Indeed, ficolins have been reported to bind to the trophoblast ce

Indeed, ficolins have been reported to bind to the trophoblast cells undergoing apoptosis in the pre-eclamptic placenta [15]. Additionally, the placenta sheds apoptotic and even living cellular and subcellular material (also called as trophoblast debris), containing cell-free fetal DNA and sFlt-1, into the maternal circulation both in normal pregnancy and with elevated amounts in pre-eclampsia [28–33]. Given the significant inverse correlation of circulating levels of ficolin-2 with those of cell-free fetal DNA and sFlt-1 in our healthy pregnant and pre-eclamptic

groups, it is tempting to speculate that ficolin-2 may be involved in the direct removal of trophoblast-derived material from the maternal circulation. In pre-eclampsia, consumption (or primary deficiency) of circulating ficolin-2, as suggested selleck inhibitor by its diminished plasma concentration, might impair the clearance of shed apoptotic and necrotic placental material leading

to the maternal syndrome of the disease. Although plasma ficolin-3 check details concentration was also decreased in our pre-eclamptic women, circulating levels of ficolin-3 did not correlate with those of cell-free fetal DNA or sFlt-1 in our pregnant study groups. This discrepancy might be explained by the differences in ligand specificity of ficolin-2 and ficolin-3, i.e. ficolin-2 can recognize DNA [22]. It is possible that low plasma concentration of ficolin-3 in pre-eclampsia is simply a consequence of its sequestration in the apoptotic placenta [15]. There is an increasing body of evidence that an imbalance between circulating angiogenic factors and their antagonists plays a crucial role in the pathogenesis of pre-eclampsia [34,35]. We have reported previously that increased serum sFlt-1 and decreased PlGF levels are associated with blood pressure, renal and endothelial dysfunction, trophoblast deportation, as well as with a shorter duration

of pregnancy, fetal growth restriction and the severity and preterm onset of the disease in pre-eclampsia [36]. not In the present study, plasma ficolin-2 levels showed significant inverse correlations with renal and liver function parameters, as well as with markers of endothelial activation and injury in women with pre-eclampsia. However, after adjustment for serum sFlt-1 levels, these associations disappeared except for that with serum creatinine concentrations. These results suggest that low levels of circulating ficolin-2 due to its consumption or primary deficiency (e.g. genetically determined) might contribute to the development of generalized endothelial dysfunction and the maternal syndrome of the disease indirectly through impaired elimination from the circulation of the placentally derived material containing sFlt-1.

Conflict of interest: The authors declare no financial or commerc

Conflict of interest: The authors declare no financial or commercial conflict of interest. Detailed facts of importance to specialist readers are published as ”Supporting Information”. Such documents are peer-reviewed, but not copy-edited or typeset. They are made available as submitted by the authors. “
“Hereditary angioedema (HAE) and acquired angioedema (AAE) are rare

life-threatening conditions Lumacaftor supplier caused by deficiency of C1 inhibitor (C1INH). Both are characterized by recurrent unpredictable episodes of mucosal swelling involving three main areas: the skin, gastrointestinal tract and larynx. Swelling in the gastrointestinal tract results in abdominal pain and vomiting, while swelling in the larynx may be fatal. There are limited UK data on these patients to help improve practice and understand more clearly the burden of disease. An audit tool was designed, informed by the published UK consensus document and clinical practice, and sent to clinicians

involved in the care of HAE patients through a number of national DNA Methyltransferas inhibitor organizations. Data sets on 376 patients were received from 14 centres in England, Scotland and Wales. There were 55 deaths from HAE in 33 families, emphasizing the potentially lethal nature of this disease. These data also show that there is a significant diagnostic delay of on average 10 years for type I HAE, 18 years for type II HAE and 5 years for AAE. For HAE the average annual frequency of swellings per patient affecting the periphery was eight, PAK6 abdomen 5 and airway 0·5, with wide individual variation. The impact on quality of life was rated as moderate or severe by 37% of adult patients. The audit has helped to define the burden of disease in the UK and has aided planning new treatments for UK patients. Hereditary angioedema (HAE) is a rare disease due to C1

inhibitor deficiency with autosomal dominant inheritance caused by mutations in SERPING1. These result in either low levels of C1 inhibitor (C1INH) (type I HAE) or normal levels with reduced C1 inhibitor function (type II HAE) [1]. A third type of HAE is now recognized (type III HAE), or HAE with normal C1INH due in some cases to mutations in Factor XII (FXII) [2, 3]. Acquired angioedema (AAE) may be caused by anti-C1INH antibodies and tends to be associated with haematological malignancy or, more rarely, autoimmune disease [4, 5]. Surveys suggest that HAE affects one in 50–100 000 of the population [6, 7] and a recent study underlined the importance of diagnosis and appropriate treatment, as the mortality of HAE patients who had not been diagnosed was 29% compared to 3% in those who had been diagnosed [8]. The mechanism causing angioedema in HAE is the generation of increased levels of bradykinin, and is distinct from allergic angioedema due to mast cell activation where the key mediator is histamine.

[2] In cooperation with signals from T-cell receptors, the recept

[2] In cooperation with signals from T-cell receptors, the receptors for IL-2, IL-4, IL-7, IL-9, IL-15 and IL-21, which are members

of the common γ chain cytokine receptor family, provide pro-survival signals involving PI3K-Akt pathways in naive T lymphocytes.[34, 35] Furthermore, click here Akt has been reported to modulate the activity of Stat3 and potentiate the expression of molecules acting downstream of Stat3.[36, 37] This suggests that various cytokines that activate the PI3K-Akt signalling pathway may confer resistance against apoptosis on resting T cells by promoting Stat3 activation, thereby enhancing Bcl-2 and Bcl-xL expression. In conclusion, our results suggest a role for Stat3 in the maintenance of naive T-cell homeostasis. Although we describe an important mechanism by which the T-cell pool is preserved under PD0332991 mouse resting conditions, further studies should address whether Stat3 can provide survival signals to relatively quiescent T or B lymphocytes, such as memory T cells. This work was supported by National Research Foundation of Korea [NRF] grants [No. 2011-0010571 and 2011-0030739] funded by the Korean government [MESF]. The funders had no role in

the study design, data collection and analysis, decision to publish, or preparation of the manuscript. We thank Dr Shizuo Akira for providing the Stat3-floxed mice. We also thank the Institute for Experimental Animals of the College of Medicine, Seoul National University. The English in this document has been checked by at least two professional editors, both native speakers of English. For a certificate, please see: http://www.textcheck.com/certificate/index/fgDfu3. The authors declare no financial or commercial conflict of interest. Figure S1. Generation of T-cell-specific Stat3-deficient mice. Figure S2. Analysis of T-cell numbers and the thymic subpopulations in Stat3WT/WT Lck-CRE−/− and Stat3WT/WT Lck-CRE+/− mice. Figure S3. Analysis of expression pattern in various T-cell receptor vβ chains from thymocytes or splenocytes “
“Dying cells release genomic DNA into the surroundings Tryptophan synthase where the DNA is first degraded to oligodeoxynucleotides,

then to nucleotides, nucleosides and so on. Given that the unmethylated CpG dinucleotide (CpG motif), which is characteristic of bacterial DNA, is also contained in mammalian DNA and has been reported to be involved in the exacerbation of DNA-associated autoimmune diseases, we investigated whether nucleotides and nucleosides affect immune responses to phosphodiester (PO)-CpG DNA. Addition of non-CpG DNA to RAW264.7, murine macrophage-like cells, induced no significant TNF-α production irrespective of treatment with DNase I; however, DNase I-treated, but not untreated, non-CpG DNA increased the PO-CpG DNA-mediated TNF-α production. This increase was not observed with phosphorothioate-CpG DNA or ligands for TLR3, TLR4 or TLR7.

[95] Furthermore type I NKT cells in spontaneous disease in (NZB 

[95] Furthermore type I NKT cells in spontaneous disease in (NZB × NZW F1) mice, were shown to promote anti-dsDNA autoantibody production by B cells in vitro as well as in vivo following adoptive transfer.[102-107] However, in NOD mice, spontaneous diabetes was exacerbated in CD1d-deficient animals lacking both NKT cell subsets. Hence, the physiological role of type I NKT cells remains controversial in spontaneous autoimmune diseases, possibly due to the absence of both NKT cell subsets in CD1d−/− mice as well as differences in background

genes, alterations in the target tissues and site(s) of priming of NKT cells. It is important to note that in most autoimmune disease models antigens or peptides are administered find more following their emulsification in complete Freund’s adjuvant. It is clear that type I NKT cells have an adjuvant-like effect, especially upon activation with αGalCer and can stimulate the activation of DCs. Therefore, the physiological contribution of type I NKT cells in experimental autoimmunity may be compromised, particularly if αGalCer is administered at the time of antigen/complete Freund’s adjuvant administration as it

can potentiate Th1 ell-mediated diseases.[108-111] Similarly, αGalCer administration can bias a global Th-dependent response towards a Th1-like or Th2-like polarized response. For example, Selleckchem PF-01367338 continuous αGalCer injection in younger (4-week-old) lupus-prone mice partially alleviates systemic lupus erythmatosus symptoms by increasing a Th2 bias,[112] whereas identical treatment in older mice (8–12 weeks old) increases a Th1-biased cytokine secretion profile and disease severity.[108] In most experimental autoimmune disease models, including experimental autoimmune encephalomyelitis (EAE) and experimental autoimmune myasthenia gravis,[19, 91, 112-115] antigen-induced disease is generally either less severe or not affected in CD1d−/− or Jα18−/− mice. These data suggest that type I NKT cells may help in the priming of antigen-reactive T cells by activating

conventional DCs and may not be regulatory in this context. These data also indicate that induction of antigen-induced autoimmune disease is not dependent upon the presence of type I or type II NKT cells. Rather, as a result of the administration of complete Tacrolimus (FK506) Freund’s adjuvant, type I NKT cells may elicit an adjuvant-like effect and thereby contribute to the severity of disease by potentiating Th1/Th17-like responses.[19] Consistent with this view, a general skewing of a conventional Th cell response towards a Th2-like cell response by αGalCer or its analogues, e.g. OCH, leads to protection from some autoimmune diseases, including EAE, type 1 diabetes, and collagen-induced arthritis.[91, 113-116, 80, 117, 47, 94] Interestingly, in some cases, an IFN-γ bias can also protect from EAE and experimental autoimmune uveitis by inducing the apoptosis of pathogenic CD4+ T cells.

Our data show that instability of Foxp3 expression is not imprint

Our data show that instability of Foxp3 expression is not imprinted early on but rather at later timepoints – after more than 2 days of coculture with DCs and TLR7 ligand. Tregs were originally believed to be a stable Th-cell lineage. However, several studies have clearly shown that Foxp3 expression can be repressed in subpopulations of natural as well as induced Tregs allowing conversion into Th1, Th2, or Th17 effector cells under the influence

of polarizing cytokines in vitro and in inflammatory environments in vivo 23, 26, 30, 31. We found that downregulation of Foxp3 Temozolomide purchase expression after transient induction in the presence of TLR7 stimulation was to a large part IL-6-dependent, suggesting that IL-6 affects the stability of Foxp3 expression. CpG-demethylation in a nonintronic upstream Foxp3 enhancer region is required for stable expression of Foxp3 and IL-6 induces methylation

at this site, leading to downregulation of Foxp3 expression 32. In addition to downregulation of Foxp3 expression, IL-6 in the presence of TGF-β reduces chromatin binding of Foxp3, and thus altering Foxp3 function 33. In our experimental setting, we found that downregulation of Foxp3 expression not only led to lower Treg numbers generated in the presence of TLR7 ligand, but also to generation of Tregs with a lower Foxp3 expression level. The suppressive activity Erlotinib ic50 of Foxp3+ T cells isolated from the cocultures was unchanged by TLR7 activation early on, but was clearly reduced at later time points correlating well with the lower Foxp3 expression level at these time points. In a mouse model of attenuated Foxp3 expression, the greatly reduced suppressive activity of Tregs correlated with reduced expression of Foxp3-dependent Treg “signature genes” and led to development of a scurfy-like autoimmune disease 23. We also found that Tregs generated in the presence of TLR7 ligand

expressed lower Chorioepithelioma levels of CD103 (αE integrin), a marker for activated effector/memory-like Tregs, which can migrate into inflamed tissues 24. CD103+ Tregs have superior suppressive activity compared with CD103− Tregs in mouse models of antigen-induced arthritis and graft versus host disease 24, 25. The reduced inhibition of responder T-cell proliferation by Tregs generated in the presence of TLR7 ligand therefore also correlates with a more “naïve”-like phenotype of these cells. In the previous reports, it has been shown that TLR stimulation (including TLR7 activation by RNA ligands) inhibits Treg-suppressive function indirectly in an APC- and IL-6-dependent manner by making responder T cells resistant to Treg-mediated suppression 19, 34. In contrast to these studies, a recent report showed that TLR7 signaling directly enhances the suppressor function of natural Tregs by sensitizing them to IL-2-induced activation in the absence of APCs as well as in the presence of bone-marrow-derived DCs 20.


“Microcirculation (2010) 17, 226–236 doi: 10 1111/j 1549-


“Microcirculation (2010) 17, 226–236. doi: 10.1111/j.1549-8719.2010.00022.x Tissue blood flow is controlled by a branching network of resistance arteries coupled in series and parallel with one another. To alter organ perfusion

during periods of elevated metabolic demand, the arterial segments comprising these networks must dilate in a coordinated manner. Gap junctions are intercellular PLX3397 pores that facilitate arterial coordination by enabling electrical stimuli to conduct among and between endothelial and/or smooth muscle cells. Through this novel perspective, readers will be introduced to the vascular communication field, the process of intercellular conduction, and how key cellular properties influence charge flow. This overview will begin with a brief historical review

and then introduce two differing theories on how electrical phenomena moves among and between vascular cells. The basis of the “syncytium” and “differential” hypothesis will be critically discussed within a framework of biophysical and experimental observations. This foundational understanding will be used to extend our mechanistic insight of: (i) “local” and “global” blood flow control; and (ii) debilitating disorders such as arterial vasospasm. “
“Vascular smooth muscle contraction and relaxation play a preponderant role on the active (acute) and structural (long-term) control of vascular diameter. This editorial overview summarizes and highlights the opinions expressed in seven reviews contained in this special topic issue of Microcirculation. Selleck PD0325901 The reviews address diverse aspects of the mechanisms that influence cell adhesion, calcium homeostasis, and cytoskeletal

remodeling, and how these mechanisms affect vascular structure and function at different levels of the circulation. “
“Please cite this paper as: Bachmeier, Beaulieu-Abdelahad, Mullan, and Paris (2011). Epitope-Dependent Effects of Beta-Amyloid Antibodies on Beta-Amyloid Clearance in an In Vitro Model of the Blood–Brain Barrier. Microcirculation 18(5), 373–379. Objective:  To investigate the role of RAGE in the epitope-dependent effects of Aβ antibodies Olopatadine used as a peripheral sink therapy in AD. Methods:  An in vitro model of the BBB was used to examine the effect of various Aβ antibodies or Aβ peptide fragments on Aβ exchange across the BBB. Results:  An N-terminal Aβ antibody significantly enhanced the basolateral-to-apical transcytosis of fluorescein-Aβ(1–42) across the BBB model (41%), while no effect was apparent with a C-terminal Aβ antibody. Interestingly, modulation of RAGE in the presence of a C-terminal Aβ antibody resulted in a 65% increase in Aβ clearance across the BBB model, suggesting the C-terminal antibody–Aβ complex is susceptible to RAGE transport.

15–17 However, the detailed mechanism of GATA-3

in chroma

15–17 However, the detailed mechanism of GATA-3

in chromatin remodelling and regulation of the Th2 cytokine locus is poorly understood. Metastasis-associated protein 2 (MTA-2) is a member of the MTA family of transcriptional co-repressors that function in histone deacetylation.18 It is a component of the nucleosome remodelling histone deacetylase (NuRD) complex, and has been shown to positively regulate histone deacetylase activity of the complex.18 Expression of MTA-2 enhances p53 deacetylation and strongly represses p53-dependent transcriptional activation.19 The MTA-2 has been shown to interact with estrogen receptor α and repress its activity, possibly through deacetylation.20 Although all MTA family proteins are found in NuRD complexes, these proteins form distinct complexes and are thought to target different www.selleckchem.com/products/Romidepsin-FK228.html sets of promoters.18,21 In this study, we investigated the role of GATA-3 in the regulation

of Th2 cytokine and ifng loci. We found that GATA-3 interacts with MTA-2, which is a component of the NuRD chromatin repression complex and has been shown to be involved in il4 gene expression. GATA-3 LEE011 in vitro and MTA-2 bind to several regulatory regions of the Th2 cytokine locus mutually exclusively and to the ifng promoter simultaneously in Th2 cells. The MTA-2 negatively regulated the transactivation activity of GATA-3 at il4 promoter, but co-operated with GATA-3 for repression at the ifng promoter. These results suggest that GATA-3 interacts with MTA-2 in the Th2 cytokine and ifng loci for the regulation of these loci. HEK293T cells in a 10-cm plate were transfected with pcDNA3-HA–GATA-3 or with the empty pcDNA3 vector. After 48 hr of transfection, cell lysates were passed through the haemagglutinin (HA) -affinity column (Roche, Mannheim, Germany). CHIR-99021 mouse The column was extensively washed, and then

Th2 nuclear extracts were passed through the column again. After several washings, bound HA–GATA-3 protein complexes were eluted using HA-peptide (Roche), following which elutes were analysed by tandem spectrometry (MS/MS). CD4 T cells were enriched from spleen cells from C57BL/6 mice by negative selection through depletion using anti-major histocompatibility complex class II (M5/115), anti-NK1.1 (HB191), and anti-CD8 (T1B105) monoclonal antibodies, followed by depletion with a mixture of magnetic beads conjugated to anti-rat immunoglobulin and anti-mouse immunoglobulin antibodies (Perseptive Biosystems, Framingham, MA). Naive CD4 T cells were sorted based on the surface markers, CD4high and CD62Lhigh. These cells (1 × 106) were then stimulated with 10 μg/ml plate-bound anti-CD3 (2C11), 2 μg/ml soluble anti-CD28, and 20 U/ml IL-2 in 5 ml of RPMI-1640 medium with 5% fetal calf serum (Invitrogen, Carlsbad, CA) and penicillin/streptomycin.

Both neurogenic niches of the mammalian brain are characterized b

Both neurogenic niches of the mammalian brain are characterized by unique stem cell populations that can give rise to discrete neuronal cell types [6]. NSPCs reside in the SVZ and line the lateral ventricles adjacent to a population of ependymal cells (Figure 1). These slowly proliferating, quiescent NSPCs, known as type B cells, project

cilia into the ventricle and contact blood vessels within the niche [8–10]. Upon activation, type B cells give rise to proliferating type C NSPCs. LEE011 in vitro This rapidly dividing population of NSPCs amplifies the pool of newborn cells and generates neuroblasts, termed type A cells. The neuronally committed type A cells exit the SVZ and migrate, along the RMS, in chains through a dense glial tube towards the OB. There, the immature neurones then differentiate into olfactory GABAergic granule interneurones, dopaminergic periglomerular interneurones or glutamatergic juxtaglomerular neurones, and integrate into the local neuronal circuits [11,12]. Studies in rodents have revealed that this dynamic neurogenic process generates many thousands of neuroblasts daily; however, only a small fraction of immature neurones survive and functionally integrate into OB

circuits [11]. In humans, recent studies have revealed a sharp drop in SVZ neurogenesis after infancy, suggesting that this germinal zone is inactive in adult humans [13,14] even though other studies suggested lifelong neurogenesis also in the human SVZ/OB system [15]. In the adult hippocampus, NSPCs reside in MK-2206 ic50 the subgranular zone (SGZ) of the DG and give rise to granule cell neurones in a multistep process (Figure 2). Relatively quiescent NSPCs, known as type 1 cells, extend a radial process through the granule cell layer (GCL) into the molecular layer (ML) [16,17]. This population of NSPCs can be activated to generate proliferating type 2, non-radial NSPCs. These type 2 cells give rise to neuroblasts and amplify the pool of neurogenic cells,

which upon neuronal differentiation Oxymatrine begin to branch out processes [18]. Immature neurones migrate up into the GCL and over a period of 3 weeks newborn granule cell neurones project out a large dendritic arbor into the ML and an axon into the hilus that terminates on target cells in the hilus and area CA3 [19–22]. In humans, the hippocampal germinal zone remains active throughout life, producing thousands on newborn neurones everyday [23]. Recent data by the Frisen group showed that during ageing the DG is composed of a declining fraction of cells generated during embryonic development, which are then gradually replaced by postnatally born granule cells [24]. Since the discovery of neurogenic niches in the adult brain, many groups have investigated the molecular mechanisms that regulate this process.

By 4 wk after i m prime or boost, CD69 was decreased on tet+CD8+

By 4 wk after i.m. prime or boost, CD69 was decreased on tet+CD8+ T cells from spleens, blood and

OUC, whereas its expression on the vagina was similar to that on unprimed CD8+ T cells. By 1 year after the boost, CD69 expression on tet+CD8+ T cells from all compartments was similar to that of naïve cells, suggesting that this molecule is unlikely to contribute for the sustained presence of vaccine-induced CD8+ BTK inhibitor nmr T cells within the GT (data not shown). Expression of CD127 was increased on tet+CD8+ T cells from ILN and the vagina at 4 wk after priming. A similar pattern was observed at 4 wk after the boost but for a modest increase in OUC. By 1 year after the boost, CD127 expression was increased in tet+CD8+ T cells from all compartments, being especially pronounced in cells from GT. The most striking difference in the expression of CD103 was seen at 1 year after the boost, when this marker was markedly upregulated on tet+CD8+ T cells from the GT, but otherwise comparable to naïve cells in the other compartments. No remarkable changes were seen in the profile of NKG2D on T cells from the compartments analyzed. Figure 4B shows the expression levels of granzyme

B, a proteolytic enzyme that induces caspase-dependent apoptosis, see more and perforin, a pore-forming protein that facilitates granzyme access through the membrane into the cytosol of the target cell 19. In

addition, Fig. 4B shows the expression levels for CTLA-4, a key molecule for downregulation of T-cell responses, Tideglusib programmed death-1 (PD-1), which negatively regulates T-cell signaling and effector functions and is expressed at increased levels on so-called exhausted T cells 20 and Ki-67, a protein associated with proliferation. Expression of granzyme B mostly mirrored that of perforin, with a very pronounced increase in both enzymes in most tet+CD8+ T cells isolated from the whole GT at 1 year after the boost. Notably, the expression levels of other markers such as CD62L at the same time point suggest that T cells isolated from the GT had differentiated into resting memory cells. Memory CD8+ T cells typically do not carry granzyme or perforin, which are markers for fully activated effector CD8+ T cells. CTLA-4 expression was decreased in tet+CD8+ T cells from spleens, ILN and vagina at 4 wk after the prime, whereas there was an increase in its expression on those from OUC.

[69] Paradoxically, many of these in vitro approaches to

[69] Paradoxically, many of these in vitro approaches to XL765 prion disease research have been developed using materials from high-titer rodent models of sheep scrapie. The challenge for human prion disease research is to apply these emerging techniques to the study of human prions in humans. Molecular strain typing in the form of classifying the mobility and glycoform ratio of protease-resistant prion protein by Western blotting is a remarkably useful adjunct to neuropathological assessment during the post-mortem diagnosis of human prion diseases

(Fig. 1). The glycoform ratio difference between vCJD and all forms of sCJD is a remarkably robust phenomenon, although the mechanism underlying it remains obscure. All cases of vCJD examined show type 2B PrPres, irrespective of brain region assayed and the PrPres type is also found in lymphoreticular tissues, albeit with presumably tissue-specific minor modification of mobility and an accentuation of the glycoform ratio. Similarly sCJD cases are characterized by a narrow range of glycoform ratios, distinct from vCJD, and the presence of either type 1 or type 2 PrPres (type 1A and type 2A). The PrPres types found in the brain in iCJD and kuru resemble those found in sCJD (type 1A and type 2A), from which they were presumably derived. Individual cases of gCJD, GSS and FFI usually ATM/ATR mutation have type

1 or type 2 PrPres, but with a glycoform ratio in which the non-glycosylated component is under-represented (which we have termed A/B). However, this is not always true and a broad spectrum of glycoform ratios can be found in genetic prion diseases. Moreover, some cases of GSS are characterized by an approximately 8 kDa (N- and C-terminally truncated) PrPres fragment, and some cases of FFI have little detectable PrPres at all. Despite the diagnostic utility, a simple

one-to-one correspondence between PrPres type and disease phenotype (and by implication to agent strain) seems unlikely in principle and is complicated by the facts. First, the choice of analyzing only that fraction of PrPSc which Erythromycin survives a particular concentration of protease may seem arbitrary. Second, the interpretation of a molecular population variable, such as glycosylation site occupancy, as conforming to two or three discrete types, could be seen as simplistic. Lastly, protease digestion may be considered to be a somewhat blunt instrument to distinguish secondary and higher-order conformational differences in PrPSc. Even when genotype (mutations and polymorphisms) is taken into account, three major types (1, 2, 8 kDa) and three wild-type genotypes (MM, MV and VV) provide insufficient molecular variation to account for all the phenotypic variations observed. For example, two forms of sCJD share methione homozygosity and type 2A PrPres but one form closely resembles FFI (without the causative mutation) and the other is CJD-like.