
Five people appear to have developed Alzheimerās disease after receiving growth hormones from deceased donorsā brains as children. Although based on a small group of people, this suggests that the condition could theoretically be transmitted during medical procedures. However, measures are in place to prevent this. One expert has also pointed out that this study doesnāt definitively prove that these recipients developed Alzheimerās in this way.
From the late 1950s until 1985, children around the world with growth issues received injections of human growth hormone, derived from the pituitary gland in the brains of donor cadavers. , more than 1800 children received this treatment, .
The approach was banned globally when it came to light that some recipients died from a rare condition called Creutzfeldt-Jakob disease after receiving hormones contaminated with misfolded proteins called prions. These cause progressive and irreparable damage to the brain and nervous system by clumping together and making other proteins misfold.
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Now, at University College London and her colleagues have uncovered a handful of other people who may have developed Alzheimerās disease from these treatments. Similar to prion-related conditions, a key characteristic of Alzheimerās is the abnormal build-up of two misfolded proteins in the brain: beta-amyloid and tau.
As part of the UKās National Prion Monitoring Cohort, the team reviewed eight cases where people received batches of donated human growth hormones as children that were later discovered to contain traces of misfolded beta-amyloid.
Of these eight, seven reported cognitive issues in their 40s and 50s. Three of them were diagnosed with Alzheimerās disease, while two met the diagnostic criteria for the condition after reporting symptoms such as memory loss and difficulty concentrating. Another two experienced cognitive impairment, while the eighth person had no symptoms, but showed signs of Alzheimerās in brain scans. Of the group, six survive.
All the recipients bar one, who only self-reported having cognitive impairment, had elevated levels of misfolded beta-amyloid and tau in their brains.
In another part of their study, the researchers analysed the DNA of five of the recipients, the only ones with samples available, and found that none had a heightened genetic risk of any neurodegenerative condition, suggesting that their symptoms werenāt inherited.
Writing in their paper, the researchers say there could be alternative explanations for the findings. For example, two of the individuals had an intellectual disability, , and the recipientsā initial growth issues may have led to cognitive impairments. But based on the fact that few people have developed early-onset Alzheimerās disease after receiving uncontaminated growth hormones, the team concludes that contaminated injections are the most plausible cause.
āItās important to recognise that this very rare, acquired form of Alzheimerās disease exists, so that people treated with cadaveric growth hormone can get help and support should they need it,ā says Banerjee. āThere is no suggestion that Alzheimerās disease can be transmitted between people during close contact, or by caring for people with Alzheimerās disease, or via routine medical care.ā
The researchers write that the results āshould prompt both further consideration of public health implications and the primary prevention of [transmissible] Alzheimerās disease ā for example, by ensuring effective decontamination of surgical instrumentsā, which is already routinely done.
They are now working with the UK Health Security Agency and the Department of Health and Social Care to determine how many people who received these hormone injections may be at risk.
at Columbia University in New York says that the study doesnāt prove that Alzheimerās was due to these injections. āThere were apparently about 2000 persons who received these HGH [human growth hormone] preparations in the UK, and Alzheimerās disease biomarker and pathological changes in the 50s are not extraordinarily uncommon, so an association, or causative association, from the injections cannot be certain,ā he says.
Nature