title: An enzyme-detergent method for effective prion decontamination of surgical steel.
abstract: Prions, transmissible agents that cause Creutzfeldt-Jakob disease (CJD) and other prion diseases, are known to resist conventional sterilization procedures. Iatrogenic transmission of classical CJD via neurosurgical instruments is well documented and the involvement of lymphoreticular tissues in variant CJD (vCJD), together with the unknown population prevalence of asymptomatic vCJD infection, has led to concerns about transmission from a wide range of surgical procedures. To address this problem, conditions were sought that destroy PrP(Sc) from vCJD-infected human tissue and eradicate RML prion infectivity adsorbed onto surgical steel. Seven proteolytic enzymes were evaluated individually and in pairs at a range of temperatures and pH values and the additional effects of detergents, lipases and metal ions were assessed. A combination of proteinase K and Pronase, in conjunction with SDS, was shown to degrade PrP(Sc) material from highly concentrated vCJD-infected brain preparations to a level below detection. When RML prion-infected wires were exposed to the same enzymic treatment, intracerebral bioassay in highly susceptible hosts showed virtually no infectivity. The prion-degrading reagents identified in this study are readily available, inexpensive, non-corrosive to instruments, non-hazardous to staff and compatible with current equipment and procedures used in hospital sterilization units.
authors.affiliation: MRC Prion Unit, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK.
authors.forename: Graham S
authors.initials: GS
authors.lastname: Jackson
authors.affiliation: MRC Prion Unit, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: McKintosh
authors.affiliation: MRC Prion Unit, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK.
authors.forename: Eckhard
authors.initials: E
authors.lastname: Flechsig
authors.affiliation: MRC Prion Unit, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK.
authors.forename: Kanella
authors.initials: K
authors.lastname: Prodromidou
authors.affiliation: MRC Prion Unit, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK.
authors.forename: Petra
authors.initials: P
authors.lastname: Hirsch
authors.affiliation: MRC Prion Unit, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK.
authors.forename: Jackie
authors.initials: J
authors.lastname: Linehan
authors.affiliation: MRC Prion Unit, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Brandner
authors.affiliation: MRC Prion Unit, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK.
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Clarke
authors.affiliation: MRC Prion Unit, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK.
authors.forename: Charles
authors.initials: C
authors.lastname: Weissmann
authors.affiliation: MRC Prion Unit, Department of Neurodegenerative Disease, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK.
authors.forename: John
authors.initials: J
authors.lastname: Collinge
mesh_terms: D007562:Creutzfeldt-Jakob Syndrome / Q000473:pathology / Q000635:transmission; D003666:Decontamination / Q000379:methods*; D003902:Detergents / Q000494:pharmacology; D019286:Endopeptidase K / Q000378:metabolism; D010755:Organophosphates / Q000494:pharmacology; D011328:Prions / Q000187:drug effects* / Q000378:metabolism; D011402:Pronase / Q000378:metabolism; D013525:Surgical Instruments
chemical_list: D003902:Detergents; D010755:Organophosphates; D011328:Prions; C052807:didodecyl phosphate; D019286:Endopeptidase K; D011402:Pronase