To clarify the mechanisms leading to the development of
Creutzfeldt-Jakob disease in some recipients of pituitary-derived
human growth hormone (hGH), we investigated the effects of repeated
injections of low
prion doses in mice. The
injections were performed, as in hGH-treated children, by a peripheral route at short intervals and for an extended period. Twelve groups of 24 mice were intraperitoneally inoculated one, two, or five times per week for 200 days with 2 x 10(-5) to 2 x 10(-8) dilutions of brain homogenate containing the mouse-adapted C506M3
scrapie strain. Sixteen control mice were injected once a week for 200 days with a 2 x 10(-4) dilution of normal brain homogenate. Of mice injected in a single challenge with a
scrapie inoculum of a 2 x 10(-4), 2 x 10(-5), or 2 x 10(-6) dilution, 2/10, 1/10, and 0/10 animals developed
scrapie, respectively. Control mice remained healthy. One hundred thirty-five of 135 mice injected with repeated
prion doses of a 2 x 10(-5) or 2 x 10(-6) dilution succumbed to
scrapie. Of mice injected with repeated
scrapie doses of a 2 x 10(-7) or 2 x 10(-8) dilution, 52/59 and 38/67 animals died of
scrapie, respectively. A high incidence of
scrapie was observed in mice receiving repeated doses at low infectivity, whereas there was no disease in mice that were injected once with the same doses. Repeated
injections of low
prion doses thus constitute a risk for development of
prion disease even if the same total dose inoculated in a single challenge does not induce the disease.