Abstract

Since the early reports of neurofibrillary Tau pathology in brains of some Huntington’s disease (HD) patients, mounting evidence of multiple alterations of Tau in HD brain tissue has emerged in recent years. Such Tau alterations range from increased total levels, imbalance of isoforms generated by alternative splicing (increased 4R-/3R-Tau ratio) or by post-translational modifications such as hyperphosphorylation or truncation. Besides, the detection in HD brains of a new Tau histopathological hallmark known as Tau nuclear rods (TNRs) or Tau-positive nuclear indentations (TNIs) led to propose HD as a secondary Tauopathy. After their discovery in HD brains, TNIs have also been reported in hippocampal neurons of early Braak stage AD cases and in frontal and temporal cortical neurons of FTD-MAPT cases due to the intronic IVS10+16 mutation in the Tau gene (MAPT) which results in an increased 4R-/3R-Tau ratio similar to that observed in HD. TNIs are likely pathogenic for contributing to the disturbed nucleocytoplasmic transport observed in HD. A key question is whether correction of any of the mentioned Tau alterations might have positive therapeutic implications for HD. The beneficial effect of decreasing Tau expression in HD mouse models clearly implicates Tau in HD pathogenesis. Such beneficial effect might be exerted by diminishing the excess total levels of Tau or specifically by diminishing the excess 4R-Tau, as well as any of their downstream effects. In any case, since gene silencing drugs are under development to attenuate both Huntingtin (HTT) expression for HD and MAPT expression for FTD-MAPT, it is conceivable that the combined therapy in HD patients might be more effective than HTT silencing alone.

Highlights

  • Huntington’s Disease OverviewHuntington’s disease (HD) is an autosomal dominant neurodegenerative disorder caused by a mutation in the gene that encodes for the protein Huntingtin (Htt)

  • There is a relationship between the length of CAG repeat and the onset and severity of the disease leading to a worse prognosis as the length increases [Snell et al, 1993; Genetic Modifiers of Huntington’s Disease (GeM-HD) Consortium, 2019]

  • Tauopathies are a class of neurodegenerative disorders that are characterized by the aggregation and intracellular deposition of Tau in neurons and/or glial cells as a consequence of abnormal increase in the levels of phosphorylation, abnormal splicing of the mRNA or mutations in MAPT gene

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Summary

Introduction

Huntington’s Disease OverviewHuntington’s disease (HD) is an autosomal dominant neurodegenerative disorder caused by a mutation in the gene that encodes for the protein Huntingtin (Htt). Tauopathies are a class of neurodegenerative disorders that are characterized by the aggregation and intracellular deposition of Tau in neurons and/or glial cells as a consequence of abnormal increase in the levels of phosphorylation, abnormal splicing of the mRNA or mutations in MAPT gene.

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