NR ADVJ
AU Evans,D.J.
TI Diagnosis of new variant Creutzfeldt-Jakob disease by tonsil biopsy
QU Lancet 1997 May 3; 349(9061): 1323
PT letter
VT
Sir - The title used by Hill and colleagues[1] somewhat oversells their findings because they report protease-resistant prion protein (PrP) in tonsillar tissue obtained in a single necropsy case. The frequency of tonsillar positivity and its temporal relation to brain disease is not yet established, though it is true that Schreuder's work[2] shows that in sheep with scrapie tonsillar involvement occurs during the early stages of the disease.
The presence of PrP antigen in lymphoid follicles is of interest; it would have been useful to confirm by a monoclonal antibody that the dendritic reticulum cells were involved. As the investigators must be aware, dendritic reticulum cells are present in various sites, but are conspicuously absent from the central nervous system. Thus, direct migration of these cells is unlikely. They are however noted scavengers of circulating antigen, which raises the question of whether antigen is present in the blood. Now that a monoclonal antibody technology for PrP is available, examination of the immunohistochemistry of other sites that contain dendritic reticulum cells is needed.
David J Evans
Imperial College School of Medicine at St Mary's, London W2 1PG, UK
1 Hill AF, Zeidler M, Ironside J, Collinge J. Diagnosis of new variant Creutzfeldt-Jakob disease by tonsil biopsy. Lancet 1997; 349: 99-100.
2 Schreuder BEC, van Keulen LJM, Vromans MEW, Langeveld JPM, Smits MA. Preclnical test for prion diseases. Nature 1996; 381: 563.
ZR 2
MH Biopsy; Creutzfeldt-Jakob Syndrome/*diagnosis; Human; Prions/*analysis; Tonsil/*pathology
SP englisch
PO England
OR Prion-Krankheiten 3