The development of technologies for the in vitro amplification of abnormal conformations of prion protein (PrPSc) has generated the potential for sensitive detection of prions. Here we developed a new PrPSc amplification assay, called real-time quaking-induced conversion (RT-QUIC), which allows the detection of ≥1 fg of PrPSc in diluted Creutzfeldt-Jakob disease (CJD) brain homogenate. Moreover, we assessed the technique first in a series of Japanese subjects and then in a blind study of 30 cerebrospinal fluid specimens from Australia, which achieved greater than 80% sensitivity and 100% specificity. These findings indicate the promising enhanced diagnostic capacity of RT-QUIC in the antemortem evaluation of suspected CJD.

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We thank the members of the CJD Surveillance Committee in Japan for their support of this work, K. Yamaguchi and K. Kuwata for helping with the circular dichroism analysis of rPrP-sen, M. Tsujihata (Nagasaki Kita Hospital) for providing CSF samples and information about subjects and A. Yamakawa and A. Matsuo for technical assistance. The work was supported by the Global Centers of Excellence Program (F12); a grant-in-aid for science research (B; grant no. 20390287) from the Ministry of Education, Culture, Sports, Science and Technology of Japan; a grant for bovine spongiform encephalopathy research and a grant-in-aid of the Research Committee of Prion disease and Slow Virus Infection, from the Ministry of Health, Labor and Welfare of Japan.

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  1. Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

    • Ryuichiro Atarashi
    • , Katsuya Satoh
    • , Kazunori Sano
    • , Takayuki Fuse
    • , Naohiro Yamaguchi
    • , Daisuke Ishibashi
    • , Takehiro Matsubara
    • , Takehiro Nakagaki
    •  & Noriyuki Nishida
  2. Nagasaki University Research Centre for Genomic Instability and Carcinogenesis, Nagasaki, Japan.

    • Ryuichiro Atarashi
  3. Global Centers of Excellence Program, Nagasaki University, Nagasaki, Japan.

    • Kazunori Sano
    •  & Noriyuki Nishida
  4. Division of Comparative Medicine, Center for Frontier Life Sciences, Nagasaki University, Nagasaki, Japan.

    • Hitoki Yamanaka
  5. Organization of Rural Medicine and Residency Education, Nagasaki University Hospital, Nagasaki, Japan.

    • Susumu Shirabe
  6. Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

    • Masahito Yamada
  7. Department of Neurology and Neurological Science, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.

    • Hidehiro Mizusawa
  8. Division of Creutzfeldt-Jakob Disease Science and Technology, Department of Prion Research, Tohoku University Graduate School of Medicine, Sendai, Japan.

    • Tetsuyuki Kitamoto
  9. Department of Pathology, Australian National Creutzfeldt-Jakob Disease Registry, University of Melbourne, Melbourne, Australia.

    • Genevieve Klug
    • , Amelia McGlade
    •  & Steven J Collins


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R.A. designed the project, performed experiments and wrote the manuscript. K. Satoh, K. Sano, T.F., N.Y., D.I., T.M., T.N. and H.Y. performed experiments. K. Satoh, S.S., M.Y., H.M., T.K., G.K., A.M. and S.J.C. contributed to the collection of human specimens and provided information about subjects. N.N. supervised the project. K. Satoh, K. Sano, A.M., S.J.C. and N.N. helped with the editing of the manuscript.

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The authors declare no competing financial interests.

Corresponding author

Correspondence to Ryuichiro Atarashi.

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