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Novel Missense Variants of Prion Protein in Creutzfeldt-Jakob Disease or Gerstmann-Sträussler Syndrome

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Abstract

We found 3 novel missense variants in the open reading frame of the prion protein (PrP) gene. The codon 105 point mutation (praline to leucine) was found on a codon 129 (Valine) PrP allele in 4 patients from 3 different Japanese families with Gerstmann-Sträussler syndrome. The codon 180 variant PrP (valine to isoleucine) was found in Creutzfeldt-Jakob disease (CJD) patients with a similar clinical course to that of codon 178 mutation. The codon 232 variant PrP (methionine to arginine) was documented in the CJD patients with typical clinical and pathological findings. These variant PrP molecules were not detected in 200 normal Japanese PrP alleles. PrP has a large repertoire of variant forms, and each primary structure of PrP corresponds to the distinct phenotype of prion diseases.

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    At the 17 months after onset, myoclonus was detected in the bilateral upper extremities. Since CJD with the M232R mutation was first described in two unrelated Japanese patients in 1993 [3], this mutation has only been found in Asian-not in Caucasian-CJD patients [4–12]. Shiga et al. examined the clinical and laboratory features of 20 fCJD (M232R) patients, and reported that those with fCJD (M232R) usually have no family history and have two clinical phenotypes: a rapidly progressive type; and a slowly progressive type [6].

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