Surprising Role of Prions in Neurodegenerative Diseases




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Prions are infectious agents, but of a very unusual kind. Technically, they are just proteins with an incorrectly folded conformation. However, there is a major difference between just any misfolded proteins (which are common in nature) and prions.

A prion, once it enters an organism, serves as a template for converting the normally folded proteins of the same kind into the alternative conformation. The process is self-propagating and results in a chain reaction, leading to conversion of a significant number of normal, functional proteins into an abnormal form. This new structure is usually extremely stable and tends to accumulate in the form of various insoluble agglomerates. This can have various negative consequences, depending on the nature of a particular prion.

The idea that an infectious agent might contain no genetic material in the form of DNA or RNA remained, for very long time, a controversial and hotly debated topic. Much of the publicity associated with prions came from the fact that the first (and so far the only) prion-transferred human infectious disease, kuru, was found among several tribes in Papua New Guinea and was clearly linked to the cannibalistic rituals. Kuru turned out to be closely related to the rare Creutzfeldt-Jakob Disease (CJD) and most likely originated from a sporadic case of this disease in early 1900s. Persistent failure to find any usual infectious agents led to the speculations that disease is transferred by proteins. This hypothesis was eventually confirmed with identification and characterization of the specific prion capable of self-proliferation by changing the conformation of normal cellular proteins of the same sequence.

The ability of prions to change the conformation of normal proteins means that, in the absence of counteracting processes, it would be enough to “seed” the environment with a prion to eventually cause the conversion of all available prion precursors into prions. This is exactly what happens in kuru, as well as in bovine spongiform encephalopathy (better known as BSE or “mad cow” disease) that can cross the species boundary and infect humans.

For very long time, the existence of prions and associated conditions was treated as a scientific curiosity with very little significance to broader health issues. This has changed dramatically in the last few years. It turned out that prions and prion-like molecules are extremely relevant to some of the most common neurodegenerative disorders among humans.

Prions have offered surprising and unexpected explanations to the development of such conditions as Alzheimer’s disease, Parkinson’s disease, motor neuron disease and many related syndromes. Thanks to this new understanding of the role of prion-like proteins, a profound change in the way we think about the nature of neurodegenerative diseases has taken place in the recent years.

Although prion-like molecules in human brain disorders do not act as infectious agents, they are capable of freely moving from one neuron to another and thus propagating through the neuronal networks – eventually affecting vast areas of brain. The initial formation and consequent propagation of prions can be helped by certain genetic alterations, which are linked to the earlier onset of the diseases.

Alzheimer’s disease is the most common case of dementia among humans. Brain cells get lost and some regions of cerebral cortex shrink in size as the disease progresses. Classical hallmarks of Alzheimer’s disease – amyloid plaques and neurofibrillary tangles – are typically observed in the brain of patients with this condition.

Amyloid plaques consisting of insoluble agglomerates of beta-amyloid peptide are one of the most obvious features of the disease. Recent research findings demonstrate that the seeds of incorrectly folded beta-amyloid peptides can be transferred from one neuron to another, thus causing progression of the disease.

Neurofibrillary tangles are also observed in Alzheimer’s patients, as well as in multiple tauopathies. Their density and pattern of distribution correlate closely with the stages of disease progression. Neurofibrillary tangles are formed inside the neurons and consist of insoluble twisted fibers of modified protein tau. Normal function of the tau protein is stabilization of microtubules. The latter are key components of cytoskeleton and provide a transportation system inside the cells. They are vital for transporting various molecules between different parts of neuron. Incorrectly folded tau, however, precipitates inside the cell and disrupts the transportation system. Again, like in the case of beta-amyloid, the seeds of misfolded tau proteins can be transferred between neurons.

It seems that acquiring the wrong form of beta-amyloid peptide or tau protein by the cell through one or another mechanism initiates the process of conversion of soluble proteins into insoluble aggregates, leading to damage to the brain functions in general.

In Parkinson’s disease, the most distinctive pathological feature is the formation of so-called Lewy bodies. They consist mostly of protein called alpha-synuclein. Lewy bodies gradually spread from brainstem to forebrain resulting in the progressive loss of various brain functions. Similar to beta-amyloid and tau proteins, alpha-synuclein forms insoluble polymeric agglomerates. The normal function of alpha-synuclein is not fully understood, although it is known to be important for the development of normal cognitive functions. Once a misfolded form of alpha-synuclein is formed, it can spread from one neuron to another, acting as “seeds” that eventually affect most of the interconnected cells.

Motor neuron disease, which is characterized by muscle atrophy, progressive weakness and difficulties in speaking, breathing and swallowing, is caused by degeneration of upper and lower motor neurons. Although the initial cause of motor neuron disease is unknown, the growing evidence points to the self-propagation of two other prion-like misfolded proteins, superoxide dismutase 1 (SOD1) and DNA/RNA-binding protein TDP-43, as major factors in the development and progression of this condition. Both SOD1 and TDP-43 are capable of participating in seeded aggregation, spreading from cell to cell after an initiating event.

It seems that most neurodegenerative conditions involve one or another type of proteins in misfolded alternative conformation that are capable of self-propagation by changing conformations of normally folded native analogues.

These prion-like misfolded conformations are capable to self-aggregation into various insoluble polymeric complexes clearly visible in or around the affected brain cells. The self-propagation of misfolded proteins depletes the cellular stock of normally folded proteins and therefore must, in one way or another, affect the normal functions of the cells. The accumulation of agglomerates themselves can also have detrimental effect on the cell functioning.

In most cases, the nature of the initial event that leads to misfolding of proteins and formation of seeds remains obscure. It is clear that genetic alterations play a role in only around 10 per cent of all neurodegenerative diseases. Sporadic cases may be initiated by various events which may include environmental factors, trauma, or other diseases. The incidence of these conditions increases with the age, thus indicating that cellular events associated with aging play a central role in the initiating process.

The mechanism of how prions spread from one neuron to another remains insufficiently studied. A number of possibilities are discussed in the literature but definite proofs still need to materialize. It appears that prion-like molecules spread via neuronal pathways using the existing connections between cells. As a result, the location of initial event dictates the pattern of disease spreading that happens at later stages.

The absence of adequate treatments for neurodegenerative diseases is tragic. Despite many decades of research, no drugs with even moderate positive effects have so far been introduced. Arguably, the reason for the lack of treatment lies in the fact that researchers have tried to use the wrong targets in previous drug development programs. Considering our new findings about the role of prions, many previous attempts to develop treatments seem ill-positioned.

Our new understanding about the role of prions points to novel therapeutic approaches. They include pharmaceutical interventions aimed at lowering the level of prion precursor protein, inhibiting prion formation, or accelerating the clearance of prions.

Lots of questions related to the development of neurodegenerative diseases still remain unanswered. However, the prion theory provides much needed clarity in our understanding of these diseases’ progression. Clear understanding of the importance of prion-like proteins in the mechanisms and development of various brain disorders have allowed us, for the first time, to have a clearer view on how to develop effective drugs.

References

Armstrong RA (2013). What causes alzheimer’s disease? Folia neuropathologica / Association of Polish Neuropathologists and Medical Research Centre, Polish Academy of Sciences, 51 (3), 169-88 PMID: 24114635

Braak H, Alafuzoff I, Arzberger T, Kretzschmar H, & Del Tredici K (2006). Staging of Alzheimer disease-associated neurofibrillary pathology using paraffin sections and immunocytochemistry. Acta neuropathologica, 112 (4), 389-404 PMID: 16906426

Braak H, Brettschneider J, Ludolph AC, Lee VM, Trojanowski JQ, & Del Tredici K (2013). Amyotrophic lateral sclerosis–a model of corticofugal axonal spread. Nature reviews. Neurology, 9 (12), 708-14 PMID: 24217521

Fernández-Borges N, Eraña H, Elezgarai SR, Harrathi C, Gayosso M, & Castilla J (2013). Infectivity versus Seeding in Neurodegenerative Diseases Sharing a Prion-Like Mechanism. International journal of cell biology, 2013 PMID: 24187553

Goedert M, Clavaguera F, & Tolnay M (2010). The propagation of prion-like protein inclusions in neurodegenerative diseases. Trends in neurosciences, 33 (7), 317-25 PMID: 20493564

Goedert M, Spillantini MG, Del Tredici K, & Braak H (2013). 100 years of Lewy pathology. Nature reviews. Neurology, 9 (1), 13-24 PMID: 23183883

Irwin DJ, White MT, Toledo JB, Xie SX, Robinson JL, Van Deerlin V, Lee VM, Leverenz JB, Montine TJ, Duda JE, Hurtig HI, & Trojanowski JQ (2012). Neuropathologic substrates of Parkinson disease dementia. Annals of neurology, 72 (4), 587-98 PMID: 23037886

Kokhan VS, Afanasyeva MA, & Van’kin GI (2012). ?-Synuclein knockout mice have cognitive impairments. Behavioural brain research, 231 (1), 226-30 PMID: 22469626

Münch C, O’Brien J, & Bertolotti A (2011). Prion-like propagation of mutant superoxide dismutase-1 misfolding in neuronal cells. Proceedings of the National Academy of Sciences of the United States of America, 108 (9), 3548-53 PMID: 21321227

Prusiner SB (2012). Cell biology. A unifying role for prions in neurodegenerative diseases. Science (New York, N.Y.), 336 (6088), 1511-3 PMID: 22723400

Prusiner SB (2013). Biology and genetics of prions causing neurodegeneration. Annual review of genetics, 47, 601-23 PMID: 24274755

Spillantini MG, & Goedert M (2013). Tau pathology and neurodegeneration. Lancet neurology, 12 (6), 609-22 PMID: 23684085

Steiner JA, Angot E, & Brundin P (2011). A deadly spread: cellular mechanisms of ?-synuclein transfer. Cell death and differentiation, 18 (9), 1425-33 PMID: 21566660

Volpicelli-Daley LA, Luk KC, Patel TP, Tanik SA, Riddle DM, Stieber A, Meaney DF, Trojanowski JQ, & Lee VM (2011). Exogenous ?-synuclein fibrils induce Lewy body pathology leading to synaptic dysfunction and neuron death. Neuron, 72 (1), 57-71 PMID: 21982369

Image via Petarg / Shutterstock.

  • Ed Gehrman

    The PROBLEM with most Government and University informational websites is that no attempt is made to critique the research reports, making it impossible for others to understand the significance of these data. There is much controversy regarding the causality of TSEs. Our research shows that prion amyloid (the TSE research focus for the past 30 years) is the result of a bacterial infection. This controversy directly reflects on Louis Pasteur’s efforts to prove that replicating crystals are not the cause of infectious disease, but instead bacteria are the culprits. Too bad we have to rehash this controversy.

    The SOLUTION is to set out a new course for TSE research. Here we present data showing involvement of spiroplasma, a tiny wall-less bacterium, in the pathogenesis of TSEs. Spiroplasma are consistently associated with the TSEs, and experimental spiroplasmosis in animals shows remarkable clinical and pathological similarities to naturally occurring TSEs. A novel spiroplasma species has been isolated into cell-free media from all forms of TSE. Recent breakthrough research shows that this bacterium induces biofilm and becomes buried in a polysaccharide (complex sugar) matrix wherein the organism is resistant to physical and chemical treatments consistent with TSE. (Dr. Frank Bastian)

  • MOIPONE

    Since Prisons have negative impacts to the prisoners’ health, why can’t they just be closed? i know they are there to control crime but is it a good thing that when some people come out of prison, they have some diseases? the assumption is that someone from prison has repent, and his/her family is just looking forward to start a knew chapter with him/her,and live as a happy family but instead of having a good time with that person, they have to work on that individual’s health, having to spend trying to provide medication

    • D

      What are you talking about? This makes no sense.

  • Terry S. Singeltary Sr.

    Friday, April 25, 2014

    Accuracy of administrative diagnostic data for pathologically confirmed cases of Creutzfeldt-Jakob disease in Massachusetts, 2000-2008

    Article in Press

    http://creutzfeldt-jakob-disease.blogspot.com/2014/04/accuracy-of-administrative-diagnostic.html

    kind regards,
    terry

  • Charl Rautenbach

    Great article…. I love the way how these prions work…. And how they affect neurons and causing diseases that degenerate the brain and causing problems.. I wish one day that they will find a cure for alzheimer’s disease.

Viatcheslav Wlassoff, PhD

Viatcheslav Wlassoff, PhD, is a scientific and medical consultant with experience in pharmaceutical and genetic research. He has an extensive publication history on various topics related to medical sciences. Dr. Wlassoff runs consulting service specialized on preparation of scientific publications, medical and scientific writing and editing.
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