Brain surgery sterilisation and safety practices under pressure

Published: 22-Feb-2018

Alzheimer’s protein ‘passed to patients during brain surgery’, researchers at University College London (UCL) say

Findings of a new study conducted by researchers at University College London (UCL) suggest the hallmark Alzheimer’s protein – amyloid beta – may have been passed to a small number of people during childhood brain surgery. The discovery should factor into future reviews of sterilisation and safety practices for surgical procedures.

The researchers studied the medical records of four people who had brain bleeds caused by amyloid beta build-up in the blood vessels of the brain. They found all four had undergone neurosurgery two or three decades earlier as children or teenagers.

They suggested the possibility that amyloid beta deposition may be transmissible through neurosurgical instruments in a similar way to prion proteins that are implicated in prion dementias such as Creutzfeldt-Jakob disease (CJD).

Researchers say this should factor into future reviews of sterilisation and safety practices for surgical procedures.

Amyloid beta is known for being one of the hallmark proteins of Alzheimer’s disease. The researchers, however, did not find evidence of Alzheimer’s in this study.

The study looked in the pathology archive at the National Hospital for Neurology and Neurosurgery for biopsy and autopsy materials of young adult patients with confirmed amyloid beta pathology, which can lead to brain bleeds or harmful plaques in the brain’s blood vessels.

Professor Sebastian Brandner of UCL Institute of Neurology and lead author, commented: “It is well known that the abnormal proteins seen in Creutzfeldt-Jakob disease have been transmitted between patients by certain medical and surgical procedures.

“We have found new evidence that amyloid beta pathology may be transmissible. This does not mean that Alzheimer’s disease can be transmitted, as we did not find any significant amount of pathological tau protein which is the other hallmark protein of Alzheimer’s disease.

“Our findings relate to neurosurgical procedures done a long time ago. Nevertheless, the possibility of pathological protein transmission, while rare, should factor into reviews of sterilisation and safety practices for surgical procedures.”

Dr David Reynolds, chief scientific officer at Alzheimer’s Research UK, said: “While it is too early to draw any firm conclusions from such a small study, the finding that people with a rare amyloid-related disease all had brain operations early in life raises the possibility of amyloid having been passed from one person to another during neurosurgery.”

Reynolds said any potential link will need to be explored in much larger studies, but it is important to remember that people receive vital and often life-saving brain surgery every day in the UK and any potential risk of disease from these procedures is minimal.

“This study didn’t look at whether those who underwent neurosurgery in childhood went on to develop Alzheimer’s disease and there is currently no evidence that Alzheimer’s can be transmitted through brain surgery,” Reynolds concluded.

The study is published in the journal Acta Neuropathologica.

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