Creutzfeldt-Jakob disease can also be transmitted via medical procedures. Dr. Anton Titov, MD. Procedures were the injection of growth hormone extracts. Extracts were pooled during preparation from tens of thousands of pituitary glands from human cadavers. Growth hormone was extracted. Dr. Anton Titov, MD. Growth hormone was administered to patients who had growth problems in their teens. Some of them developed Creutzfeldt-Jakob disease. Dr. Sebastian Brandner, MD. It was discovered that this was a problem in 1985. Then the genetically engineered growth hormone was used instead. But risks of Creutzfeldt-Jakob disease remained. Growth hormone preparation practice was not the same in all countries. Growth hormone preparations were not done everywhere. Different countries have different methods of preparation. In the UK we had over 400,000 pituitary glands collected between 1958 and 1985. They were used for growth hormone preparation. That explains the human iatrogenic transmission of Creutzfeldt-Jakob disease (CJD). "Iatrogenic" word means that medical doctors transmit a disease. Another common transmission method for Creutzfeldt-Jakob disease (CJD) was via "dura mater". It is a covering of the brain. This covering is often used in neurosurgery. It is used for neurosurgical wound repair. Dr. Sebastian Brandner, MD. Little patches of dura mater are put into place to cover brain. This is done after a brain trauma or after brain tumor surgery. Dura mater grafts were derived from cadavers. They were pre-treated, disinfected. But many patients developed iatrogenic Creutzfeldt-Jakob disease. It happened particularly in Japan. 200 infected dura mater grafts were used. More than 200 patients developed iatrogenic Creutzfeldt-Jakob disease. So that means CJD is transmissible. A different method of transmission of CJD is Bovine Spongiform Encephalopathy. BSE occurred in cattle. There were big epidemics in the UK. More than 170,000 cattle in the UK had BSE. That went into human food chain. Prions then resulted in more than 200 patients developing "variant CJD”. Variant Creutzfeldt-Jakob disease has the pathology that resembles the cattle BSE disease. It was not exactly a human CJD Creutzfeldt-Jakob disease. Dr. Anton Titov, MD. So it looks very different from what we see in humans. I should also add that. The transmissibility of protein diseases such as CJD is not limited to CJD. We have found it last year. We describe that in a clinical trial. Alongside a CJD Creutzfeldt-Jakob disease protein transmission another protein exists. It is the protein that is involved in Alzheimer's disease. Dr. Sebastian Brandner, MD. This Alzheimer’s disease protein can be transmitted in the very same way. That's an area of research that we're expanding. We have found that amyloid beta has been co-transmitted with CJD prion. Amyloid beta is Alzheimer-type protein. So it is obviously also present in pituitary glands. They were used for extraction of growth hormone. So Amyloid beta was in the same way transmitted. It took 30 years, somewhere between 20 or 25 years. But the neurodegeneration disease developed. It is not exactly Alzheimer’s disease. But it is a way of depositing the proteins in the walls of blood vessels. This disease is called "cerebral amyloid angiopathy”. In the brain parenchyma, it is the brain tissue itself. It's Alzheimer's-type changes. It is amyloid plaques. The transmissibility of a protein disease is not unique to prions. It can also occur with amyloid beta. Dr. Sebastian Brandner, MD. This is the protein that is also involved in Alzheimer's disease. Let’s return to the concept of CJD. Dr. Anton Titov, MD. Let’s talk about also Alzheimer's disease. There is a genetic influence. But it can also arise spontaneously. The vast majority, 95% of of Alzheimer’s disease cases are spontaneous. 95% Creutzfeldt-Jakob disease (CJD) cases are spontaneous. Dr. Anton Titov, MD. But once disease happens, it can be transmitted via the biological material. Yes, that's correct! I would say very clearly, Alzheimer’s disease and Creutzfeldt-Jakob disease could be transmitted via medical procedures. Procedures where brain tissue is transmitted in some way. We don't yet know how risky that is. We don’t know how common that is. Whether it's easy or difficult. We should also say. It’s not that we can transmit Alzheimer's disease. We can transmit the protein that then deposits and amplifies in the recipient brain. It was established that this protein can cause some problems in the blood vessels. Dr. Sebastian Brandner, MD. Blood vessels in the brain become more brittle. They start bleeding. We have seen a few examples. The transmission without prion disease was also possible. That leads young patients to the potential development of these vascular problems. It is like Alzheimer’s disease. We call it cerebral amyloid angiopathy. Dr. Anton Titov, MD. This is a whole different concept of disease. Yes, that's correct! It's amazing, these diseases are not bacterial and not viral. Alzheimer’s disease and Creutzfeldt-Jakob disease are caused by a protein. It can precipitate intrinsic changes in the brain. Leading degenerative brain disease expert. “We can’t transmit Alzheimer’s disease, but we can transmit the protein that then stays and increases in the recipient brain, and, it was established, this protein can cause blood vessels to become brittle and bleeding”.