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Salem S, Kilgore MD, Anwer M, Maxan A, Child D, Bird TD, Keene CD, Cicchetti F, Latimer C. Evidence of mutant huntingtin and tau-related pathology within neuronal grafts in Huntington's disease cases. Neurobiol Dis 2024; 198:106542. [PMID: 38810948 DOI: 10.1016/j.nbd.2024.106542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 05/31/2024] Open
Abstract
A number of post-mortem studies conducted in transplanted Huntington's disease (HD) patients from various trials have reported the presence of pathological and misfolded proteins, in particular mutant huntingtin (mHtt) and phosphorylated tau neuropil threads, in the healthy grafted tissue. Here, we extended these observations with histological analysis of post-mortem tissue from three additional HD patients who had received similar striatal allografts from the fetal tissue transplantation trial conducted in Los Angeles in 1998. Immunohistochemical staining was performed using anti-mHtt antibodies, EM48 and MW7, as well as anti-hyperphosphorylated tau antibodies, AT8 and CP13. Immunofluorescence was used to assess the colocalization of EM48+ mHtt aggregates with the neuronal marker MAP2 and/or the extracellular matrix protein phosphacan in both the host and grafts. We confirmed the presence of mHtt aggregates within grafts of all three cases as well as tau neuropil threads in the grafts of two of the three transplanted HD patients. Phosphorylated tau was also variably expressed in the host cerebral cortex of all three subjects. While mHtt inclusions were present within neurons (immunofluorescence co-localization of MAP2 and EM48) as well as within the extracellular matrix of the host (immunofluorescence co-localization of phosphacan and EM48), their localization was limited to the extracellular matrix in the grafted tissue. This study corroborates previous findings that both mHtt and tau pathology can be found in the host and grafts of HD patients years post-grafting.
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Affiliation(s)
- Shireen Salem
- Centre de Recherche du CHU de Québec, Axe Neurosciences, T2-07, 2705, Boulevard Laurier, Québec, QC G1V 4G2, Canada; Departement de Médecine Moléculaire, Université Laval, Québec, QC, Canada
| | - Mitchell D Kilgore
- Department of Laboratory Medicine and Pathology, Neuropathology Division, University of Washington, Seattle, WA, USA
| | - Mehwish Anwer
- Centre de Recherche du CHU de Québec, Axe Neurosciences, T2-07, 2705, Boulevard Laurier, Québec, QC G1V 4G2, Canada; Departement de Psychiatrie et Neurosciences, Université Laval, Québec, QC, Canada
| | - Alexander Maxan
- Centre de Recherche du CHU de Québec, Axe Neurosciences, T2-07, 2705, Boulevard Laurier, Québec, QC G1V 4G2, Canada; Departement de Psychiatrie et Neurosciences, Université Laval, Québec, QC, Canada
| | - Dan Child
- Department of Laboratory Medicine and Pathology, Neuropathology Division, University of Washington, Seattle, WA, USA
| | - Thomas D Bird
- Department of Neurology, University of Washington, Seattle, WA, USA; Geriatric Research, Education, and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, USA
| | - C Dirk Keene
- Department of Laboratory Medicine and Pathology, Neuropathology Division, University of Washington, Seattle, WA, USA
| | - Francesca Cicchetti
- Centre de Recherche du CHU de Québec, Axe Neurosciences, T2-07, 2705, Boulevard Laurier, Québec, QC G1V 4G2, Canada; Departement de Médecine Moléculaire, Université Laval, Québec, QC, Canada; Departement de Psychiatrie et Neurosciences, Université Laval, Québec, QC, Canada.
| | - Caitlin Latimer
- Department of Laboratory Medicine and Pathology, Neuropathology Division, University of Washington, Seattle, WA, USA.
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Bachoud-Lévi AC, Massart R, Rosser A. Cell therapy in Huntington's disease: Taking stock of past studies to move the field forward. Stem Cells 2021; 39:144-155. [PMID: 33176057 PMCID: PMC10234449 DOI: 10.1002/stem.3300] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/01/2020] [Accepted: 10/20/2020] [Indexed: 06/02/2023]
Abstract
Huntington's disease (HD) is a rare inherited neurodegenerative disease that manifests mostly in adulthood with progressive cognitive, behavioral, and motor dysfunction. Neuronal loss occurs predominantly in the striatum but also extends to other brain regions, notably the cortex. Most patients die around 20 years after motor onset, although there is variability in the rate of progression and some phenotypic heterogeneity. The most advanced experimental therapies currently are huntingtin-lowering strategies, some of which are in stage 3 clinical trials. However, even if these approaches are successful, it is unlikely that they will be applicable to all patients or will completely halt continued loss of neural cells in all cases. On the other hand, cellular therapies have the potential to restore atrophied tissues and may therefore provide an important complementary therapeutic avenue. Pilot studies of fetal cell grafts in the 2000s reported the most dramatic clinical improvements yet achieved for this disease, but subsequent studies have so far failed to identify methodology to reliably reproduce these results. Moving forward, a major challenge will be to generate suitable donor cells from (nonfetal) cell sources, but in parallel there are a host of procedural and trial design issues that will be important for improving reliability of transplants and so urgently need attention. Here, we consider findings that have emerged from clinical transplant studies in HD to date, in particular new findings emerging from the recent multicenter intracerebral transplant HD study, and consider how these data may be used to inform future cell therapy trials.
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Affiliation(s)
- Anne-Catherine Bachoud-Lévi
- Assistance Publique-Hôpitaux de Paris, National Reference Center for Huntington's Disease, Neurology Department, Henri Mondor-Albert Chenevier Hospital, Créteil, France
- Département d'Etudes Cognitives, École Normale Supérieure, PSL University, Paris, France
- Inserm U955, Institut Mondor de Recherche Biomédicale, Equipe E01 NeuroPsychologie Interventionnelle, Créteil, France
- NeurATRIS, Créteil, France
- Université Paris-Est Créteil, Faculté de Médecine, Créteil, France
| | - Renaud Massart
- Assistance Publique-Hôpitaux de Paris, National Reference Center for Huntington's Disease, Neurology Department, Henri Mondor-Albert Chenevier Hospital, Créteil, France
- Département d'Etudes Cognitives, École Normale Supérieure, PSL University, Paris, France
- Inserm U955, Institut Mondor de Recherche Biomédicale, Equipe E01 NeuroPsychologie Interventionnelle, Créteil, France
- NeurATRIS, Créteil, France
| | - Anne Rosser
- Centre for Trials Research, Cardiff University, Cardiff, UK
- Cardiff University Brain Repair Group, Life Sciences Building, School of Biosciences, Cardiff, UK
- Neuroscience and Mental Health Research Institute and Division of Psychological Medicine and Clinical Neurosciences, Hadyn Ellis Building, Cardiff, UK
- Brain Repair And Intracranial Neurotherapeutics (BRAIN) Unit, Cardiff University, Cardiff, UK
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New approaches for brain repair—from rescue to reprogramming. Nature 2018; 557:329-334. [DOI: 10.1038/s41586-018-0087-1] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/15/2018] [Indexed: 01/05/2023]
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Indications and prospects of neural transplantation for chronic neurological diseases. Curr Opin Organ Transplant 2017; 21:490-6. [PMID: 27517509 DOI: 10.1097/mot.0000000000000344] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW The replacement of damaged cells in the central nervous system (CNS) affected by degenerative disorders represents an attractive therapeutic strategy. The advent of stem cell technology may offer the possibility of generating a large number of renewable, specifically differentiated cells to potentially cure large cohorts of patients. In this review, we discuss current knowledge and issues involved in neural cell transplantation. The most important preclinical and clinical results of cellular transplantation applied to Parkinson's, Huntington's disease and amyotrophic lateral sclerosis will be summarized. RECENT FINDINGS Cellular transplantation is emerging as a possible therapy for a variety of incurable neurological disorders. The disorders that will primarily take advantage from neural stem cell grafting are those involving a well defined cell population in a restricted area of the CNS. Several clinical trials have been initiated to assess safety and efficacy of different stem cell-derived products, and promising results have been obtained for disorders such as Parkinson's disease. However, several scientific questions remain unanswered. Among these, the impact of the immunological interaction between host and graft in the particular environment of the CNS still requires additional investigations. SUMMARY Several chronic neurological disorders appear to be amenable to cell regenerative therapies. However, safety, efficacy and immunological issues will need to be carefully evaluated beforehand.
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Tom CM, Younesi S, Meer E, Bresee C, Godoy M, Mattis VB. Survival of iPSC-derived grafts within the striatum of immunodeficient mice: Importance of developmental stage of both transplant and host recipient. Exp Neurol 2017; 297:118-128. [PMID: 28760579 DOI: 10.1016/j.expneurol.2017.07.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/29/2017] [Accepted: 07/26/2017] [Indexed: 01/04/2023]
Abstract
Degeneration of the striatum can occur in multiple disorders with devastating consequences for the patients. Infantile infections with streptococcus, measles, or herpes can cause striatal necrosis associated with dystonia or dyskinesia; and in patients with Huntington's disease the striatum undergoes massive degeneration, leading to behavioral, psychological and movement issues, ultimately resulting in death. Currently, only supportive therapies are available for striatal degeneration. Clinical trials have shown some efficacy using transplantation of fetal-derived primary striatal progenitors. Large banks of fetal progenitors that give rise to medium spiny neurons (MSNs), the primary neuron of the striatum, are needed to make transplantation therapy a reality. However, fetal tissue is of limited supply, has ethical concerns, and is at risk of graft immunorejection. An alternative potential source of MSNs is induced pluripotent stem cells (iPSCs), adult somatic tissues reprogrammed back to a stem cell fate. Multiple publications have demonstrated the ability to differentiate striatal MSNs from iPSCs. Previous publications have demonstrated that the efficacy of fetal progenitor transplants is critically dependent upon the age of the donor embryo/fetus as well as the age of the transplant recipient. With the advent of iPSC technology, a question that remains unanswered concerns the graft's "age," which is crucial since transplanting pluripotent cells has an inherent risk of over proliferation and teratoma formation. Therefore, in order to also determine the effect of transplant recipient age on the graft, iPSCs were differentiated to three stages along a striatal differentiation paradigm and transplanted into the striatum of both neonatal and adult immunodeficient mice. This study demonstrated that increased murine transplant-recipient age (adult vs neonate) resulted in decreased graft survival and volume/rostro-caudal spread after six weeks in vivo, regardless of "age" of the cells transplanted. Importantly, this study implicates that the in vivo setting may provide a better neurogenic niche for iPSC-based modeling as compared to the in vitro setting. Together, these results recapitulate findings from fetal striatal progenitor transplantation studies and further demonstrate the influence of the host environment on cellular survival and maturation.
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Affiliation(s)
- Colton M Tom
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Shahab Younesi
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Elana Meer
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Catherine Bresee
- Biostatistics & Bioinformatics Research Center, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Marlesa Godoy
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Virginia B Mattis
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
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Mason SL, Barker RA. Novel targets for Huntington's disease: future prospects. Degener Neurol Neuromuscul Dis 2016; 6:25-36. [PMID: 30050366 PMCID: PMC6053088 DOI: 10.2147/dnnd.s83808] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Huntington's disease (HD) is an incurable, inherited, progressive, neurodegenerative disorder that is characterized by a triad of motor, cognitive, and psychiatric problems. Despite the noticeable increase in therapeutic trials in HD in the last 20 years, there have, to date, been very few significant advances. The main hope for new and emerging therapeutics for HD is to develop a neuroprotective compound capable of slowing down or even stopping the progression of the disease and ultimately prevent the subtle early signs from developing into manifest disease. Recently, there has been a noticeable shift away from symptomatic therapies in favor of more mechanistic-based interventions, a change driven by a better understanding of the pathogenesis of this disorder. In this review, we discuss the status of, and supporting evidence for, potential novel treatments of HD that are currently under development or have reached the level of early Phase I/II clinical trials.
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Affiliation(s)
| | - Roger A Barker
- John van Geest Centre for Brain Repair, .,Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
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Modeling Huntington׳s disease with patient-derived neurons. Brain Res 2015; 1656:76-87. [PMID: 26459990 DOI: 10.1016/j.brainres.2015.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 08/17/2015] [Accepted: 10/02/2015] [Indexed: 10/22/2022]
Abstract
Huntington׳s Disease (HD) is a fatal neurodegenerative disorder caused by expanded polyglutamine repeats in the Huntingtin (HTT) gene. While the gene was identified over two decades ago, it remains poorly understood why mutant HTT (mtHTT) is initially toxic to striatal medium spiny neurons (MSNs). Models of HD using non-neuronal human patient cells and rodents exhibit some characteristic HD phenotypes. While these current models have contributed to the field, they are limited in disease manifestation and may vary in their response to treatments. As such, human HD patient MSNs for disease modeling could greatly expand the current understanding of HD and facilitate the search for a successful treatment. It is now possible to use pluripotent stem cells, which can generate any tissue type in the body, to study and potentially treat HD. This review covers disease modeling in vitro and, via chimeric animal generation, in vivo using human HD patient MSNs differentiated from embryonic stem cells or induced pluripotent stem cells. This includes an overview of the differentiation of pluripotent cells into MSNs, the established phenotypes found in cell-based models and transplantation studies using these cells. This review not only outlines the advancements in the rapidly progressing field of HD modeling using neurons derived from human pluripotent cells, but also it highlights several remaining controversial issues such as the 'ideal' series of pluripotent lines, the optimal cell types to use and the study of a primarily adult-onset disease in a developmental model. This article is part of a Special Issue entitled SI: Exploiting human neurons.
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Shannon KM, Fraint A. Therapeutic advances in Huntington's Disease. Mov Disord 2015; 30:1539-46. [DOI: 10.1002/mds.26331] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 06/15/2015] [Indexed: 01/09/2023] Open
Affiliation(s)
- Kathleen M. Shannon
- Department of Neurological Sciences; Rush Medical College; Chicago Illinois USA
| | - Avram Fraint
- Department of Neurological Sciences; Rush Medical College; Chicago Illinois USA
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Mascalchi M, Diciotti S, Paganini M, Bianchi A, Ginestroni A, Lombardini L, Porfirio B, Conti R, Di Lorenzo N, Vannelli GB, Gallina P. Large-sized Fetal Striatal Grafts in Huntington's Disease Do Stop Growing: Long-term Monitoring in the Florence Experience. PLOS CURRENTS 2014; 6. [PMID: 25642368 PMCID: PMC4172581 DOI: 10.1371/currents.hd.c0ad575f12106c38f9f5717a8a7d05ae] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Development of six large nodules of solid tissue after bilateral human fetal striatal transplantation in four Huntington's disease patients has raised concern about the safety of this experimental therapy in our setting. We investigated by serial MRI-based volumetric analysis the growth behaviour of such grafts. After 33-73 months from transplantation the size of five grafts was stable and one graft showed a mild decrease in size. Signs neither of intracranial hypertension nor of adjuctive focal neurological deficit have ever been observed. This supports long-term safety of the grafting procedure at our Institution.
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Affiliation(s)
- Mario Mascalchi
- Quantitative and Functional Neuroradiology Research Unit, Meyer Children and Careggi Hospitals, Florence, Italy; Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Stefano Diciotti
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena, Italy
| | | | | | | | | | - Berardino Porfirio
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | | | - Nicola Di Lorenzo
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | | | - Pasquale Gallina
- Department of Surgery and Translational Medicine, University of Florence, Italy
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Cicchetti F, Lacroix S, Cisbani G, Vallières N, Saint-Pierre M, St-Amour I, Tolouei R, Skepper JN, Hauser RA, Mantovani D, Barker RA, Freeman TB. Mutant huntingtin is present in neuronal grafts in huntington disease patients. Ann Neurol 2014; 76:31-42. [DOI: 10.1002/ana.24174] [Citation(s) in RCA: 139] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 04/29/2014] [Accepted: 04/29/2014] [Indexed: 12/13/2022]
Affiliation(s)
- Francesca Cicchetti
- Centre Hospitalier Universitaire de Québec Research Center
- Departments of Psychiatry and Neurosciences
| | - Steve Lacroix
- Centre Hospitalier Universitaire de Québec Research Center
- Molecular Medicine, Laval University; Quebec City Quebec Canada
| | - Giulia Cisbani
- Centre Hospitalier Universitaire de Québec Research Center
| | | | | | | | - Ranna Tolouei
- Biomaterials and Bioengineering Laboratory; Saint-François d'Assise Hospital
- Department of Mining Engineering, Metallurgy, and Materials; Laval University; Quebec City Quebec Canada
| | - Jeremy N. Skepper
- Cambridge Advanced Imaging Centre; University of Cambridge; Cambridge United Kingdom
| | - Robert A. Hauser
- Departments of Neurology, Pharmacology, and Experimental Therapeutics; Parkinson's Disease and Movement Disorders National Parkinson's Foundation Center of Excellence, University of South Florida; Tampa Florida
| | - Diego Mantovani
- Biomaterials and Bioengineering Laboratory; Saint-François d'Assise Hospital
- Department of Mining Engineering, Metallurgy, and Materials; Laval University; Quebec City Quebec Canada
| | - Roger A. Barker
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences; University of Cambridge; Cambridge United Kingdom
| | - Thomas B. Freeman
- Department of Neurosurgery and Brain Repair
- Center of Excellence for Aging and Brain Repair; University of South Florida; Tampa Florida
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