβ, and α-synuclein deposits in the adeno/neurohypophysis of patients with ND and control patients. No cases of AD or PD were identified, and 3 deaths attributed to amyotrophic lateral sclerosis (ALS) were found among US NHPP c-hGH recipients, including 2 of the 796 decedents in the originally confirmed NHPP c-hGH cohort database.Conclusions and Relevance 
                  Despite the likely frequent exposure of c-hGH recipients to NDAPs, and their markedly elevated risk of PrPsc-related disease, this population of NHPP c-hGH recipients does not appear to be at increased risk of AD or PD. We discovered 3 ALS cases of unclear significance among US c-hGH recipients despite the absence of pathological deposits of ALS-associated proteins (TDP-43, FUS, and ubiquilin) in human pituitary glands. In this unique in vivo model of human-to-human transmission, we found no evidence to support concerns that NDAPs underlying AD and PD transmit disease in humans despite evidence of their cell-to-cell transmission in model systems of these disorders. Further monitoring is required to confirm these conclusions.
SN  - 2168-6149
M3  - doi: 10.1001/jamaneurol.2013.1933
UR  - http://dx.doi.org/10.1001/jamaneurol.2013.1933
ER  -