The rapid expansion of chronic wasting disease (CWD), a prion disease of free-ranging and farmed deer, elk
and moose, is a major and ongoing threat in North America. Approximately 1 in 36 Americans hunt deer and elk
and eat venison, and it is estimated that 7,000 – 15,000 CWD-infected cervids are consumed annually. This
fuels growing concerns about the human health risks imposed by CWD. There are no documented cases of
CWD transmission to humans, even though with the long incubation periods of all prion diseases and the
unknown presentation of CWD in humans definite conclusions are not possible. The zoonotic potential of prion
diseases has been exemplified by bovine spongiform encephalopathy (BSE, mad cow disease) which resulted
in a new form of human prion disease (vCJD). BSE was transmissible to Cynomolgus macaques and transgenic
mice expressing the human prion protein. Initial results of CWD transmission studies to the same non-human
primate and mouse models of human prion disease were not successful, corroborating the conclusion that the
zoonotic potential of CWD is low, if not absent. Our groups were part of a consortium that inoculated Cynomolgus
macaques via different routes with CWD. Some animals exhibited subtle clinical signs reminiscent of prion
disease, and upon euthanasia, weak signs of vacuolation, PrPSc deposition and astrocytosis in the brain were
found, while no proteinase K (PK) resistant prion protein (PrP) was detectable. We have now demonstrated for
the first time that CWD from macaques can transmit clinical prion disease to transgenic mouse models of CWD
and human prion disease, albeit in the absence of detectable PK-resistant PrP. Bona fide PrPSc was only
detected upon 3rd passage from mouse to bank vole models. Altogether, this is the first evidence that CWD very
likely has zoonotic potential. The goal of the current proposal is to redefine the zoonotic potential of CWD
by characterizing the biological properties of CWD prions emerging upon experimental transmission
into macaques, for obtaining important information on how CWD could manifest in humans. In Aim 1, we
will study whether CWD from macaque (CWDmac) in bank voles represents a new prion strain, by comparing
biochemical and biological properties to an array of known prion strains from different species. Aim 2 addresses
the question whether CWDmac represents an intermediate prion strain, adaptable to cervids or humans upon
passage, and possessing an expanded host range. We will address this by in vivo passage in cervidized or
humanized mouse models. In vitro, we will utilize serial PMCA and a newly generated PrP0/0 cell culture model
for infection, upon reconstitution with PrP from different species. In Aim 3, we will shed light on the observed
dissociation between infectivity and the presence of bona fide PrPSc. We propose to identify atypical PrP
fragments associated with CWDmac, and we will elucidate brain cell responses to CWDmac exposure by innovative
single cell RNA sequencing. In summary, our studies will uncover the possible manifestation of CWD in humans,
which is of critical importance for drawing definite conclusions about the zoonotic potential of CWD.