Volume 377, Issue 9764, Pages (February 2011)

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Volume 377, Issue 9764, Pages 487-493 (February 2011) Detection of prion infection in variant Creutzfeldt-Jakob disease: a blood-based assay Julie Ann Edgeworth, PhD, Michael Farmer, BSc, Anita Sicilia, MSc, Paul Tavares, MSc, Jonathan Beck, BSc, Tracy Campbell, BSc, Jessica Lowe, BSc, Simon Mead, PhD, Peter Rudge, FRCP, Prof John Collinge, FRS, Dr Graham S Jackson, PhD The Lancet Volume 377, Issue 9764, Pages 487-493 (February 2011) DOI: 10.1016/S0140-6736(10)62308-2 Copyright © 2011 Elsevier Ltd Terms and Conditions

Figure 1 Assay sensitivity to exogenous vCJD A serial dilution of vCJD prion-infected brain homogenate in whole human blood compared with a baseline control of normal human brain in whole blood; data shown are the mean of six replicates and are expressed as a ratio relative to the cutoff value (three SDs greater than the mean chemiluminescent signal for a normal brain sample; dashed line). Error bars show SDs. vCJD=variant Creutzfeldt-Jakob disease. *Two tailed, unpaired t test with Welch correction. The Lancet 2011 377, 487-493DOI: (10.1016/S0140-6736(10)62308-2) Copyright © 2011 Elsevier Ltd Terms and Conditions

Figure 2 Discrimination of endogenous vCJD blood samples from normal control samples Data shown are the mean chemiluminescent signal (arbitrary units) of 14 blood samples from individual patients with confirmed vCJD compared with the mean signal from 100 normal controls. Error bars show SDs for the mean signals. vCJD=variant Creutzfeldt-Jakob disease. *Two tailed, unpaired t test with Welch correction. The Lancet 2011 377, 487-493DOI: (10.1016/S0140-6736(10)62308-2) Copyright © 2011 Elsevier Ltd Terms and Conditions

Figure 3 Two independent assay runs for a masked panel of 190 blood samples The masked panel consisted of blood samples from 21 patients infected with vCJD, 100 healthy normal controls (dark blue bars), 27 patients with sCJD (green bars), and 42 controls with other neurological diseases (turquoise bars). Data are shown as the chemiluminescent signal ratio relative to a cutoff established as the mean of the signal for normal controls plus three SDs. Samples shown in grey are from patients infected with vCJD that had a ratio of less than 1 in one or both assays and were therefore scored as negative. Red bars show all samples that had a ratio greater than 1 relative to cutoff in both assays and were scored as positive. vCJD=variant Creutzfeldt-Jakob disease. sCJD=sporadic Creutzfeldt-Jakob disease. The Lancet 2011 377, 487-493DOI: (10.1016/S0140-6736(10)62308-2) Copyright © 2011 Elsevier Ltd Terms and Conditions