Transmission properties of atypical Creutzfeldt-Jakob disease: A clue to disease etiology?

Atsushi Kobayashi, Piero Parchi, Masahito Yamada, Paul Brown, Daniela Saverioni, Yuichi Matsuura, Atsuko Takeuchi, Shirou Mohri, Tetsuyuki Kitamoto

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)


The genotype at polymorphic codon 129 of the PRNP gene has a profound influence on both phenotypic expression and prion strain susceptibility in humans. For example, while the most common sporadic Creutzfeldt-Jakob disease (CJD) subtype, sporadic CJD-MM1 (M1 strain), induces a single phenotype after experimental transmission regardless of the codon 129 genotype of the recipient animal, the phenotype elicited by sporadic CJD-VV2 (V2 strain), the second most common subtype, varies according to the host codon 129 genotype. In particular, the propagation of the V2 strain in codon 129 methionine homozygotes has been linked only to acquired forms of CJD such as plaque-type dura mater graft-associated CJD (dCJD), a subgroup of iatrogenic CJD with distinctive phenotypic features, but has never been observed in sporadic CJD cases. In the present report, we describe atypical CJD cases carrying codon 129 methionine homozygosity, in a neurosurgeon and in a patient with a medical history of neurosurgery without dural grafting, showing the distinctive phenotypic features and transmission properties of plaque-type dCJD. These findings raise the possibility that the two cases, previously thought to represent sporadic CJD, might actually represent acquired CJD caused by infection with the V2 strain. Thus, careful analyses of phenotypic features and transmission properties in atypical cases may be useful to distinguish acquired from sporadic cases of CJD.

Original languageEnglish
Pages (from-to)3939-3946
Number of pages8
JournalJournal of Virology
Issue number7
Publication statusPublished - 2015


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