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Location: BACLIFF, Texas, United States

My mother was murdered by what I call corporate and political homicide i.e. FOR PROFIT! she died from a rare phenotype of CJD i.e. the Heidenhain Variant of Creutzfeldt Jakob Disease i.e. sporadic, simply meaning from unknown route and source. I have simply been trying to validate her death DOD 12/14/97 with the truth. There is a route, and there is a source. There are many here in the USA. WE must make CJD and all human TSE, of all age groups 'reportable' Nationally and Internationally, with a written CJD questionnaire asking real questions pertaining to route and source of this agent. Friendly fire has the potential to play a huge role in the continued transmission of this agent via the medical, dental, and surgical arena. We must not flounder any longer. ...TSS

Thursday, August 07, 2014

A Test for Creutzfeldt–Jakob Disease Using Nasal Brushings

Original Article

A Test for Creutzfeldt–Jakob Disease Using Nasal Brushings

Christina D. Orrú, Ph.D., Matilde Bongianni, Ph.D., Giovanni Tonoli, M.D., Sergio Ferrari, M.D., Andrew G. Hughson, M.S., Bradley R. Groveman, Ph.D., Michele Fiorini, Ph.D., Maurizio Pocchiari, M.D., Salvatore Monaco, M.D., Byron Caughey, Ph.D., and Gianluigi Zanusso, M.D., Ph.D.

N Engl J Med 2014; 371:519-529August 7, 2014DOI: 10.1056/NEJMoa1315200

Share: Background Definite diagnosis of sporadic Creutzfeldt–Jakob disease in living patients remains a challenge. A test that detects the specific marker for Creutzfeldt–Jakob disease, the prion protein (PrPCJD), by means of real-time quaking-induced conversion (RT-QuIC) testing of cerebrospinal fluid has a sensitivity of 80 to 90% for the diagnosis of sporadic Creutzfeldt–Jakob disease. We have assessed the accuracy of RT-QuIC analysis of nasal brushings from olfactory epithelium in diagnosing sporadic Creutzfeldt–Jakob disease in living patients.

Methods We collected olfactory epithelium brushings and cerebrospinal fluid samples from patients with and patients without sporadic Creutzfeldt–Jakob disease and tested them using RT-QuIC, an ultrasensitive, multiwell plate–based fluorescence assay involving PrPCJD-seeded polymerization of recombinant PrP into amyloid fibrils.

Results The RT-QuIC assays seeded with nasal brushings were positive in 30 of 31 patients with Creutzfeldt–Jakob disease (15 of 15 with definite sporadic Creutzfeldt–Jakob disease, 13 of 14 with probable sporadic Creutzfeldt–Jakob disease, and 2 of 2 with inherited Creutzfeldt–Jakob disease) but were negative in 43 of 43 patients without Creutzfeldt–Jakob disease, indicating a sensitivity of 97% (95% confidence interval [CI], 82 to 100) and specificity of 100% (95% CI, 90 to 100) for the detection of Creutzfeldt–Jakob disease. By comparison, testing of cerebrospinal fluid samples from the same group of patients had a sensitivity of 77% (95% CI, 57 to 89) and a specificity of 100% (95% CI, 90 to 100). Nasal brushings elicited stronger and faster RT-QuIC responses than cerebrospinal fluid (P<0 .001="" 105="" 107="" approximately="" at="" between-group="" brushings="" cerebrospinal="" comparison="" concentrations="" contained="" fluid.="" for="" greater="" in="" individual="" logs10="" of="" p="" prion="" response="" seeds="" several="" strength="" than="" the="" to="">
Conclusions In this preliminary study, RT-QuIC testing of olfactory epithelium samples obtained from nasal brushings was accurate in diagnosing Creutzfeldt–Jakob disease and indicated substantial prion seeding activity lining the nasal vault. (Funded by the Intramural Research Program of the National Institute of Allergy and Infectious Diseases and others.)

Supported by the Intramural Research Program of the National Institute of Allergy and Infectious Diseases (NIAID), by a grant from Fondazione Cariverona (Disabilità cognitiva e comportamentale nelle demenze e nelle psicosi, to Dr. Monaco), by a grant from the Italian Ministry of Health (RF2009-1474758, to Drs. Zanusso and Pocchiari), by a grant from the Creutzfeldt–Jakob Disease Foundation (to Dr. Orrú), by a fellowship from Programma Master and Back–Percorsi di rientro (PRR-MAB-A2011-19199, to Dr. Orrú), and by donations to the NIAID Gift Fund from Mary Hilderman Smith, Zoë Smith Jaye, and Jenny Smith Unruh, in memory of Jeffrey Smith.

Disclosure forms provided by the authors are available with the full text of this article at

Drs. Orrú and Bongianni contributed equally to this article.

We thank our many colleagues (see Acknowledgments in the Supplementary Appendix) for their support of this project and for assistance with the preparation of earlier versions of the manuscript.

Source Information From the Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health, Hamilton, MT (C.D.O., M.B., A.G.H., B.R.G., B.C.); and the Department of Biomedical Sciences, University of Cagliari, Cagliari (C.D.O.), the Department of Neurologic and Movement Sciences, University of Verona, Verona (M.B., S.F., M.F., S.M., G.Z.), Clinica Otorinolaringoiatrica, Policlinico G.B. Rossi, Azienda Ospedaliera Universitaria Integrata, Verona (G.T.), and the Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome (M.P.) — all in Italy.

Address reprint requests to Dr. Caughey at Rocky Mountain Laboratories, NIAID, 903 S. 4th St., Hamilton, MT 59840, or at; or to Dr. Zanusso at Policlinico G.B. Rossi, Piazzale L.A. Scuro, 10, 37134 Verona, Italy, or at

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Thursday, August 07, 2014
Prions in the Urine of Patients with Variant Creutzfeldt–Jakob Disease
Original Article


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