Surgical instruments may spread amyloid protein linked to neurological disease

Could Aβ aggregates clinging to surgical equipment seed pathology in patients’ brains? Possibly, according to Sebastian Brandner and colleagues at the UCL Institute of Neurology. Their study involving CAA patients suggested that amyloid proteins may be transmitted through infected medical tools during brain surgery.


Aβ contamination

Sifting through pathology archives at the National Hospital for Neurology and Neurosurgery (NHNN), the scientists found four adults who had developed cerebral amyloid angiopathy (CAA) at an uncharacteristically young age, mostly in their 30s. Strikingly, all four had undergone brain surgery decades prior. The researchers identified four similar cases in the literature, as well. They claim that during childhood neurosurgery, Aβ from contaminated surgical equipment was transferred into the brain, and seeded the buildup of amyloid in the cerebrovasculature. Brandner and colleagues call for larger studies to address the potential link directly, and for better sterilization of instruments.

“These findings raise the possibility that Aβ pathology may be transmissible, as prion disease is, through neurosurgical procedures,” the researchers said.

Lary Walker of Emory University in Atlanta acknowledged the possibility that Aβ contamination caused the CAA in these cases, but emphasized that the data are both sparse and complex. “The evidence is highly speculative at this point,” he said. “It is really impossible, with such a small number of cases that are complicated in many ways, to pin down a specific cause of disease.”


Can Alzheimer’s disease spread from one patient to another?

Brandner and his colleagues said that their findings do not necessarily mean that Alzheimer’s disease is contagious. Although amyloid beta is considered as one of the hallmark proteins of Alzheimer’s disease, the researchers did not find evidence of the neurological illness in the patients involved in their study.

“We have found new evidence that amyloid beta pathology may be transmissible. This does not mean that Alzheimer’s disease can be transmitted, as we did not find any significant amount of pathological tau protein which is the other hallmark protein of Alzheimer’s disease,” Brandner said.

 

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Source: Alzforum | 28 February 2018

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