Abstract | BACKGROUND: Iatrogenic transmission of human prion disease can occur through medical or surgical procedures, including injection of hormones such as gonadotropins extracted from cadaver pituitaries. Annually, more than 300,000 women in the United States and Canada are prescribed urine-derived gonadotropins for infertility. Although menopausal urine donors are screened for symptomatic neurological disease, incubation of Creutzfeldt-Jakob disease (CJD) is impossible to exclude by non-invasive testing. Risk of carrier status of variant CJD (vCJD), a disease associated with decades-long peripheral incubation, is estimated to be on the order of 100 per million population in the United Kingdom. Studies showing infectious prions in the urine of experimental animals with and without renal disease suggest that prions could be present in asymptomatic urine donors. Several human fertility products are derived from donated urine; recently prion protein has been detected in preparations of human menopausal gonadotropin (hMG). METHODOLOGY/PRINCIPAL FINDINGS: CONCLUSIONS/SIGNIFICANCE: The presence of protease-sensitive prion protein in urinary-derived injectable fertility products containing hCG, hMG, and hMG-HP suggests that prions may co-purify in these products. Intramuscular injection is a relatively efficient route of transmission of human prion disease, and young women exposed to prions can be expected to survive an incubation period associated with a minimal inoculum. The risks of urine-derived fertility products could now outweigh their benefits, particularly considering the availability of recombinant products.
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Authors | Alain Van Dorsselaer, Christine Carapito, François Delalande, Christine Schaeffer-Reiss, Daniele Thierse, Hélène Diemer, Douglas S McNair, Daniel Krewski, Neil R Cashman |
Journal | PloS one
(PLoS One)
Vol. 6
Issue 3
Pg. e17815
(Mar 23 2011)
ISSN: 1932-6203 [Electronic] United States |
PMID | 21448279
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Chorionic Gonadotropin
- Fertility Agents
- Peptides
- Prions
- Menotropins
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Topics |
- Amino Acid Sequence
- Chorionic Gonadotropin
(urine)
- Chromatography, Liquid
- Electrophoresis, Gel, Two-Dimensional
- Female
- Fertility Agents
(urine)
- Humans
- Injections
- Mass Spectrometry
- Menotropins
(isolation & purification, urine)
- Molecular Sequence Data
- Peptides
(chemistry)
- Prions
(chemistry, urine)
- Proteomics
(methods)
- Reference Standards
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