Journal Article

All Clinically-Relevant Blood Components Transmit Prion Disease following a Single Blood Transfusion: A Sheep Model of vCJD

Smith, Antony, Hornsey, Valerie S., Groschup, Martin H., Hunter, Nora, McCutcheon, Sandra, Manson, Jean C., Turner, Marc, Prowse, Christopher V., MacGregor, Ian R., Alejo Blanco, Anthony Richard, de Wolf, Christopher, Houston, E. Fiona, Tan, Boon Chin

2011

Overview

Variant CJD (vCJD) is an incurable, infectious human disease, likely arising from the consumption of BSE-contaminated meat products. Whilst the epidemic appears to be waning, there is much concern that vCJD infection may be perpetuated in humans by the transfusion of contaminated blood products. Since 2004, several cases of transfusion-associated vCJD transmission have been reported and linked to blood collected from pre-clinically affected donors. Using an animal model in which the disease manifested resembles that of humans affected with vCJD, we examined which blood components used in human medicine are likely to pose the greatest risk of transmitting vCJD via transfusion. We collected two full units of blood from BSE-infected donor animals during the pre-clinical phase of infection. Using methods employed by transfusion services we prepared red cell concentrates, plasma and platelets units (including leucoreduced equivalents). Following transfusion, we showed that all components contain sufficient levels of infectivity to cause disease following only a single transfusion and also that leucoreduction did not prevent disease transmission. These data suggest that all blood components are vectors for prion disease transmission, and highlight the importance of multiple control measures to minimise the risk of human to human transmission of vCJD by blood transfusion.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Animal models / Animals / Biological products / Blood / Blood Component Transfusion - adverse effects / Blood Component Transfusion - veterinary / Blood Donors / Blood transfusion / Blood transfusions / Blood-brain barrier / Bovine spongiform encephalopathy / Brain - metabolism / Brain - pathology / BSE / Cattle / Creutzfeldt-Jakob disease / Creutzfeldt-Jakob Syndrome - blood / Creutzfeldt-Jakob Syndrome - etiology / Creutzfeldt-Jakob Syndrome - transmission / Disease control / Disease Models, Animal / Disease transmission / Encephalopathy, Bovine Spongiform - blood / Encephalopathy, Bovine Spongiform - transmission / Epidemics / Erythrocyte Transfusion - adverse effects / Erythrocyte Transfusion - veterinary / Food contamination / Genotype & phenotype / Humans / Immunoblotting / Immunohistochemistry / Infections / Infectivity / Laboratories / Leukocyte Reduction Procedures / Meat / Meat products / Medicine / Pathogenesis / Platelet Transfusion - adverse effects / Platelet Transfusion - veterinary / Platelets / Prion Diseases - blood / Prion Diseases - etiology / Prion Diseases - transmission / Proteins / PrPSc Proteins - analysis / Sheep / Spinal cord / Spleen / Transfusion / Vectors / Veterinary medicine