Higher numbers than previously predicted could be incubating vCJD
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《英国医生杂志》
More people in the United Kingdom than previously thought could be incubating the variant Creutzfeldt-Jakob disease (vCJD), suggests new research.
An analysis of nearly 13 000 anonymised appendix and tonsil samples has found that prion proteins associated with vCJD had accumulated in three of them.
However, only one of the samples showed a pattern of prion accumulation that resembled that seen in tissue of known vCJD cases. The other two had different patterns of accumulation and their significance is uncertain, although they cannot be dismissed as unimportant, say researchers.
Extrapolating these findings to the UK population most at risk of developing vCJD—those aged between 10 and 30 years—the researchers estimate that 237 people in every million, or a total of 3808 people - could potentially be carrying markers for the disease (95% CI, 49-692 per million).
The study was published online as "early view" paper (ahead of the printed version) on 21 May in the Journal of Pathology (doi: 10.1002/path.1580; www.interscience.wiley.com/thejournalofpathology).
If these estimates are verified in further studies, they would indicate a bigger epidemic of vCJD than that suggested by the most recent predictions, which have been based on clinical cases.
Up until March 2004 there had been 146 confirmed and probable cases of vCJD in the United Kingdom, six cases in France, and one in each of Canada, Hong Kong, the Irish Republic, Italy, and the United Sates.
Based on these figures, scientists have estimated that any vCJD epidemic in the United Kingdom will be relatively small, with about 540 future cases.
However, Dr David Hilton, consultant histopathologist at Derriford Hospital in Plymouth and lead author of the study, sounded a note of caution when interpreting the findings because of the uncertain clinical implications of the different prion patterns found.
"Our findings need to be interpreted with caution but cannot be discounted," said Dr Hilton. "There is still much to learn about vCJD, and presence of the protein in these tissue samples does not necessarily mean that those affected will go on to develop vCJD. It is important that we clarify the significance of these findings by prospective screening of fresh tonsillectomy tissue."
A larger scale study on 80 000 to 100 000 fresh tonsils would allow more definitive tests to be done that would provide clear cut results, he said.
The National Anonymous Tonsil Archive, set up by the Health Protection Agency last year, hopes to collect in the region of 100 000 tonsils over the next three years to provide the data to be informative, said Dr Hilton.
Dr Hilton and colleagues conclude in their paper that: "Although the numbers of cases are currently in decline, the possibility of further rises cannot be excluded."(London Zosia Kmietowicz)
An analysis of nearly 13 000 anonymised appendix and tonsil samples has found that prion proteins associated with vCJD had accumulated in three of them.
However, only one of the samples showed a pattern of prion accumulation that resembled that seen in tissue of known vCJD cases. The other two had different patterns of accumulation and their significance is uncertain, although they cannot be dismissed as unimportant, say researchers.
Extrapolating these findings to the UK population most at risk of developing vCJD—those aged between 10 and 30 years—the researchers estimate that 237 people in every million, or a total of 3808 people - could potentially be carrying markers for the disease (95% CI, 49-692 per million).
The study was published online as "early view" paper (ahead of the printed version) on 21 May in the Journal of Pathology (doi: 10.1002/path.1580; www.interscience.wiley.com/thejournalofpathology).
If these estimates are verified in further studies, they would indicate a bigger epidemic of vCJD than that suggested by the most recent predictions, which have been based on clinical cases.
Up until March 2004 there had been 146 confirmed and probable cases of vCJD in the United Kingdom, six cases in France, and one in each of Canada, Hong Kong, the Irish Republic, Italy, and the United Sates.
Based on these figures, scientists have estimated that any vCJD epidemic in the United Kingdom will be relatively small, with about 540 future cases.
However, Dr David Hilton, consultant histopathologist at Derriford Hospital in Plymouth and lead author of the study, sounded a note of caution when interpreting the findings because of the uncertain clinical implications of the different prion patterns found.
"Our findings need to be interpreted with caution but cannot be discounted," said Dr Hilton. "There is still much to learn about vCJD, and presence of the protein in these tissue samples does not necessarily mean that those affected will go on to develop vCJD. It is important that we clarify the significance of these findings by prospective screening of fresh tonsillectomy tissue."
A larger scale study on 80 000 to 100 000 fresh tonsils would allow more definitive tests to be done that would provide clear cut results, he said.
The National Anonymous Tonsil Archive, set up by the Health Protection Agency last year, hopes to collect in the region of 100 000 tonsils over the next three years to provide the data to be informative, said Dr Hilton.
Dr Hilton and colleagues conclude in their paper that: "Although the numbers of cases are currently in decline, the possibility of further rises cannot be excluded."(London Zosia Kmietowicz)