One microliter of serum samples were pretreated with DNAse I for

One microliter of serum samples were pretreated with DNAse I for 30 min and diluted 1:100 in PBS + Tween 20 before being added to the arrays in duplicates. Arrays were incubated with samples at room temperature for 1 h with agitation. Olaparib supplier Detection was with Cy3-labeled anti-mouse IgM and Cy5-labeled anti-mouse IgG (Jackson ImmunoResearch). A Genepix 4000B scanner with laser wavelengths 532 (for Cy3) and 635 (for Cy5) was used to generate images for analysis. Images were analyzed using Genepix Pro 6.0 software to generate

a Gene Pix results file. Background subtracted fluorescence intensities of duplicated spots were averaged and then normalized using mouse IgG or IgM which were spotted onto each array as internal controls. Hierarchical clustering analysis of autoantibodies was performed using Cluster and Treeview software (http://rana.lbl.gov/EisenSoftware.htm). Kidneys from 8- to 12-month-old mice were fixed in 10% buffered

formalin (Fisher Scientific). Sagittal sections were stained with H&E and with periodic acid Schiff and examined by pathologists who were blind to the identity of the samples. GN and tubular interstitial nephritis severity were graded on a scale of 0–4 as described in [63, 64]. For IgG staining, a representative piece of fresh kidney cortex was embedded with Tissue-Tek O.C.T. this website Compound (Sakura Finetek) and frozen in a Leica CM1850 cryostat (Leica Biosystems). A frozen section was cut at 3–5 μm thickness, placed on a positively charged slide and air dried at room temperature for 30 min. The slide was then rinsed with PBS, fixed in 95% ethanol,

hydrated with PBS, and placed in a darkened humidity chamber. One hundred microliters of diluted (1:250), FITC-conjugated, goat polyclonal Ab to mouse IgG (ab97022, Abcam) was added and the slide incubated at room temperature for 30 min, followed by rinsing with PBS. The stained slide was mounted with a coverslip using Aquamount (Thermo Fisher Scientific) and viewed with Olympus BX51 fluorescence microscope (Olympus). The intensity of staining was graded on a scale of 0–3 by a pathologist blind to the identity of the samples. Splenocytes were lysed in Trizol® (Invitrogen). Total RNA was Phosphoprotein phosphatase prepared using a Qiagen RNeasy Kit (Qiagen), and cDNA was generated with a cDNA Archive Kit (Applied Biosystems) according to the manufacturers’ instructions. Quantitative PCR was performed in a Bio-Rad CFX96 machine using Taqman reagents specific for IL-21 and GAPDH (Applied Biosystems). Data were normalized to GAPDH using the delta comparative threshold cycle method [65]. We thank Arturo Menchaca, Lyndsay Joson, and Veronica Gaffney for excellent technical assistance and Veronica Gaffney for critical reading of the manuscript. This work was funded by NIH grants P01 AI039824 (A.B.S.) and 1 F31 GM076982 (T.G.). A.B.S. is a Southwestern Medical Foundation Scholar in Biomedical Research.

Localized CL is the most frequent clinical form of ATL [18,36,39]

Localized CL is the most frequent clinical form of ATL [18,36,39]. It can be caused by all pathogenic Leishmania species with dermal tropism, including L. braziliensis and L. amazonensis[18]. Clinical and histopathological differences have been described between human infections with these two species: L. braziliensis causes mucosal leishmaniasis, a clinical form associated with the up-regulation of Th1-type responses [15–18], whereas L. amazonensis is the aetiological agent of anergic diffuse cutaneous Kinase Inhibitor Library manufacturer leishmaniasis, a condition associated with specific impairment of the

cell-mediated immune response [3,10,18,37,40]. Furthermore, a respectable amount of data in the murine model indicates impairment in multiple immune functions after L. amazonensis infection [41–47]. Taken together, these observations suggest major differences in cell-mediated immunity against these Leishmania species, and that the mechanisms responsible for susceptibility to L. amazonensis are complex and deserve more

thorough investigation. In the present study, we were able to show that crude promastigotes extracts obtained from KPT-330 concentration L. braziliensis and L. amazonensis induce a different magnitude and quality of the Th1 response in PBMCs from healed CL patients. To our knowledge, this is the first time that multifunctional Farnesyltransferase CD4+T cells have been evaluated in human leishmaniasis. Corroborating previous data [48], in this study we confirmed that LbAg induces higher levels of IFN-γ than LaAg, and are now able to demonstrate that this fact was related not to a higher percentage of cytokine-producing cells, but to a higher

amount of protein produced by individual CD4+T cells (Fig. 1a and b). Furthermore, using multiparametric flow cytometry approach, we were also able to indicate that it might be associated to differences in the quality of Th1 CD4+T cells induced by both antigen extracts (Fig. 2). Because the same results regarding IFN-γ levels induced by LbAg and LaAg were observed in PBMCs obtained from ATL patients before therapy [48], and that parasites isolated from patients of the former and current studies were characterized as L braziliensis, it could be expected that their T cells would respond more strongly to antigens from the homologous species with which they have been infected than to antigens from species belonging to a different subgenus. Conversely, it has been demonstrated that LbAg is a more potent stimulator of T cell response than LaAg in individuals infected with L. amazonensis, as well as in individuals infected with parasites from the Viannia subgenus, before and after therapy [49]. It has also been shown that LaAg or live L.

It is generally accepted that if the cage environment includes re

It is generally accepted that if the cage environment includes resources

that are relevant for the animals, their welfare is improved when compared to animals housed in standard cages [3]. The impact of such resources can be determined using standard animal welfare research methods such as tests of preference and motivational strength [4]. Traditionally, nesting material would only be given to pregnant and lactating females. However, there is ample evidence that males and non-breeding females also build nests [3], even in the presence of other sheltering structures [5]. Of notice, mice work by key-pressing [6] and overcome their aversion for a grid floor [5] to get access to nesting material. Mice also show a preference for cages with shelters [3] and work for access to a cage structured with a plastic nest box [7]. Studies as Selleckchem Staurosporine these form the fundament for the recent

European recommendation according to which mice should be given access to nesting material and refuges [8]. Although the scientific community acknowledges that mouse Opaganib research buy well-being is enhanced by using enriched cages, there is the obvious concern that altering the housing conditions of laboratory rodents may influence the experimental results [9, 10]. The major concern regards the disruption of standardization and the loss of precision and reproducibility, in the case variability increases in enriched cages triclocarban [11]. The few available reports are inconclusive:

there are single studies indicating an increased variation in enriched cages [10, 12] but two large inter-laboratory studies showing no evidence for such an increase [11, 13]. Another concern is that a change in housing conditions may cause stress. In fact, there is a sizeable body of evidence showing that, in general, animals housed in enriched cages show reduced stress [14]. This may in turn influence experimental variables that are affected by stress, such as the basal level of blood corticosteroids, behaviour or even some parameters of the immune system [15, 16]. Because infectious diseases are a major cause of morbidity and mortality in the world, [17] it is expectable that a large number of animals will continue to be used to study the immune response to infection. Of the 21.1 million animals used for research in the European Union in 2005, 31% were used for research and development in medicine (human and veterinary) [18]. Infections caused by bacteria from the Mycobacterium genus are among the leading causes of illness and death because of infectious diseases [19].

There has been a large increase in reports of haemolysis to the C

There has been a large increase in reports of haemolysis to the Canada vigilance programme in the last 3 years; it is not clear whether this is due to increased IgG use, changes in prescribing practice, higher dose infusions or increased 5-Fluoracil concentration vigilance. Desborough et al. [11] reviewed all published cases of haemolysis following IgG infusion and also reports made to vigilance

authorities in North America and Europe between January 1998 and May 2012. They documented 925 reported cases and 34 recorded deaths in these individuals. If every death was associated with the reported haemolytic event, this would represent a case fatality rate of 0·3%; however, the review does not confirm whether or not this is the case. The predominant mechanism thought to be responsible for haemolysis following IgG therapy involves anti-A or anti-B isoagglutinins in gammaglobulin preparations. As type O is the most predominant blood type across all ethnic groups, it is logical to assume that anti-A and anti-B isoagglutinins will be found in significant Opaganib in vivo concentrations in a pooled plasma

product. The review by Desborough et al. [11] investigated 62 published cases of haemolysis, and of these identified 40 in patients with blood type A and 16 in patients with type AB, indicating the importance of type A as a target antigen in these patients. The presence of one reported case in a type B patient, and another with type O,

suggest that haemolysis could also have been associated with other specificities such as anti-D. Almost all DCLK1 cases were reported in patients receiving high-dose anti-inflammatory IgG therapy. It should be noted that death directly associated with haemolysis did not occur in these reported cases. The principal risk factor for haemolysis is non-O blood type. Antigen density on red blood cells may be another risk factor, as may the non-secretor phenotype. Further investigation is required to ascertain whether non-A/B antibodies contribute. Macrophage activation and inflammation are also probably implicated, and pre-existing haemolytic disease may be another risk factor. The events also occur more frequently after high-dose infusion, >1·5–2 g/kg over 1–5 days, with 45% of reported cases occurring after a 2–3 g/kg dose. Currently, specifications for IgG products in the United States and the European Union set an antibody limit of ≤1:64 in a direct haemagglutinin assay [12], and precautionary labelling of these products is also in use. Research is currently ongoing to identify ways to reduce the amount of agglutinin in the final product: affinity extraction is currently under investigation, but is not yet widely used. It is also important to monitor the fraction of type O donors contributing to the product, as a larger proportion of type O will lead to a larger proportion of agglutinins in the final product.

2A) In addition, STAT1 depletion resulted in a reduced release o

2A). In addition, STAT1 depletion resulted in a reduced release of CXCL10 and CCL2 chemokines by IFN-γ-activated keratinocytes, whereas CXCL8 production, not highly induced by IFN-γ in human keratinocytes, did not change in STAT1-silenced strains (Fig. 2B). In light of these results, we investigated whether PS-5, and KIR peptide as control, influenced the expression of these

IFN-γ-induced inflammatory molecules. To this end, keratinocyte cultures were pretreated with PS-5, KIR, or NC peptides, and then stimulated or not with IFN-γ for 24 h. As expected, PS-5 partly dampened IFN-γ-induced Venetoclax chemical structure ICAM-1 expression, whereas they completely abrogated HLA-DR induction in keratinocytes (Fig. 3A). In addition, keratinocyte cultures treated with PS-5 peptide showed a reduced CXCL10 and CCL2 release upon IFN-γ stimulation, whereas they exhibited unchanged expression levels of CXCL8 (Fig. 3B). Taken together, these results indicated that PS-5 efficiently

inhibits the inflammatory gene expression mediated by STAT1 in IFN-γ-activated human keratinocytes. ICAM-1, an IFN-γ-induced membrane molecule, plays a critical role in T lymphocyte-to-keratinocytes adhesion by acting as the ligand for LFA-1 and Mac-1 molecules [20, 21]. To investigate the functional consequences of the inhibition of the IFN-γ signaling determined by PS-5 mimetic, we analyzed T cell-keratinocyte adhesiveness in an in vitro cell contact model. A monolayer of human cultured keratinocytes was pretreated or not

with PS-5, KIR, or NC peptides, then stimulated MLN0128 with IFN-γ for 24 h, and finally cocultured for 6 h with autologous carboxyfluorescein succinimidyl ester (CFSE)-labeled T cell clones. After extensive washing, the number of adherent T cells was determined Farnesyltransferase by counting CFSE+ cells by a fluorescence microscope. As shown in Figure 4, we found that T cells barely adhered to resting keratinocytes, independently of the presence of the relevant Ag (average numbers of T cells per square millimeter = 2 ± 0.2). In contrast, numerous T lymphocytes adhere to IFN-γ-treated keratinocytes treated or not with NC peptide [average number of T cells per square millimeter = 65 ± 4.8 and 61 ± 5.1, respectively]. Consistently with the reduced ICAM-1 expression observed in IFN-γ-activated cells treated with PS-5 or KIR, the exposure of the keratinocyte monolayer to PS-5 or KIR significantly impaired its adhesiveness of T cells, compared to NC peptide (average number of T cells per square millimeter = 23 ± 1.5 and 18 ± 0.9, respectively) (Fig. 4). Moreover, T cell-keratinocyte adhesiveness was strongly decreased by blocking ICAM-1 with an anti-ICAM-1 Ab in IFN-γ treated keratinocytes (average number of T cells per square millimeter = 5 ± 0.6), confirming the strict dependence of T-cell-keratinocyte adhesiveness on ICAM-1 expression.


“J A Bevilacqua, N Monnier, M Bitoun, B Eymard, A Fe


“J. A. Bevilacqua, N. Monnier, M. Bitoun, B. Eymard, A. Ferreiro, S. Monges, F. Lubieniecki, A. L. Taratuto, A. Laquerrière, K. G. Claeys, I. Marty, M. Fardeau, P. Guicheney, J. Lunardi and N. B. Romero (2011) Neuropathology and Applied Neurobiology37, 271–284 Recessive RYR1 mutations cause unusual congenital myopathy with prominent nuclear internalization and large areas of myofibrillar disorganization Aims: To report the clinical, pathological and genetic findings in a group of patients with a previously not described phenotype

of congenital myopathy due to recessive mutations in the gene encoding the type 1 muscle ryanodine receptor channel (RYR1). Methods: Seven unrelated patients shared a predominant axial and proximal weakness of varying severity, with onset during the neonatal period, associated

with bilateral ptosis and R788 ic50 ophthalmoparesis, and unusual muscle biopsy features at light and electron microscopic levels. Results: Muscle biopsy histochemistry revealed a peculiar morphological pattern characterized by numerous internalized myonuclei in up to 51% of fibres and large areas of myofibrillar disorganization with undefined borders. Ultrastructurally, such areas frequently occupied the whole myofibre cross MEK inhibitor section and extended to a moderate number of sarcomeres in length. Molecular genetic investigations identified recessive mutations in the ryanodine receptor (RYR1) gene in six compound heterozygous patients and one homozygous patient. Nine mutations are novel and four have already been reported either as pathogenic recessive mutations or as changes affecting a residue associated with dominant malignant hyperthermia susceptibility. Only two mutations were located in the C-terminal transmembrane domain whereas the others were

distributed throughout the cytoplasmic region of RyR1. Conclusion: Our data enlarge the spectrum of RYR1 mutations and highlight their clinical and morphological heterogeneity. A congenital myopathy featuring ptosis and external ophthalmoplegia, concomitant with the novel histopathological phenotype showing fibres with large, poorly delimited Atazanavir areas of myofibrillar disorganization and internal nuclei, is highly suggestive of an RYR1-related congenital myopathy. The RYR1 gene (OMIM 180901) encodes the ryanodine receptor 1, a Ca2+ channel expressed on sarcoplasmic reticulum membranes at the triad of skeletal muscle fibres. RyR1 mediates the release of Ca2+ from intracellular pool in response to nerve stimulation and then plays a crucial role in excitation–contraction coupling [1]. Mutations of the RYR1 gene cause well-defined forms of congenital myopathies, that is, central core disease (CCD; OMIM 117000) and malignant hyperthermia susceptibility (MHS; OMIM 145600), an autosomal dominant pharmacogenetic disease.

6C), suggesting that Klf10 may inhibit IL-12p40 by binding direct

6C), suggesting that Klf10 may inhibit IL-12p40 by binding directly to the CACCC site of the promoter. ChIP assays were performed to determine whether Klf10 was recruited to the CACCC https://www.selleckchem.com/products/atezolizumab.html element of IL-12p40 promoter. Semi-qPCR and qPCR results verify that Klf10 can bind to the CACCC site of the IL-12p40 promoter (Fig. 6D and E). Therefore, we demonstrate that Klf10 inhibited the transcriptional activity of IL-12p40 by

binding directly to the CACCC site of the IL12p40 promoter. Macrophages are important mediators in immune responses to inflammation. The remarkable plasticity of macrophages has recently been the subject of intense investigation. M-CSF and GM-CSF are mediators involved in the regulation of macrophage heterogeneity. Macrophages induced by GM-CSF and stimulated with IFN-γ and LPS are characterized by a high expression of inflammatory cytokines and iNOS. By contrast, macrophages induced by M-CSF and then stimulated with IL-4 are responsible for the resolution of inflammation. Controlling the expression of inflammatory factors is critical in maintaining the antiinflammatory state in M-CSF-induced macrophages. KLFs are important zinc finger transcription factors that can regulate the transcriptional activity of target genes, thereby affecting their expression. So far, Klf4 has been demonstrated to be critical during macrophage differentiation. Klf4 is expressed in a monocyte-restricted

and stage-specific pattern during myelopoiesis [23]. Recent studies identified Klf4 as a key regulator in M2 macrophage polarization [5]. Klf4 is also related to macrophage activation. https://www.selleckchem.com/products/Maraviroc.html Klf4 overexpression can induce macrophage activation marker iNOS and inhibit TGF-β1 and Smad3 signaling [25]. Klf10, initially identified and named as TGF-β inducible early gene 1 in human osteoblasts [26], has been reported to have a critical role in T-cell biology [28, 29]. In this study, we demonstrated that Klf10 functions as a specific repressor to IL-12p40 in M-BMMs,

whereas the expression of other cytokines, such as TNF-α and IL-10, were not obviously affected. Selleck Fludarabine IL-12p40 is a subunit shared by IL-12p70 and IL-23, and its regulation is important for both innate and adaptive immunity. IL-10 can suppress IL-12 by inhibiting the transcription of its encoding genes [43]. TGF-β is also an inhibitor of IL-12 production through the reduction of the stability of IL-12 p40 mRNA [35]. Type I interferons, such as IFN-α and IFN-β, can also inhibit the production of IL-12 [33]. However, the aforementioned cytokines that regulate IL-12p40 were unaffected by Klf10 in our results. In addition, some transcription factors, such as IRF5, IRF8, C/EBP α, and C/EBP β, regulate the expression of IL-12p40. We found that the expression of these factors was not obviously affected in Klf10-deficient mice (data not shown). Therefore, Klf10 may directly regulate the expression of IL-12p40 in transcriptional levels.

44 Therapy for or prevention of MetS, including lifestyle change

44 Therapy for or prevention of MetS, including lifestyle change and medications, may also play a role in decreasing

nocturia. Further study will be required. The individual components of MetS (obesity, diabetes, HT, and dyslipidemia) can be independent risk factors. Our epidemiological survey also showed that the risk for nocturia significantly increases with a higher number of MetS components. Nocturia is associated MetS or MetS components. Individual components of MetS may interact with each other. Our progestogen antagonist results indicate that nocturia can be a marker of not only MetS but also the precursor of MetS. Clinicians may need to consider MetS and its precursor in the differential diagnosis of nocturia. Patients need to recognize that nocturia can be a sign of lifestyle-related or other chronic disease. The authors declare no conflict of interest. “
“The aims of this study were to compare the impact of urodynamic training on the young urologists after fellowship training as well as on senior urologists who attend regular courses on the management of benign prostatic hyperplasia (BPH) and their capacity to do and interpret urodynamic studies. Sixty-four consecutive young urologists admitted to fellowship program on voiding dysfunctions Compound Library clinical trial and 110 senior urologists attending to periodical meetings were interviewed before and after the 3-day-courses regarding their ability to set, interpret through and do urodynamic studies. They were

also questioned on the reasons that led them to attend the courses and how they use the new concepts

to manage BPH. A rank of the used parameters to indicate transurethral resection of the prostate (TURP) in BPH patients were scored before and after the course. Fellowship and senior urologists mainly attended the course because of lack of confidence and belief that this urological issue is too important to be disregarded. A significant portion of both groups do not trust third-party examiners. More than 90% of the urologists acquired confidence in interpreting, setting and were able to do the exam after the course. The majority of both groups believed urodynamic study was essential to manage BPH, disregarding volume as the main reason to operate on patients. Many outdated parameters became less important on the decision to operate. Doctors exposed to intensive or long urodynamic training dramatically changed their perceptions on the utility of this tool and became more attentive it. Urodynamic exams became the gold-standard procedure to evaluate patients with voiding dysfunction being the only objective functional test on the relationship of bladder and urethra.[1] Benign prostatic hyperplasia (BPH) benefits most with the use of this tool to clarify the source of clinical symptoms since there is wide acknowledgement that infravesical obstruction, prostate enlargement and clinical picture do not match perfectly with overlapping areas among them.

Early in the disease process systemic mRNA expression of T-bet an

Early in the disease process systemic mRNA expression of T-bet and Rorγ was increased in STAT6–/– mice. We conclude that STAT6 is required for attenuation of Th1 and Th17 nephritogenic immune responses and protection from crescentic glomerulonephritis. Glomerulonephritis (GN) is a common cause of renal disease, including end-stage renal failure. Experimental crescentic GN is the murine homologue of rapidly progressive

GN, the most severe form of GN. Severe injury in this model is mediated by cellular immunity and CD4+ T cells are key components of renal injury [1,2]. Upon activation, naive CD4+ cells tend to differentiate into subsets (T helper cells – Th1, Th2 and Th17) that engage immune effectors in different ways. In proliferative forms of www.selleckchem.com/products/nu7441.html GN, T cells direct adaptive immune responses that drive glomerular disease, but also, in rapidly progressive GN, CD4+ cells themselves accumulate in glomeruli as effectors. These effector R428 mw T helper cells activate innate immune effector cells, predominantly neutrophils and macrophages, which activate and damage intrinsic renal cells. While humoral immunity influences the patterns and severity of some forms of GN, in this model severe renal injury is driven by cell-mediated immunity [3] and occurs independently

of autologous antibodies [4]. There is evidence that both Th1 [5] and Th17 [6] responses are pathogenic in experimental crescentic GN. Deficiencies in the key transcription factors, T-bet for Th1 cells [7] and retinoic acid-related orphan receptor-γt (Rorγt) for Th17

cells [8], result in significantly attenuated renal injury. Traditionally, Th2 cells have been considered essential for host protection from parasitic infections, while AZD9291 cost aberrant Th2 responses have been associated with allergy and asthma. In experimental crescentic GN, some Th2-associated cytokines are reno-protective [9]. The signal transducer and activation of transcription (STAT) proteins provide a direct link between cytokine receptors and cytokine induced gene transcription [10]. Activation of the interleukin (IL)-4 receptor on undifferentiated T cells results in the activation of STAT6 with expression of IL-4 related genes [11]. STAT6 is considered central to mounting effective Th2 responses, including the production of Th2 cytokines IL-4 and IL-5, and the key transcription factor GATA binding protein 3 (GATA3) [12]. STAT6-deficient mice have impaired Th2 immune responses, but otherwise are phenotypically normal and produce normal numbers of CD4+ T cells [13]. While early studies suggested that STAT6 was an absolute requirement for IL-4 production [14,15], subsequently it was demonstrated that STAT6-deficient mice can produce IL-4 in response to parasitic infection [16,17]. STAT6 deficiency is protective in several Th2-associated disease models, including allergic asthma [18,19] and eosinophilia with airway hypersensitivity [20].

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

[69] Paradoxically, many of these in vitro approaches to U0126 mw 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 selleck chemicals 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 Leukocyte receptor tyrosine kinase 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.