Neurosurgery Could Spread Protein Linked To Alzheimer's, Study Finds (theguardian.com) 63
An anonymous reader quotes a report from The Guardian: Surgical instruments used in brain operations should be treated to ensure they are not contaminated with proteins linked to Alzheimer's disease, according to scientists who found evidence that they may be spread by certain medical procedures. The researchers urged doctors to decontaminate neurosurgical tools more thoroughly as a precautionary measure to reduce the potential risk of spreading abnormal proteins known to build up in the brains of Alzheimer's patients. Prof John Collinge, director of the Medical Research Council prion unit at University College London, said that while Alzheimer's disease was not contagious, there was a slim risk that harmful proteins that drive the disease could spread through brain surgery and other rare procedures.
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They couldn't really be sterile, could they?
Protein? (Score:2, Funny)
Please excuse what is probably a dumb question, but I don't know biology. When they say this protein could be "spread", is it like a bacteria or virus?
I read another article about Alzheimers that I didn't really understand that talked about researchers following the possibility that it is bacteria-based. Is this related to that? If I wasn't halfway into my third beer, watching the football game, I might try to figure it out, but I doubt I'd get very far unless one of you kind Slashdot souls helps me.
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They're suggesting that Alzheimer's spreads like a prion disease once started.
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Well, they're considering the possibility that it might be prion based. Nobody knows what causes it, and mis-folded proteins can't be ruled out.
So far the evidence supporting the idea that it's prion based is quite weak, but promising approaches seem to keep failing. So it's unreasonable to just dismiss the idea.
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The shape of a protein determines a lot of its characteristics and effects. A protein could have different shapes depending on how the elements that make it up are linked, and how its folded. Sometimes a misfolded protein can encourage other proteins of the same kind to misfold themselves. These misfolded proteins are called prions, and are usually very stable which means they are difficult for the body to get rid of. They're also difficult to destroy in the environment.
Naturally we evolved some capabil
Re:Protein? (Score:5, Informative)
Google "prion [wikipedia.org]".
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Thank you, friend.
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Re:Protein? (Score:4, Informative)
Prions are misfolded proteins that appear to catalyse other proteins to misfold in a chain reaction. "Mad Cow Disease" and CJD (mad cow disease for humans) are the most well known types. It is not clear if Alzheimer's is caused by, or related to prions, but that is one hypothesis.
The point of TFA is that normal sterilization techniques such as heat, alcohol, or chlorine bleach, work fine on bacteria and viruses, but may not destroy prions. Proteins can be much tougher than DNA. We may need to use higher heat and/or harsher chemicals.
Here is a joke my daughter told me after she had a big fight with her boyfriend:
Her: Why don't men get mad cow disease?
My: Why?
Her: Because they're pigs.
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That implies that women are cows, though.
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No.
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Creutzfeldt-Jakob disease (CJD) is the human equivalent of Mad Cow disease. It is caused by prions, where defective proteins invade the brain and induce other prion protein molecules to misfold in a self-sustaining feedback loop. It can be transmitted by surgical instruments or eating contaminated tissue, and there is no easy way to sterilize it.
The researchers are suggesting that cerebral amyloid angiopathy (CAA), a condition similar to Alzheimer's disease, could be spread by amyloid and tau proteins on
Creutzfeldt-Jakob Disease (Score:5, Interesting)
Deja Vu (Score:4, Informative)
Almost identical Guardian article from 2015.
https://www.theguardian.com/sc... [theguardian.com]
pernicious: an apt term for prions (Score:5, Interesting)
Not sure why they left out the more ominous method by which these proteins can spread: eye surgery. Eye surgery is fairly common and not normally associated with such grave dangers. Those affected by these proteins (they are called 'prions'), invariably have them living in optical neural tissues. Surgeons, who may schedule multiple operations per day, need to find a better way to sterilize their instruments as the proteins are resistant to normal techniques. These discoveries seem to be new for some reason.
This has been my first opportunity to use the word 'pernicious', an exquisite word that has somehow escaped my notice until today. Thank you, dear Slashdot readers, for allowing me this occasion.
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Can't spell 'pernicious' without 'prions'.
Or 'Prius' for that matter...
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Sorry, but you've been affected by selective reporting (at multiple levels).
Prions are necessary for life. Much of the dry intra-cellular fluid is prions. Not all proteins are built initially in the active form, they often need a chaperon to cause them to fold correctly. These are prions just as much as the ones that cause incorrect folding. And without it no mammalian, I suspect no eucaryotic, life would exist.
For more details you need to consult a real expert, I'm just a sometimes interested layman,
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The useful ones are exactly the same as the deleterious ones except in the particular way they fold a particular protein. They are equally infectious. They are equally proteinaceous.
Re: pernicious: an apt term for prions (Score:1)
And you just might be wholly wrong
"Properly" has changed (Score:2)
It happens when the definition of "properly" changes to accommodate new evidence about how infection spreads.
How clean is clean enough for brain surgery? (Score:1)
If they're concerned about the spread of proteins then they aren't properly cleaning their instruments to begin with. Anything that can't be put in an autoclave or cleaned using chemicals that break down organic matter completely should be disposed of.... the fact that this isn't happening already, especially for brain surgery, is deeply concerning.
Re:How clean is clean enough for brain surgery? (Score:5, Informative)
The problem with your statement is that prions survive autoclaving and generally require incineration at temps exceeding the melting point of most surgical metals.
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Some surgical instruments cost a lot of money. A simple micro instrument could cost ~$1000. If you need to throw them out, you're looking at padding the bill by another $50-100k.
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Wellllll.....
At the end of the day, they're just specialized alloys of metal bent, cut, and specially heat-treated into fancy shapes. You could probably make them for less than $100 each, if the demand was high enough.
But "high enough" means a continuously active production line, that you don't shut down every other month. How much brain surgery do you plan on that specialized tools used in only particular variants of the operation will be cheap?
I'll grant that there is a huge mark-up, because the system
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Wouldn't immersion in anhydrous ethyl alcohol solution of concentrated potassium hydroxide work? Of course, when we were cleaning glassware we preceded that by a bath in concentrated nitric acid, and followed it by a rinse in distilled water. We were, however, working with glassware that we wanted to remove proteins from...but we weren't worried about infection, merely analysis.
That said, it seems to me that there are a lot of protein cleaving enzymes that could be used in a pre-treatment bath. So the pr
"Slim risk", "rare procedures". Why is this news? (Score:2)
Seriously, panic much?
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A 'slim risk' is one ambulance-chaser away from a "known risk that should've been mitigated."
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A slim risk in a rare case is "you get run over a car while crossing a road". Not something that prevents you from crossing roads, is it?
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Almost half of all adults are expected to get a nuero-degenerative disease in the course of their life.
And that is the wrong number. How many adults do get brain-surgery? Right...
What was the article about again? (Score:2)
Which brain tool is the problem? The drill, the scalpel, the cracker, or the cauterizer?
--
What's important is that you have a faith in people, that they're basically good and smart, and if you give them tools, they'll do wonderful things with them. - Steve Jobs
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The blackjack.
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Or at least cauterize it so nothing else comes out.
it's more of a reminder than news (Score:2)
I think what this is about is that it is really old news, and because it's rare and been a long time since then, newly trained doctors don't have this on their radar.
The much larger risk is from transfusions and graft material, a few hundred of those have occurred vs the 6 or so from surgical instruments over the last few decades.
overview
https://www.ncbi.nlm.nih.gov/p... [nih.gov]
https://www.cdc.gov/prions/cjd... [cdc.gov]
Here's the WHO guidelines from 1999 for avoiding and decontamination
https://www.who.int/csr/resour... [who.int]
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Sterilization sufficient to kill / destroy usual pathogens like bacteria or viruses is not sufficient for prions.
Prions are much tougher. They can easily withstand a few hundred degrees Celsius, prolonged immersion in formaldehyde or high doses of ionizing radiation.
Why is this an issue? (Score:2)
I'm sorry, but why aren't they cleaning the equipment properly to begin with? And why is it news that using dirty equipment for surgery can cause problems for the patient?
explains a lot (Score:2)
cbd (Score:1)