Virtually all transmissible encephalopathies
(TSEs), such as scrapie, CJD, and BSE, are
caused by a type of infectious particle that
remains enigmatic. The language of prion theory
supersedes the reality of what is, and what is
not known. This review questions the predictive
value, consistency and accuracy of this now
dominant assumption. Many people believe the
normal cellular prion protein (PrP)
self-converts into an infectious amyloid protein
or prion. Although the amyloidogenic capacity of
proteins is well established, the concept of an
infectious protein without nucleic acid was
"revolutionary." Diverse experiments have
repeatedly shown, however, that this protein
alone, in any form, is incapable of reproducing
transmissible infection. In contrast, the
infectious agent copurifies with many other
molecules, including nucleic acids, while it
separates from the majority of PrP. The
infectious particle has a homogeneous viral size
of ~25 nm, and infectivity is markedly reduced
by conditions that disrupt viral core components
but do not disrupt multimers of PrP amyloid.
Additionally, the infectious agent replicates to
high levels before any PrP abnormalities can be
detected. Hence, we initially proposed that PrP
changes are part of the host's pathologic
response to high levels of infectious agent, but
not the agent itself. Newer data clarifying a
role for myeloid cells in the spread of
infection, the unique character of two different
agent strains propagated in a single animal, and
the demonstration of long nucleic acids in a
variety of simplified high titer preparations
continue to raise serious questions for the
prion hypothesis. Moreover, the epidemic spread
of TSEs, and the activation of host innate
immune mechanisms by infection, further indicate
these agents are recognizably foreign, and
probably viral.