Deposits of disease-associated alpha-synuclein may be present in the dura mater in Lewy body disorders: implications for potential inadvertent transmission by surgery

  • Ellen Gelpi Department of Neuropathology and Neurochemistry, Neurology Department, Medical University of Vienna
  • Naomi P. Visanji
  • Selma Hönigschnabl
  • Angelika Reiner
  • Peter Fischer
  • Anthony Lang
  • Herbert Budka
  • Gabor G. Kovacs
Keywords: Alpha-synuclein, Dura mater, Lymphatic drainage, Prion, Propagation, Transmission

Abstract

Deposition of alpha-synuclein in the brain is a hallmark of Lewy body disorders. Alpha-synuclein has been considered to show prion-like properties. Prion diseases can be transmitted by the transplantation of cadaveric dura mater causing iatrogenic Creutzfeldt-Jakob disease. Recent observations of amyloid-β deposition in dural grafts support the seeding properties of amyloid-β. Here we assessed the presence of alpha-synuclein in dura mater samples as a potential transmissible seed source. We immunostained 32 postmortem dura mater samples; 16 cases with Lewy-body disorder (LBD) showing different pathology stages and 16 non-LBD cases for phosphorylated (Ser129) and disease-associated (5G4) alpha-synuclein. Disease-associated alpha-synuclein aggregates were identified in intradural nerve fibres and associated with a vessel in a single LBD-Braak stage 4 case. We conclude that alpha-synuclein is detectable, although rarely, in dura mater samples in patients with LBD. The risk of potential transmissibility of dural alpha-synuclein deserves assessment by complementary experimental studies.

Published
2020-02-12
How to Cite
Gelpi, E., Visanji, N., Hönigschnabl, S., Reiner, A., Fischer, P., Lang, A., Budka, H., & Kovacs, G. (2020). Deposits of disease-associated alpha-synuclein may be present in the dura mater in Lewy body disorders: implications for potential inadvertent transmission by surgery. Free Neuropathology, 1, 6. https://doi.org/10.17879/freeneuropathology-2020-2616
Section
Original Paper