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Innes EA, Qiu J, Morales‐Briceño H, Farrar MA, Mohammad SS. Oculomotor Apraxia as an Early Presenting Sign of Juvenile-Onset Huntington's Disease. Mov Disord Clin Pract 2023; 10:S12-S14. [PMID: 37636223 PMCID: PMC10448626 DOI: 10.1002/mdc3.13775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/02/2023] [Accepted: 04/17/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Emily Amy Innes
- Neurology DepartmentSydney Children’ Hospital at RandwickSydneyNew South WalesAustralia
- Sydney Medical SchoolThe University of Notre DameSydneyNew South WalesAustralia
| | - Jessica Qiu
- Sydney Medical School, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Movement Disorders Unit, Neurology DepartmentWestmead HospitalSydneyNew South WalesAustralia
| | - Hugo Morales‐Briceño
- Movement Disorders Unit, Neurology DepartmentWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Paediatrics, School of Women's and Children's HealthUNSW Medicine, The University of New South WalesSydneyNew South WalesAustralia
| | - Michelle A. Farrar
- Neurology DepartmentSydney Children’ Hospital at RandwickSydneyNew South WalesAustralia
- Discipline of Paediatrics, School of Women's and Children's HealthUNSW Medicine, The University of New South WalesSydneyNew South WalesAustralia
| | - Shekeeb S. Mohammad
- Sydney Medical School, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- TY Nelson Department of Neurology and NeurosurgeryThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
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Bao YF, Li XY, Dong Y, Wu ZY. Loss of CAA interruption and intergenerational CAG instability in Chinese patients with Huntington's disease. J Mol Med (Berl) 2023; 101:869-876. [PMID: 37231148 DOI: 10.1007/s00109-023-02329-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 04/06/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023]
Abstract
Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder caused by CAG expansions in huntingtin (HTT) gene, involving motor, cognitive, and neuropsychiatric symptoms. However, genetic modifiers and CAG repeat instability may lead to variations of clinical manifestations, making diagnosis of HD difficult. In this study, we recruited 229 HD individuals from 164 families carrying expanded CAG repeats of HTT, and analyzed loss of CAA interruption (LOI) on the expanded allele and CAG instability during germline transmission. Sanger sequencing and TA cloning were used to determine CAG repeat length and identify LOI variants. Detailed clinical features and genetic testing results were collected. We identified 6 individuals with LOI variants from 3 families, and all probands presented with earlier motor onset age than predicted onset age. In addition, we also presented 2 families with extreme CAG instability during germline transmission. One family showed an expansion from 35 to 66 CAG repeats, while the other family showed both CAG expansion and contraction in lineal three generations. In conclusion, we present the first document of Asian HD population with LOI variant, and we suggest that for symptomatic individuals with intermediate or reduced penetrance allele or negative family history, HTT gene sequencing should be considered in the clinical practice. KEY MESSAGES : We screened the loss of CAA interruption (LOI) variant in a Chinese HD cohort and presented the first document of Asian patients with Huntington's disease carrying LOI variant. We identified 6 individuals with LOI variants from 3 families, and all probands presented with earlier motor onset age than predicted onset age. We presented 2 families with extreme CAG instability during germline transmission. One family showed an expansion from 35 to 66 CAG repeats, while the other family showed both CAG expansion and contraction in lineal three generations. We suggest that for symptomatic individuals with intermediate or reduced penetrance allele or negative family history, HTT gene sequencing should be considered in the clinical practice.
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Affiliation(s)
- Yu-Feng Bao
- Department of Medical Genetics and Center for Rare Diseases, Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
- Department of Neurology and Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Xiao-Yan Li
- Department of Medical Genetics and Center for Rare Diseases, Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
- Department of Neurology and Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Yi Dong
- Department of Medical Genetics and Center for Rare Diseases, Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
- Department of Neurology and Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Zhi-Ying Wu
- Department of Medical Genetics and Center for Rare Diseases, Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China.
- Department of Neurology and Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China.
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Dawson J, Baine-Savanhu FK, Ciosi M, Maxwell A, Monckton DG, Krause A. A probable cis-acting genetic modifier of Huntington disease frequent in individuals with African ancestry. HGG ADVANCES 2022; 3:100130. [PMID: 35935919 PMCID: PMC9352962 DOI: 10.1016/j.xhgg.2022.100130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 07/07/2022] [Indexed: 11/21/2022] Open
Abstract
Huntington disease (HD)is a dominantly inherited neurodegenerative disorder caused by the expansion of a polyglutamine encoding CAG repeat in the huntingtin gene. Recently, it has been established that disease severity in HD is best predicted by the number of pure CAG repeats rather than total glutamines encoded. Along with uncovering DNA repair gene variants as trans-acting modifiers of HD severity, these data reveal somatic expansion of the CAG repeat as a key driver of HD onset. Using high-throughput DNA sequencing, we have determined the precise sequence and somatic expansion profiles of the HTT repeat tract of 68 HD-affected and 158 HD-unaffected African ancestry individuals. A high level of HTT repeat sequence diversity was observed, with three likely African-specific alleles identified. In the most common disease allele (30 out of 68), the typical proline-encoding CCGCCA sequence was absent. This CCGCCA-loss disease allele was associated with an earlier age of diagnosis of approximately 7.1 years and occurred exclusively on haplotype B2. Although somatic expansion was associated with an earlier age of diagnosis in the study overall, the CCGCCA-loss disease allele displayed reduced somatic expansion relative to the typical HTT expansions in blood DNA. We propose that the CCGCCA loss occurring on haplotype B2 is an African cis-acting modifier that appears to alter disease diagnosis of HD through a mechanism that is not driven by somatic expansion. The assessment of a group of individuals from an understudied population has highlighted population-specific differences that emphasize the importance of studying genetically diverse populations in the context of disease.
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Affiliation(s)
- Jessica Dawson
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Fiona K. Baine-Savanhu
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Marc Ciosi
- Institute of Molecular, Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Alastair Maxwell
- Institute of Molecular, Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Darren G. Monckton
- Institute of Molecular, Cell and Systems Biology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Amanda Krause
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
- Corresponding author
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Sienes Bailo P, Lahoz R, Sánchez Marín JP, Izquierdo Álvarez S. Incidence of Huntington disease in a northeastern Spanish region: a 13-year retrospective study at tertiary care centre. BMC MEDICAL GENETICS 2020; 21:233. [PMID: 33228555 PMCID: PMC7684714 DOI: 10.1186/s12881-020-01174-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/12/2020] [Indexed: 11/15/2022]
Abstract
Background Despite the progress in the knowledge of Huntington disease (HD) in recent years, the epidemiology continues uncertain, so the study of incidence becomes relevant. This is important since various factors (type of population, diagnostic criteria, disease-modifying factors, etc.) make these data highly variable. Therefore, the genetic diagnosis of these patients is important, since it unequivocally allows the detection of new cases. Methods Descriptive retrospective study with 179 individuals. Incidence of HD was calculated from the ratio of number of symptomatic cases newly diagnosed per 100,000 inhabitants per year during the period 2007–2019 in Aragon (Spain). Results 50 (27.9%) incident cases of HD (CAG repeat length ≥ 36) were identified from a total of 179 persons studied. The remaining 129/179 (72.1%) were HD negative (CAG repeat length < 36). 29 (58.0%) females and 21 (42.0%) males were confirmed as HD cases. The overall incidence was 0.648 per 100,000 patient-years. 11/50 positive HD cases (22.0%) were identified by performing a predictive test, without clinical symptoms. The minimum number of CAG repeats found was 9 and the most common CAG length among HD negative individuals was 16. Conclusions Our incidence lied within the range reported for other Caucasian populations. Implementation of new techniques has allowed to determine the exact number of CAG repeats, which is especially important in patients with triplet expansions in an HD intermediate and/or incomplete penetrance allele, both in diagnostic, predictive and prenatal tests. Supplementary Information The online version contains supplementary material available at 10.1186/s12881-020-01174-z.
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Affiliation(s)
- Paula Sienes Bailo
- Departamento de Genética. Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet. C/ Padre Arrupe, s/n. Consultas Externas. Planta 3ª. 50009, Zaragoza, Spain
| | - Raquel Lahoz
- Departamento de Genética. Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet. C/ Padre Arrupe, s/n. Consultas Externas. Planta 3ª. 50009, Zaragoza, Spain.
| | - Juan Pelegrín Sánchez Marín
- Departamento de Genética. Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet. C/ Padre Arrupe, s/n. Consultas Externas. Planta 3ª. 50009, Zaragoza, Spain
| | - Silvia Izquierdo Álvarez
- Departamento de Genética. Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet. C/ Padre Arrupe, s/n. Consultas Externas. Planta 3ª. 50009, Zaragoza, Spain
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Farrell M, Lichtenstein M, Crowley JJ, Filmyer DM, Lázaro-Muñoz G, Shaughnessy RA, Mackenzie IR, Hirsch-Reinshagen V, Stowe R, Evans JP, Berg JS, Szatkiewicz J, Josiassen RC, Sullivan PF. Developmental Delay, Treatment-Resistant Psychosis, and Early-Onset Dementia in a Man With 22q11 Deletion Syndrome and Huntington's Disease. Am J Psychiatry 2018; 175:400-407. [PMID: 29712475 PMCID: PMC5935124 DOI: 10.1176/appi.ajp.2017.17060638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Martilias Farrell
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
| | - Maya Lichtenstein
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
| | - James J Crowley
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
| | - Dawn M Filmyer
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
| | - Gabriel Lázaro-Muñoz
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
| | - Rita A Shaughnessy
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
| | - Ian R Mackenzie
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
| | - Veronica Hirsch-Reinshagen
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
| | - Robert Stowe
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
| | - James P Evans
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
| | - Jonathan S Berg
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
| | - Jin Szatkiewicz
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
| | - Richard C Josiassen
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
| | - Patrick F Sullivan
- From the Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill; the Department of Neurology, Geisinger Health System, Wilkes-Barre, Pa.; Translational Neuroscience, Conshohocken, Pa.; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston; the Department of Pathology and Laboratory Medicine and the Department of Psychiatry, University of British Columbia, Vancouver; and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
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Gymrek M, Willems T, Reich D, Erlich Y. Interpreting short tandem repeat variations in humans using mutational constraint. Nat Genet 2017; 49:1495-1501. [PMID: 28892063 PMCID: PMC5679271 DOI: 10.1038/ng.3952] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 08/14/2017] [Indexed: 12/19/2022]
Abstract
Identifying regions of the genome that are depleted of mutations can distinguish potentially deleterious variants. Short tandem repeats (STRs), also known as microsatellites, are among the largest contributors of de novo mutations in humans. However, per-locus studies of STR mutations have been limited to highly ascertained panels of several dozen loci. Here we harnessed bioinformatics tools and a novel analytical framework to estimate mutation parameters for each STR in the human genome by correlating STR genotypes with local sequence heterozygosity. We applied our method to obtain robust estimates of the impact of local sequence features on mutation parameters and used these estimates to create a framework for measuring constraint at STRs by comparing observed versus expected mutation rates. Constraint scores identified known pathogenic variants with early-onset effects. Our metric will provide a valuable tool for prioritizing pathogenic STRs in medical genetics studies.
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Affiliation(s)
- Melissa Gymrek
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- New York Genome Center, New York, NY, USA
- Department of Medicine, University of California San Diego, La Jolla, CA USA
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA USA
| | - Thomas Willems
- New York Genome Center, New York, NY, USA
- Computational and Systems Biology Program, Massachusetts Institute of Technology, Cambridge, MA USA
| | - David Reich
- Department of Genetics, Harvard Medical School, Boston, MA USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA USA
| | - Yaniv Erlich
- New York Genome Center, New York, NY, USA
- Department of Computer Science, Fu Foundation School of Engineering, Columbia University, New York, NY, USA
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Kim HS, Lyoo CH, Lee PH, Kim SJ, Park MY, Ma HI, Lee JH, Song SK, Baik JS, Kim JH, Lee MS. Current Status of Huntington's Disease in Korea: A Nationwide Survey and National Registry Analysis. J Mov Disord 2015; 8:14-20. [PMID: 25614781 PMCID: PMC4298714 DOI: 10.14802/jmd.14038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 12/19/2014] [Accepted: 12/24/2014] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Huntington's disease (HD) is a rare neurological disorder, and its current status in Korea is not well investigated. This study aims to determine the prevalence and incidence of HD and to investigate the clinical features of HD patients in Korea. METHODS We estimated the crude prevalence and annual incidence of HD based on the databases of the Rare Diseases Registry (RDR) and the National Health Insurance (NHI). The clinical data of genetically confirmed HD patients was collected from 10 referral hospitals and analyzed. RESULTS The mean calculated annual incidence was 0.06 cases per 100,000 persons, and the mean calculated prevalence was 0.38 based on the NHI database. The estimated crude prevalence based on the RDR was 0.41. Of the sixty-eight HD patients recruited, the mean age of onset was 44.16 ± 14.08 years and chorea was most frequently reported as the initial symptom and chief complaint. The mean CAG repeat number of the expanded allele was 44.7 ± 4.8 and correlated inversely with the age of onset (p < 0.001). About two-thirds of the patients have a positive family history, and HD patients without positive family history showed a delay in onset of initial symptoms, a prolonged interval between initial symptom onset and genetic diagnosis and a delay in the age of genetic diagnosis. CONCLUSIONS To the best of our knowledge, this is the first study to estimate the prevalence and incidence of HD in Korea and the largest HD series in the Asian population. Our analyses might be useful for further studies and large-scale investigations in HD patients.
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Affiliation(s)
- Hyun Sook Kim
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology and Brain Research Institute, Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Jin Kim
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Mee Young Park
- Department of Neurology, Yeungnam University Medical Center, Daegu, Korea
| | - Hyeo-Il Ma
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jae Hyeok Lee
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Sook Kun Song
- Department of Neurology, Jeju National University Hospital, Jeju, Korea
| | - Jong Sam Baik
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jin Ho Kim
- Department of Neurology, Chosun University School of Medicine, Gwangju, Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Aronin N, DiFiglia M. Huntingtin-lowering strategies in Huntington's disease: antisense oligonucleotides, small RNAs, and gene editing. Mov Disord 2014; 29:1455-61. [PMID: 25164989 DOI: 10.1002/mds.26020] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 08/12/2014] [Accepted: 08/15/2014] [Indexed: 12/21/2022] Open
Abstract
The idea to lower mutant huntingtin is especially appealing in Huntington's disease (HD). It is autosomal dominant, so that expression of the mutant allele causes the disease. Advances in RNA and gene regulation provide foundations for the huntingtin gene (both normal and mutant alleles) and possibly the mutant allele only. There is much preclinical animal work to support the concept of gene and RNA silencing, but, to date, no clinical studies have been attempted in HD. Preventing expression of mutant huntingtin protein is at the cusp for a human trial. Antisense oligonucleotides delivered to patients with amyotrophic lateral sclerosis have been well tolerated; small RNAs administered to rodent and nonhuman primate brain knocked down huntingtin messenger RNA (mRNA); short-hairpin complementary DNA of microRNAs can be expressed in adeno-associated virus to provide long-term silencing of huntingtin mRNA and protein. We expect that these approaches will be ready for clinical studies in the near future, once safety has been validated. Our understanding of gene editing-changing the huntingtin gene itself-is rapidly progressing. Harnessing our knowledge of transcription and translation should push scientific creativity to new and exciting advances that overcome the lethality of the mutant gene in HD.
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Affiliation(s)
- Neil Aronin
- Department of Medicine and RNA Therapeutics Institute, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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