Prions cause transmissible and genetic neurodegenerative diseases, including scrapie and bovine spongiform encephalopathy of animals and Creutzfeldt-Jakob and Gerstmann-Sträussler-Scheinker diseases of humans. Infectious prion particles are composed largely, if not entirely, of an abnormal isoform of the prion protein, which is encoded by a chromosomal gene. A posttranslational process, as yet unidentified, converts the cellular prion protein into an abnormal isoform. Scrapie incubation times, neuropathology, and prion synthesis in transgenic mice are controlled by the prion protein gene. Point mutations in the prion protein genes of animals and humans are genetically linked to development of neuro-degeneration. Transgenic mice expressing mutant prion proteins spontaneously develop neurologic dysfunction and spongiform neuropathology. Understanding prion diseases may advance investigations of other neurodegenerative disorders and of the processes by which neurons differentiate, function for decades, and then grow senescent.

Naturally occurring neuron-abundant proteins including amyloid Aβ42 peptide and the microtubule-associated protein tau (MAPT) can, over time and under pathological situations, assume atypical conformations, altering their normal biological structure and function, and causing them to aggregate into insoluble and neurotoxic intracellular inclusions. These misfolded proteins ultimately contribute to the pathogenesis of several progressive, age-related and ultimately lethal human neurodegenerative disorders. The molecular mechanism of this pathological phenomenon of neuronal protein misfolding lends support to the ‘prion hypothesis’, which predicts that the aberrant folding of endogenous natural protein structures into unusual pathogenic isoforms can induce the atypical folding of other similar brain-abundant proteins, underscoring the age-related, progressive nature and potential transmissible and spreading capabilities of the aberrant protein isoforms that drive these invariably fatal neurological syndromes. The abnormal folding and aggregation of host proteins is a consistent feature of both amyloidopathies and tauopathies that encompass a continuous spectrum of brain diseases that include Alzheimer’s disease (AD), prion disorders (PrD) such as scrapie in sheep and goats (Bovidae), experimental prion infection of rodents (Muridae), Creutzfeldt–Jakob disease (CJD) and Gerstmann–Sträussler–Scheinker syndrome (GSS) in humans (Hominidae), and other fatal prion-driven neurological disorders. Because AD patients accumulate both misfolded tau and Aβ peptides, AD may be somewhat unique as the first example of a ‘double prion disorder’. This commentary will examine current research trends in this fascinating research area, with a special emphasis on AD and PrD, and the novel pathological misfolded protein processes common to both intractable neurological disorders.

Bovine spongiform encephalopathy (BSE), also referred to as mad cow disease, is a chronic degenerative disease that affects the central nervous system. BSE is caused by a misfolded isoform of the prion protein, a widely expressed glycoprotein. The illness is referred to as Variant Creutzfeldt-Jakob disease (vCJD) in humans. In the United Kingdom (UK), BSE in cattle was first discovered in 1986. Based on epidemiological data, it appears that animal feed containing tainted meat and bone meal (MBM) as a source of meat protein is the common cause of the BSE outbreak in the UK. Clinical indicators in cows include irregular body posture, incoordination, difficulty in standing, weight loss, and temperamental changes, including agitation and hostility. Feeding livestock MBM obtained from BSE-infected livestock contaminated with BSE prions is the only known risk factor for BSE development. Strong evidence linking BSE to human transmission and a variant type of CJD has brought the disease to the attention of many countries. Screening living animals for BSE is challenging. In most cases, suspected animals are usually killed. Typically, the central nervous system is examined for prions to diagnose this illness. There is currently no robust treatment for BSE. The prevention of BSE can be achieved by avoiding the feeding of susceptible animals with ruminant tissues that might carry prions.

The "protein only" hypothesis holds that the infectious agent causing transmissible spongiform encephalopathies is a conformational isomer of PrP, a host protein that is predominantly expressed in the brain. This hypothesis is strongly supported by many lines of evidence. To date, prion diseases are unique among conformational diseases in that they are transmissible-experimentally and by natural routes (mainly by ingestion). The pathway of prions to the brain has been elucidated in outline. A striking feature of prions is their extraordinary resistance to conventional sterilization procedures and their capacity to bind to surfaces of metal and plastic without losing infectivity. This property, first observed in a clinical setting, is now being investigated in experimental settings, both in animals and in cell culture.