1. Medicine
  2. Neuroscience
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PMCA generated prions from the olfactory mucosa of patients with Fatal Familial Insomnia cause prion disease in mice

  1. Edoardo Bistaffa
  2. Alba Marín Moreno
  3. Juan Carlos Espinosa
  4. Chiara Maria Giulia De Luca
  5. Federico Angelo Cazzaniga
  6. Sara Maria Portaleone
  7. Luigi Celauro
  8. Giuseppe Legname
  9. Giorgio Giaccone
  10. Juan Maria Torres
  11. Fabio Moda  Is a corresponding author
  1. Fondazione IRCCS Istituto Neurologico Carlo Besta, Italy
  2. Centro de Investigación en Sanidad Animal (CISA-INIA), Spain
  3. ASST Santi Paolo e Carlo Università Degli Studi di Milano, Italy
  4. Scuola Internazionale Superiore Di Studi Avanzati (SISSA), Italy
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Cite this article as: eLife 2021;10:e65311 doi: 10.7554/eLife.65311

Abstract

Background: Fatal Familial Insomnia (FFI) is a genetic prion disease caused by the D178N mutation in the prion protein gene (PRNP) in coupling phase with methionine at PRNP 129. In 2017, we have shown that the olfactory mucosa (OM) collected from FFI patients contained traces of PrPSc detectable by Protein Misfolding Cyclic Amplification (PMCA).

Methods In this work, we have challenged PMCA generated products obtained from OM and brain homogenate of FFI patients in BvPrP-Tg407 transgenic mice expressing the bank vole prion protein to test their ability to induce prion pathology.

Results: All inoculated mice developed mild spongiform changes, astroglial activation and PrPSc deposition mainly affecting the thalamus. However, their neuropathological alterations were different from those found in the brain of BvPrP-Tg407 mice injected with raw FFI brain homogenate.

Conclusions: Although with some experimental constraints, we show that PrPSc present in OM of FFI patients is potentially infectious.

Funding: This work was supported in part by the Italian Ministry of Health (GR-2013-02355724 and Ricerca Corrente), MJFF, ALZ, Alzheimer's Research UK and the Weston Brain Institute (BAND2015), and Euronanomed III (Speedy) to FM; by the Spanish Ministerio de Economía y Competitividad [grant AGL2016-78054-R (AEI/FEDER, UE)] to J.M.T. and J.C.E.; A.M.-M. was supported by a fellowship from the INIA (FPI-SGIT-2015-02).

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All data generated or analyzed during this study are included in the manuscript.

Article and author information

Author details

  1. Edoardo Bistaffa

    Division of Neurology 5 and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
    Competing interests
    The authors declare that no competing interests exist.
  2. Alba Marín Moreno

    Centro de Investigación en Sanidad Animal (CISA-INIA), Centro de Investigación en Sanidad Animal (CISA-INIA), Valdeolmos (Madrid), Spain
    Competing interests
    The authors declare that no competing interests exist.
  3. Juan Carlos Espinosa

    Centro de Investigación en Sanidad Animal (CISA-INIA), Centro de Investigación en Sanidad Animal (CISA-INIA), Valdeolmos (Madrid), Spain
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-6719-9902
  4. Chiara Maria Giulia De Luca

    Division of Neurology 5 and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
    Competing interests
    The authors declare that no competing interests exist.
  5. Federico Angelo Cazzaniga

    Division of Neurology 5 and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
    Competing interests
    The authors declare that no competing interests exist.
  6. Sara Maria Portaleone

    Department of Health Sciences, Otolaryngology Unit, ASST Santi Paolo e Carlo Università Degli Studi di Milano, Milan, Italy
    Competing interests
    The authors declare that no competing interests exist.
  7. Luigi Celauro

    Department of Neuroscience, Laboratory of Prion Biology, Scuola Internazionale Superiore Di Studi Avanzati (SISSA), Trieste, Italy
    Competing interests
    The authors declare that no competing interests exist.
  8. Giuseppe Legname

    Department of Neuroscience, Laboratory of Prion Biology, Scuola Internazionale Superiore Di Studi Avanzati (SISSA), Trieste, Italy
    Competing interests
    The authors declare that no competing interests exist.
  9. Giorgio Giaccone

    Division of Neurology 5 and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
    Competing interests
    The authors declare that no competing interests exist.
  10. Juan Maria Torres

    Centro de Investigación en Sanidad Animal (CISA-INIA), Centro de Investigación en Sanidad Animal (CISA-INIA), Valdeolmos (Madrid), Spain
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-0443-9232
  11. Fabio Moda

    Division of Neurology 5 and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
    For correspondence
    Fabio.Moda@istituto-besta.it
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-2820-9880

Funding

Ministero della Salute (GR-2013-02355724)

  • Fabio Moda

Ministero della Salute (Ricerca Corrente)

  • Fabio Moda

MJFF, ALZ, Alzheimer's Research UK and the Weston Brain Institute (BAND2015)

  • Fabio Moda

Euronanomed III (Speedy)

  • Fabio Moda

Spanish Ministerio de Economia y Competitividad (AGL2016-78054-R (AEI/FEDER,UE))

  • Juan Maria Torres

INIA (Fellowship FPI-SGIT-2015-02)

  • Alba Marín Moreno

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Ethics

Animal experimentation: We conducted animal experiments in accordance with the Code for Methods and Welfare Considerations in Behavioural Research with Animals (Directive 2010/63/EU) and made every effort to minimize suffering. Experiments developed in Centro de Investigación en Sanidad Animal-Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (Madrid, Spain) were evaluated by the Committee on the Ethics of Animal Experiments of the Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria and approved by the General Directorate of the Madrid Community Government (permit no. PROEX 263-15)

Human subjects: Written informed consent for participation in research and all procedures for sample collection and experimental studies were in accordance with the 1964 Declaration of Helsinki and its later amendments and were approved by the Ethical Committee of "Fondazione IRCCS Istituto Neurologico Carlo Besta" (Milan, Italy).

Reviewing Editor

  1. J Paul Taylor, St Jude Children's Research Hospital, United States

Publication history

  1. Received: November 30, 2020
  2. Accepted: April 13, 2021
  3. Accepted Manuscript published: April 14, 2021 (version 1)
  4. Version of Record published: April 23, 2021 (version 2)

Copyright

© 2021, Bistaffa et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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    Background:

    It remains unclear whether combination antiretroviral therapy (ART) regimens differ in their ability to fully suppress human immunodeficiency virus (HIV) replication. Here, we report the results of two cross-sectional studies that compared levels of cell-associated (CA) HIV markers between individuals receiving suppressive ART containing either a non-nucleoside reverse transcriptase inhibitor (NNRTI) or a protease inhibitor (PI).

    Methods:

    CA HIV unspliced RNA and total HIV DNA were quantified in two cohorts (n = 100, n = 124) of individuals treated with triple ART regimens consisting of two nucleoside reverse transcriptase inhibitors (NRTIs) plus either an NNRTI or a PI. To compare CA HIV RNA and DNA levels between the regimens, we built multivariable models adjusting for age, gender, current and nadir CD4+ count, plasma viral load zenith, duration of virological suppression, NRTI backbone composition, low-level plasma HIV RNA detectability, and electronically measured adherence to ART.

    Results:

    In both cohorts, levels of CA HIV RNA and DNA strongly correlated (rho = 0.70 and rho = 0.54) and both markers were lower in NNRTI-treated than in PI-treated individuals. In the multivariable analysis, CA RNA in both cohorts remained significantly reduced in NNRTI-treated individuals (padj = 0.02 in both cohorts), with a similar but weaker association between the ART regimen and total HIV DNA (padj = 0.048 and padj = 0.10). No differences in CA HIV RNA or DNA levels were observed between individual NNRTIs or individual PIs, but CA HIV RNA was lower in individuals treated with either nevirapine or efavirenz, compared to PI-treated individuals.

    Conclusions:

    All current classes of antiretroviral drugs only prevent infection of new cells but do not inhibit HIV RNA transcription in long-lived reservoir cells. Therefore, these differences in CA HIV RNA and DNA levels by treatment regimen suggest that NNRTIs are more potent in suppressing HIV residual replication than PIs, which may result in a smaller viral reservoir size.

    Funding:

    This work was supported by ZonMw (09120011910035) and FP7 Health (305522).