Surgical instruments may spread Alzheimer’s proteins


SURGICAL instruments may need to
be cleaned more thoroughly after
brain operations, following the news that they might be spreading proteins linked to Alzheimer’s disease.
There’s no evidence yet that spreading these proteins from one person to another can cause Alzheimer’s disease itself. But a study of eight people suggests that unclean instruments may sometimes lead to a rare and potentially fatal kind of brain bleeding disorder.
People who have Alzheimer’s disease typically have plaques of sticky amyloid proteins in their brains, although it remains unclear whether these are a cause or a consequence of the condition. But when amyloid builds up in blood vessels in the brain, it can sometimes make them so brittle that they leak or burst. This condition, called cerebral amyloid angiopathy (CAA), usually doesn’t develop until people reach their sixties or older.
But Sebastian Brandner, at University College London, and his team have been investigating the cases of eight people who developed CAA under the age of 60. Scouring their medical records, the team found that all eight of these people had undergone brain surgery during childhood or their teenage years for a variety of reasons.
Of the eight people, at least three have already died from strokes, which can be caused by CAA. They died between the ages of 37 and 57.
None of these people have known gene variants that would raise the risk of developing CAA early. Brandner’s team says the most likely explanation is that amyloid proteins were seeded into their bodies during childhood brain surgery, from instruments previously used for surgeries on people with Alzheimer’s disease. Creutzfeldt-Jakob Disease (CJD), a brain disease caused by prion proteins, is already known to have been spread in a similar way.
There has previously been evidence that Alzheimer’s proteins may have been spread to people in grafts of brain material, and injections of cadaver extracts used to boost growth – a procedure that was halted in the UK in 1985 when it was discovered that it carries a risk of spreading CJD. Last year, questions were raised over whether amyloid might also spread through blood transfusions.
But the new findings are the first to implicate surgical instruments as a means for transmitting amyloid.

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