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In reply

We very much appreciate the valuable comments by Iwasaki et al. We agree that elevated levels of the anti-inflammatory cytokines IL-4 and IL-10 in the CSF may reflect the neurodegenerative process in Creutzfeldt-Jakob disease. However, we do not know to date in which pathological pathway IL-4 and IL-10 are involved in Creutzfeldt-Jakob disease. This indeed is a subject of interest and should be investigated in further studies using animal disease models and human brain material. Here it would be important to clarify whether the release of IL-4 and IL-10 is directly associated with PrP^Sc accumulation and neuronal death or whether it reflects an immunological response mediated by immunological potent CNS cells, microglia, and astrocytes.

Interesting questions were raised by Iwasaki et al in their letter. They asked whether IL-4 and IL-10 levels correlated with disease duration and presence of 14-3-3 proteins in CSF and whether serial levels of . . . [Full Text of this Article]

AUTHOR INFORMATION

Katharina Stoeck, MD; Inga Zerr, MD

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