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From the Division of Neuropathology (Drs. Petersen, Tabaton, Chen, Monari, Manetto, Autilio-Gambetti, and Gambetti, and S. Richardson), Institute of Pathology, Case Western Reserve University, Cleveland, OH; the Departments of Neurology, Preventive Medicine and Environmental Health, and Pathology, and the Sanders Brown Institute on Aging (Drs. Lanska and Markesbery), University of Kentucky, Lexington, Ky, the Neurology Service (Dr. Lanska), Veterans Administration Medical Center, Lexington, Ky; the Department of Neurology (Dr. Currier), University of Mississippi Medical Center, Jackson, MS; the Department of Neurology (Dr. Lynches), College of Physicians and Surgeons of Columbia University, New York, Ny, and the University of California Gallo Center (Dr. Wilhelmsen), San Francisco, CA.
Article abstract—Progressive subcortical gliosis (PSG) is a sporadic and familial dementing disease characterized pathologically by astrogliosis at the cortex-white matter junction, a feature present in some prion diseases. With im-munocytochemical and Western blot analyses, we investigated the presence of deposits of the prion protein (PrP) and of the protease-resistant PrP isoform, the hallmarks of prion diseases, in six affected members of two large kindreds with PSG. The coding region of the PrP gene was sequenced and chromosomal linkage determined. We demonstrated "diffuse" PrP plaques in the cerebral cortex of two subjects from one kindred and protease-resistant PrP fragments in four of the five subjects examined. We found no mutation in the coding region of the PrP gene. Moreover, the disease was linked to chromosome 17 and not to chromosome 20, where the PrP gene resides. The familial form of PSG is the first human genetic disease characterized by the presence of protease-resistant PrP that lacks a mutation in the coding region of the PrP gene. The linkage to chromosome 17 suggests that other genes are involved in the PrP metabolism. Whether the protease-resistant PrP plays a primary or secondary role in the pathogenesis of this form of PSG remains to be determined.
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