Researchers remain uncertain as to what causes PrP to misfold in the first place, perhaps a mutation. But once the change has occurred, abnormal prions induce normal PrP to misfold, and eventually prions crowd cells and cause nerve damage. When investigators injected prions of a different abnormal conformations into different hosts, the hosts developed prions with the same abnormal conformation as the parent prion. Still many scientists require more proof that prions are actually causing the nervous system disorders.
"Ironing Out the Wrinkles in the Prion Strain Problem," Science, vol. 274, page 2010, December 20, 1996