1887

Abstract

Apart from a few cases of iatrogenic and familial human transmissible spongiform encephalopathies (TSEs) or prion diseases, the cause of Creutzfeldt–Jakob disease (CJD) remains unknown. In this paper we investigated the possibility that dental procedures may represent a potential route of infection. This was assessed by using the experimental model of scrapie in hamster. In the first part of this study we found that after intraperitoneal inoculation, oral tissues commonly involved in dental procedures (gingival and pulp tissues) bore a substantial level of infectivity. We also found high scrapie infectivity in the trigeminal ganglia, suggesting that the scrapie agent had reached the oral tissues through the sensitive terminal endings of the trigeminal nerves. In the second part of the study we inoculated a group of hamsters in the tooth pulp and showed that all of them developed scrapie disease. In these animals, we detected both infectivity and the pathological prion protein (PrPsc) in the trigeminal ganglion homolateral to the site of injection but not in the controlateral one. This finding suggests that the scrapie agent, and likely other TSE agents as well, spreads from the buccal tissues to the central nervous system through trigeminal nerves. Although these findings may not apply to humans affected by TSEs, they do raise concerns about the possible risk of transmitting these disorders through dental procedures. Particular consideration should be taken in regard to new variant CJD patients because they may harbour more infectivity in peripheral tissues than sporadic CJD patients.

Loading

Article metrics loading...

/content/journal/jgv/10.1099/0022-1317-80-11-3043
1999-11-01
2020-01-29
Loading full text...

Full text loading...

/deliver/fulltext/jgv/80/11/0803043a.html?itemId=/content/journal/jgv/10.1099/0022-1317-80-11-3043&mimeType=html&fmt=ahah

References

  1. Adams, D. H. & Edgar, W. M. ( 1978; ). Transmission of agent of Creutzfeldt–Jakob disease. British Medical Journal 1, 987.
    [Google Scholar]
  2. Arakawa, K. , Nagara, H. , ltoyama, Y. , Doh-ura, K. , Tomokane, N. , Tateishi, J. & Goto, I. ( 1991; ). Clustering of three cases of Creutzfeldt–Jakob disease near Fukuoka City, Japan. Acta Neurologica Scandinavica 84, 445-447.[CrossRef]
    [Google Scholar]
  3. Baldauf, E. , Beekes, M. & Diringer, H. ( 1997; ). Evidence for an alternative direct route of access for the scrapie agent to the brain bypassing the spinal cord. Journal of General Virology 78, 1187-1197 .
    [Google Scholar]
  4. Beekes, M. , Baldauf, E. & Diringer, H. ( 1996; ). Sequential appearance and accumulation of pathognomonic markers in the central nervous system of hamsters orally infected with scrapie. Journal of General Virology 77, 1925-1934 .[CrossRef]
    [Google Scholar]
  5. Bernoulli, C. , Siegfried, J. , Baumgartner, G. , Regli, F. , Rabinowicz, T. , Gajdusek, D. C. & Gibbs, C. J.Jr ( 1977; ). Danger of accidental person-to-person transmission of Creutzfeldt–Jakob disease by surgery. Lancet 1, 478-479.
    [Google Scholar]
  6. Billette de Villemeur, T. , Deslys, J. P. , Pradel, A. , Soubrie, C. , Alperovitch, A. , Tardieu, M. , Chaussain, J. L. , Hauw, J. J. , Dormont, D. , Ruberg, M. & Agid, Y. ( 1996; ). Creutzfeldt–Jakob disease from contaminated growth hormone extracts in France. Neurology 47, 690-695.[CrossRef]
    [Google Scholar]
  7. Brown, P. ( 1980; ). An epidemiologic critique of Creutzfeldt–Jakob disease. Epidemiologic Reviews 2, 113-135.
    [Google Scholar]
  8. Brown, P. , Gajdusek, D. C. , Gibbs, C. J.Jr & Asher, D. M. ( 1985; ). Potential epidemic of Creutzfeldt–Jakob disease from human growth hormone therapy. New England Journal of Medicine 313, 728-731.[CrossRef]
    [Google Scholar]
  9. Bruce, M. E. , Will, R. G. , lronside, J. W. , McConnell, I. , Drummond, D. , Suttie, A. , McCardie, L. , Chree, A. , Hope, J. , Birkett, C. , Cousens, S. , Fraser, H. & Bostock, C. J. ( 1997; ). Transmissions to mice indicate that ‘new variant’ CJD is caused by the BSE agent. Nature 389, 489-501.[CrossRef]
    [Google Scholar]
  10. Buyukmihci, N. , Goehring Harmon, F. & Marsh, R. F. ( 1983; ). Neural pathogenesis of experimental scrapie after intraocular inoculation of hamsters. Experimental Neurology 81, 396-406.[CrossRef]
    [Google Scholar]
  11. Carp, R. I. ( 1982; ). Transmission of scrapie agent by oral route: effect of gingival scarification. Lancet 16, 170-171.
    [Google Scholar]
  12. Cochius, J. I. , Burns, R. J. , Blumbergs, P. C. , Mack, K. & Alderman, C. P. ( 1990; ). Creutzfeldt–Jakob disease in a recipient of human pituitary- derived gonadotrophin. Australian and New Zealand Journal of Medicine 20, 592-593.[CrossRef]
    [Google Scholar]
  13. Collins, S. , Law, M. G. , Fletcher, A. , Boyd, A. , Kaldor, J. & Masters, C. L. ( 1999; ). Surgical treatment and risk of sporadic Creutzfeldt–Jakob disease: a case-control study. Lancet 353, 693-697.[CrossRef]
    [Google Scholar]
  14. Davanipour, Z. , Alter, M. , Sobel, E. , Asher, D. M. & Gajdusek, D. C. ( 1985; ). Creutzfeldt–Jakob disease: possible medical risk factors. Neurology 35, 1483-1486 .[CrossRef]
    [Google Scholar]
  15. Deslys, J. P. , Jaegly, A. , d’Aignaux, J. H. , Mouthon, F. , Billette de Villemeur, T. & Dormont, D. ( 1998; ). Genotype at codon 129 and susceptibility to Creutzfeldt–Jakob disease. Lancet 351, 1251.
    [Google Scholar]
  16. el Hachimi, K. H. , Chaunu, M. P. , Cervenakova, L. , Brown, P. & Foncin, J. F. ( 1997; ). Putative neurosurgical transmission of Creutzfeldt–Jakob disease with analysis of donor and recipient: agent strains. Comptes Rendus de I’Académie des Sciences. Série III, Sciences de la Vie 320, 319-328.
    [Google Scholar]
  17. Groschup, M. H. , Weiland, F. , Straub, O. C. & Pfaff, E. ( 1996; ). Detection of scrapie agent in the peripheral nervous system of a diseased sheep. Neurobiology of Disease 3, 191-195.[CrossRef]
    [Google Scholar]
  18. Guiroy, D. C. , Shankar, S. K. , Gibbs, C. J.Jr , Messenheimer, J. A. , Das, S. & Gajdusek, D. C. ( 1989; ). Neuronal degeneration and neurofilament accumulation in the trigeminal ganglia in Creutzfeldt–Jakob disease. Annals of Neurology 25, 102-106.[CrossRef]
    [Google Scholar]
  19. Hadlow, W. J. , Kennedy, R. C. , Race, R. E. & Eklund, C. M. ( 1980; ). Virologic and neurohistologic findings in dairy goats affected with natural scrapie. Veterinary Pathology 17, 187-199.
    [Google Scholar]
  20. Hadlow, W. J. , Kennedy, R. C. & Race, R. E. ( 1982; ). Natural infection of Suffolk sheep with scrapie virus. Journal of Infectious Diseases 146, 657-664.[CrossRef]
    [Google Scholar]
  21. Hill, A. F. , Butterworth, R. J. , Joiner, S. , Jackson, G. , Rossor, M. N. , Thomas, D. J. , Frosh, A. , Tolley, N. , Bell, J. E. , Spencer, M. , King, A. , AI-Sarrai, S. , lronside, J. W. , Lantos, P. L. & Collinge, J. ( 1999; ). Investigation of variant Creutzfeldt–Jakob disease with tonsil biopsy samples. Lancet 353, 183-189.[CrossRef]
    [Google Scholar]
  22. Kimberlin, R. H. & Walker, C. A. ( 1977; ). Characteristics of a short incubation model of scrapie in the golden hamster. Journal of General Virology 34, 295-304.[CrossRef]
    [Google Scholar]
  23. Kimberlin, R. H. & Walker, C. A. ( 1979; ). Pathogenesis of mouse scrapie: dynamics of agent replication in spleen, spinal cord and brain after infection by different routes. Journal of Comparative Pathology 89, 551-562.[CrossRef]
    [Google Scholar]
  24. Kimberlin, R. H. & Walker, C. A. ( 1982; ). Pathogenesis of mouse scrapie: patterns of agent replication in different parts of the CNS following intraperitoneal infection. Journal of the Royal Society of Medicine 75, 618-624.
    [Google Scholar]
  25. Kimberlin, R. H. & Walker, C. A. ( 1986; ). Pathogenesis of scrapie (strain 263K) in hamsters infected intracerebrally, intraperitoneally or intraocularly. Journal of General Virology 67, 255-263.[CrossRef]
    [Google Scholar]
  26. Kimberlin, R. H. , Field, H. J. & Walker, C. A. ( 1983a; ). Pathogenesis of mouse scrapie: evidence for spread of infection from central to peripheral nervous system. Journal of General Virology 64, 713-716.[CrossRef]
    [Google Scholar]
  27. Kimberlin, R. H. , Hall, S. M. & Walker, C. A. ( 1983b; ). Pathogenesis of mouse scrapie: evidence for direct neural spread of infection to the CNS after injection of sciatic nerve. Journal of the Neurological Sciences 61, 315-325.[CrossRef]
    [Google Scholar]
  28. Kondo, K. & Kuroiwa, Y. ( 1982; ). A case control study of Creutzfeldt–Jakob disease: association with physical injuries. Annals of Neurology 11, 377-381.[CrossRef]
    [Google Scholar]
  29. Lang, C. J. , Heckmann, J. G. & Neundorfer, B. ( 1998; ). Creutzfeldt–Jakob disease via dural and corneal transplants. Journal of the Neurological Sciences 160, 128-139.[CrossRef]
    [Google Scholar]
  30. McBride, P. A. & Beekes, M. ( 1999; ). Pathological PrP is abundant in sympathetic and sensory ganglia of hamsters fed with scrapie. Neuroscience Letters 265, 135-138.[CrossRef]
    [Google Scholar]
  31. Matthews, W. B. ( 1975; ). Epidemiology of Creutzfeldt–Jakob disease in England and Wales. Journal of Neurology, Neurosurgery and Psychiatry 38, 210-213.[CrossRef]
    [Google Scholar]
  32. Muramoto, T. , Kitamoto, T. , Tateishi, J. & Goto, I. ( 1993; ). Accumulation of abnormal prion protein in mice infected with Creutzfeldt–Jakob disease via intraperitoneal route: a sequential study. American Journal of Pathology 143, 1470-1479 .
    [Google Scholar]
  33. Pocchiari, M. ( 1994; ). Prions and related neurological diseases. Molecular Aspects of Medicine 15, 195-291.[CrossRef]
    [Google Scholar]
  34. Pocchiari, M. , Schmittinger, S. & Masullo, C. ( 1987; ). Amphotericin B delays the incubation period of scrapie in intracerebrally inoculated hamsters. Journal of General Virology 68, 219-223.[CrossRef]
    [Google Scholar]
  35. Pocchiari, M. , Casaccia, P. & Ladogana, A. ( 1989; ). Amphotericin B: a novel class of antiscrapie drug. Journal of Infectious Diseases 160, 795-802.[CrossRef]
    [Google Scholar]
  36. Scott, J. R. & Fraser, H. ( 1989; ). Enucleation after intraocular scrapie injection delays the spread of infection. Brain Research 504, 301-305.[CrossRef]
    [Google Scholar]
  37. van Duijn, C. M. , Delasnerie-Laupretre, N. , Masullo, C. , Zerr, I. , de Silva, R. , Wientjens, D. P. W. M. , Brandel, J.-P. , Weber, T. , Bonavita, V. , Zeidler, M. , Alperovitch, A. , Poser, S. , Granieri, E. , Hofman, A. & Will, R. G. ( 1998; ). Case-control study of risk factors of Creutzfeldt–Jakob disease in Europe during 1993–95. Lancet 351, 1081-1085 .[CrossRef]
    [Google Scholar]
  38. Wells, G. A. H. , Hawkins, S. A. C. , Green, R. B. , Austin, A. R. , Dexter, I. , Spencer, Y. I. , Chaplin, M. J. , Stack, M. J. & Dawson, M. ( 1998; ). Preliminary observations on the pathogenesis of experimental bovine spongiform encephalopathy (BSE): an update. Veterinary Record 142, 103-106.[CrossRef]
    [Google Scholar]
  39. Will, R. G. ( 1996; ). Surveillance of prion diseases in humans. In Methods in Molecular Medicine. Prion Diseases, pp. 119-137. Edited by H. F. Baker & R. M. Ridley. Totowa, New Jersey: Humana Press.
  40. Will, R. G. & Matthews, W. B. ( 1982; ). Evidence for case-to- case transmission of Creutzfeldt–Jakob disease. Journal of Neurology, Neurosurgery and Psychiatry 45, 235-238.[CrossRef]
    [Google Scholar]
  41. Will, R. G. , lronside, J. W. , Zeidler, M. , Cousens, S. N. , Estibeiro, K. , Alperovitch, A. , Poser, S. , Pocchiari, M. , Hofman, A. & Smith, P. G. ( 1996; ). A new variant of Creutzfeldt–Jakob disease in the UK. Lancet 347, 921-925.[CrossRef]
    [Google Scholar]
  42. Xi, Y. G. , Cardone, F. & Pocchiari, M. ( 1994; ). Detection of proteinase-resistant protein (PrP) in small brain tissue samples from Creutzfeldt–Jakob disease patients. Journal of the Neurological Sciences 124, 171-173.[CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jgv/10.1099/0022-1317-80-11-3043
Loading
/content/journal/jgv/10.1099/0022-1317-80-11-3043
Loading

Data & Media loading...

Most cited articles

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error