캐나다, 프랑스, 미국의 학자들로 구성된 국제학술팀의 연구결과에 따르면, 오줌(소변, 뇨)에서 추출한 불임치료제(hCG, hMG, hMG-HP 호르몬이 포함된 제품) 주사를 투여받은 여성은 프리온 질병(iCJD=iatrogenic CJD=의인성 또는 의원성 크로이츠펠트 야콥병)에 걸릴 위험이 있을 수 있다는 소식입니다.(아래 뉴스 참조, 논문 전문은 첨부파일 참조)
그동안 수혈, 수술, 호르몬 주사(사체의 뇌하수체에서 추출한 호르몬)를 통한 인간광우병(vCJD)를 포함한 크로이츠펠트-야콥병(CJD)의 전염은 학계에 널리 알려졌습니다.(CJD의 분류 상 iCJD라고 하는데… sCJD나 vCJD 모두 수혈, 수술, 주사 등을 통해 감염될 수 있습니다)
몇 년 전 오줌, 우유 등에서도 프리온 단백질이 존재한다는 연구결과가 보고되었는데, 이번 연구결과는 거기에서 한 발 더 나아가 오줌을 원료로 한 의약품을 통한 크로이츠펠트-야콥병(CJD)의 전염가능성을 제기하고 있습니다.
현재까지 오줌(소변, 뇨)에서 추출한 불임치료제(hCG, hMG, hMG-HP 호르몬이 포함된 제품) 주사를 투여받은 사람이 크로이츠펠트-야콥병(CJD)에 걸렸다는 보고가 나오진 않았지만 앞으로 예의주시해봐야 할 것 같습니다.
오줌에 들어 있는 프리온 단백질이 소량이고… 크로이츠펠트-야콥병(CJD)의 잠복기가 길며…
임상증상을 나타내지 않는 불현성 감염으로 캐리어 상태인 경우도 있을 수 있는 등의 이유로
공중보건상의 위험은 거의 없는데 관련 학계에서 많은 연구비를 타내기 위해 위험을 과장하고
있다는 비판도 제기되고 있고… 다른 한편으로는 사전예방적 원칙에 따라서 위험가능성을
무시해서는 안된다는 반론도 있습니다.
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Canadian Study Shows Risk Of Prion Disease From Urine-Derived, Injectable Fertility Products
출처 :Medical News Today 24 Mar 2011 – 9:00 PDT
http://www.medicalnewstoday.com/articles/220136.php
Women who are injected with urine-derived fertility products may be at risk of developing prion disease, according to a just-released study by an international research team from Canada, France and the United States.
The study, published in the Public Library of Science (PLoS) ONE, for the first time documents the presence of prion protein in urinary-derived fertility products. Prion protein is naturally found in the human body in a harmless form, but is the major constituent of infectious prions in an aggregated misfolded form. Prions are the infectious agents responsible for such transmissible and fatal neurodegenerative diseases as Creutzfeldt-Jakob disease (CJD) in humans, and bovine spongiform encephalopathy (BSE), commonly known as “mad cow disease,” in cattle.
More than 300,000 women in Canada and the United States each year are prescribed gonadotropins (fertility hormones), including those that are urine-derived. Although CJD has never been reported in a recipient of urine-derived fertility hormones, the study, which looked at dozens of urine-derived drug samples from various pharmaceutical companies and batches, demonstrated a previously unrecognized risk of contamination with infectious prions.
Transmission of human prion disease can occur through blood transfusion as well as through medical or surgical procedures, including injection of hormones – such as gonadotropins – historically extracted from cadaver pituitary glands. In some cases, prions can incubate in humans for decades when transmitted by medical or surgical procedures.
”While urine donors are screened for symptomatic neurological disease, a lengthy symptom-free incubation period for prion disease, during which the urine of affected donors may be infectious, is impossible to exclude without invasive testing,” said Dr. Neil Cashman, Scientific Director of PrioNet Canada and Canada Research Chair in Neurodegeneration and Protein Misfolding Diseases at the University of British Columbia, who authored the paper with Dr. Daniel Krewski, Director of the R. Samuel McLaughlin Centre for Population Health Risk Assessment at the University of Ottawa.
According to Dr. Cashman, disorders such as CJD – suffered by roughly one in 10,000 people – typically develop in the 60 to 70 year-old age group. With urine donations tending to come from older women, the risk of transmission of infectious prions may increase, he said. Unlike the blood-donor system, current urine-collection systems pool the urine of thousands of donors, so individual donors cannot be traced.
”PrioNet Canada’s mission is to help manage the risks of prion diseases to Canadians, and society at large,” said Dr. Cashman. “By participating in this international research study, we are fulfilling our objectives.”
”Based on the information we now have – including the detection of prions in urine of experimental animals, the relative ease of human-to-human transmission, the risk of prion infection through fertility drug injections, and the young age of fertility drug recipients – it is important to consider whether the risks of these products may now outweigh their benefits,” Dr. Cashman emphasized, adding that the extent of the risk is at this point difficult to determine and further scientific study is required.
According to Dr. Krewski: “Risk management paradigms are shifting towards more proactive, rather than reactive, approaches that are intended to help regulatory systems anticipate and prevent risks to population health.”
”Careful examination of the risk of transmission of human prion disease in pharmaceuticals is now warranted,” Dr. Krewski said, explaining that the study results indicate a need for better screening and tracking of prion diseases related to donor-derived pharmaceuticals. Further investigation into the use of synthetic substitutes that can achieve the same therapeutic results and the extent of prion contamination of urine-derived products, is also needed, he added.
Background
This paper was a result of research into the risk of prion disease transmission led by Dr. Neil Cashman, Scientific Director of PrioNet Canada and Canada Research Chair in Neurodegeneration and Protein Misfolding Diseases at the University of British Columbia. Dr. Daniel Krewski, Director of the R. Samuel McLaughlin Centre for Population Health Risk Assessment and Natural Sciences and Engineering Research Council of Canada Chair in Risk Science at the University of Ottawa, collaborated in the study, examining the risk management implications of the study results. Dr. Alain Van Dorsselaer, CNRS Research Director at Strasbourg University and Director of the Analytical Sciences Department at the Hubert Curien Institute in France, applied proteomic techniques to document the presence of prion protein in urine-derived fertility drugs.
Source: PrioNet Canada
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Detection of Prion Protein in Urine-Derived Injectable Fertility Products by a Targeted Proteomic Approach
Neil R Cashman … S. McNair 2 Daniel Krewski 3 Neil R. Cashman … et de la Recherche Médicale, France
* E-mail: neil.cashman@vch.ca
PLoS ONE: Research Article, published 23 Mar 2011 10.1371/journal.pone.0017815
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0017815
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[참고]
스위스의 니콜라 프란치니 박사 등 미국, 독일, 스위스 출신의 과학자들은 2006년 12월20일자 국제과학 온라인 저널인 ‘PLoS ONE’에 ‘우유 내 프리온 단백질’이라는 제목의 논문을 발표했다. 연구자들은 “최근의 연구에 따르면, 양의 유선조직에서 프리온(단백질로만 이뤄진 병원체) 복제가 일어나 스크래피(동물의 중추신경에 감염되는 질환)와 유방염을 일으킨다는 사실이 증명됐다”며 “우유 속에 정상 프리온 단백질이 존재한다는 사실은 우유가 전염성 해면상 뇌증(TSE)의 감염원으로 작용할 가능성이 있다는 사실을 의미한다”고 경고했다.
미국 캘리포니아주립대 스크립스 연구소의 마이클 올드스톤 박사팀은 2006년 7월7일자 ‘사이언스’지에 “최근 쥐 실험을 통해서 프리온이 원인이 되는 새로운 유형의 심장병을 규명했으며, 프리온은 혈액순환을 통해 심장 감염을 일으키는 것으로 추정된다”는 연구결과를 발표했다. 또한 최근 수혈을 통해 인간광우병(vCJD)에 감염된 사례가 3건 보고된 것과 관련, 미국과 스페인 학자들로 구성된 공동연구팀은 광우병 증상이 나타나기 전에 혈액검사를 통해 프리온을 검출할 방법을 연구한 논문을 발표했다. 기드온 M. 셰이크드는 2001년 8월24일자 ‘생물화학회지’에 오줌 속에 들어 있는 소량의 변형 프리온을 진단하는 방법을 보고하기도 했다
