Nasal Biopsy May Diagnose Fatal Brain Disease
February 19, 2003 02:43:19 PM PST,A sample of tissue taken from inside the nasal passages may offer an easier way for doctors to diagnose one form of Creutzfeldt-Jakob disease, a fatal degenerative brain disorder, new study findings suggest.
Currently, the only way to prove the existence of this type of the disease, known as sporadic CJD, is by brain biopsy, which involves making an incision in the skull to remove tissue for testing. The disease can also be confirmed upon death with an autopsy.
, 百拇医药
But in the new study, published in the February 20th issue of The New England Journal of Medicine, Italian researchers have found the abnormal proteins called prions that are believed to cause the disease in the nasal passages of nine people who died from sporadic CJD, raising the possibility that a nasal biopsy may be used to diagnose the disease in the living.
Sporadic CJD, the most common form of the rare disease, affects about one in a million Americans, mostly the elderly. The symptoms, such as memory loss and hallucinations, may be mistaken for Alzheimer's disease or other forms of dementia.
, 百拇医药
It is not known how people contract sporadic CJD. Another form of the disorder, new variant CJD, is linked to the consumption of meat contaminated with bovine spongiform encephalopathy, or "mad cow" disease. There are no effective treatments for CJD.
Doctors can use a tonsil biopsy to accurately diagnose new variant CJD, but there has been no simpler way to definitively diagnose the sporadic form of the disease, said Dr. Kenneth L. Tyler, a professor of neurology at the University of Colorado Health Sciences Center in Denver."Up till now, it's pretty much been a brain biopsy or an autopsy," he told Reuters Health.Having an easier way to diagnose the disease in the living could speed the development of therapies, said Tyler, who wrote an editorial accompanying the study.
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The new findings suggest that patients with symptoms suggestive of sporadic CJD may one day be able to get a nasal biopsy performed in a doctor's office under local anesthesia, Tyler said. Doctors would go in through the nostrils and remove a sample of nasal tissue for examination, he explained.In the study, Dr. Salvatore Monaco of the University of Verona and colleagues found the abnormal prions in nasal tissue taken from nine patients who had died from sporadic CJD. In all nine, the disease had been confirmed by autopsy examination of the brain.
, 百拇医药
In contrast, there was no evidence of sporadic CJD in brain or nasal tissue of another 11 people who were not suspected of dying from sporadic CJD. Some of these people had other neurological disorders."Our findings suggest that a biopsy of (nasal) tissue in patients with suspected sporadic Creutzfeldt-Jakob disease may provide a means of early clinical diagnosis and a way to assess the potential effectiveness of anti-prion compounds when they become available," the study authors write.They also suggested that the findings raise the possibility that people might become infected with the deadly prions through the nasal passages, perhaps through contaminated surgical instruments, though this is only speculation.
Tyler said studies in living people are needed to confirm that nasal biopsy is an effective means of diagnosing sporadic CJD.
SOURCE: The New England Journal of Medicine 2003;348:681-682,711-719., 百拇医药
Currently, the only way to prove the existence of this type of the disease, known as sporadic CJD, is by brain biopsy, which involves making an incision in the skull to remove tissue for testing. The disease can also be confirmed upon death with an autopsy.
, 百拇医药
But in the new study, published in the February 20th issue of The New England Journal of Medicine, Italian researchers have found the abnormal proteins called prions that are believed to cause the disease in the nasal passages of nine people who died from sporadic CJD, raising the possibility that a nasal biopsy may be used to diagnose the disease in the living.
Sporadic CJD, the most common form of the rare disease, affects about one in a million Americans, mostly the elderly. The symptoms, such as memory loss and hallucinations, may be mistaken for Alzheimer's disease or other forms of dementia.
, 百拇医药
It is not known how people contract sporadic CJD. Another form of the disorder, new variant CJD, is linked to the consumption of meat contaminated with bovine spongiform encephalopathy, or "mad cow" disease. There are no effective treatments for CJD.
Doctors can use a tonsil biopsy to accurately diagnose new variant CJD, but there has been no simpler way to definitively diagnose the sporadic form of the disease, said Dr. Kenneth L. Tyler, a professor of neurology at the University of Colorado Health Sciences Center in Denver."Up till now, it's pretty much been a brain biopsy or an autopsy," he told Reuters Health.Having an easier way to diagnose the disease in the living could speed the development of therapies, said Tyler, who wrote an editorial accompanying the study.
, http://www.100md.com
The new findings suggest that patients with symptoms suggestive of sporadic CJD may one day be able to get a nasal biopsy performed in a doctor's office under local anesthesia, Tyler said. Doctors would go in through the nostrils and remove a sample of nasal tissue for examination, he explained.In the study, Dr. Salvatore Monaco of the University of Verona and colleagues found the abnormal prions in nasal tissue taken from nine patients who had died from sporadic CJD. In all nine, the disease had been confirmed by autopsy examination of the brain.
, 百拇医药
In contrast, there was no evidence of sporadic CJD in brain or nasal tissue of another 11 people who were not suspected of dying from sporadic CJD. Some of these people had other neurological disorders."Our findings suggest that a biopsy of (nasal) tissue in patients with suspected sporadic Creutzfeldt-Jakob disease may provide a means of early clinical diagnosis and a way to assess the potential effectiveness of anti-prion compounds when they become available," the study authors write.They also suggested that the findings raise the possibility that people might become infected with the deadly prions through the nasal passages, perhaps through contaminated surgical instruments, though this is only speculation.
Tyler said studies in living people are needed to confirm that nasal biopsy is an effective means of diagnosing sporadic CJD.
SOURCE: The New England Journal of Medicine 2003;348:681-682,711-719., 百拇医药