Huntington's disease: fighting on many fronts

Abstract

The discovery in 1993 of the genetic abnormality that causes Huntington's disease triggered an explosion in our understanding of this inherited neurodegenerative disorder (The Huntington's Disease Collaborative Research Group, 1993). Since the Huntington's disease mutation is fully penetrant, everyone with the same underlying CAG triplet repeat expansion in the huntingtin ( HTT ) gene will develop a devastating combination of motor, cognitive and psychiatric disturbances. The monogenic nature of Huntington's disease suggests that disease modifying therapies should be within reach. Currently, however, no such treatments exist (Mestre et al. , 2009). Nevertheless, much has been done to characterize the huntingtin (Htt) protein and the effects of its toxic twin, mutant huntingtin. We know that Htt is a large and ubiquitously expressed protein with a range of possible functions, and that Huntington's disease is predominantly caused by the damaging effects of mutant Htt on neurons. A range of animal models recapitulate the molecular, cellular and clinical phenotypes of Huntington's disease, enhancing our understanding and facilitating the search for treatments (Ross and Tabrizi, 2011). Numerous potential pathogenic mechanisms have been identified, leading to promising therapeutic approaches in transgenic Huntington's disease mice and other models. Although none has yet been found effective in human patients, there is optimism in the field that Huntington's disease is a disease for which the goal of effective therapy might be achieved (Munoz-Sanjuan and Bates, 2011). Two articles in this issue of Brain highlight the Huntington's disease research community's multi-faceted approach to developing new treatments for Huntington's disease. Grondin and colleagues report success in a 6-month study of HTT gene silencing using RNA interference in the adult non-human primate brain (Grondin et al. , 2012); while Labbadia et al. (2012) describe the means by which a molecular chaperone can suppress aggregation of disease-associated Htt complexes. Gene silencing is an …