Huntington’s disease: pathogenesis to animal models

Huntington's disease (HD) is an inherited genetic disorder, characterized by cognitive dysfunction and abnormal body movements called chorea. George Huntington, an Ohio physician, described the disease precisely in 1872. HD is a dominantly inherited disorder, characterized by progressive neurodegeneration of the striatum but also involves other regions, primarily the cerebral cortex. The mutation responsible for this fatal disease is an abnormally expanded and unstable CAG repeat within the coding region of the gene encoding the huntingtin protein. Various hypotheses have been put forward to explain the pathogenic mechanisms of mutant huntingtin-induced neuronal dysfunction and cell death. None of these hypotheses, however, offers a clear explanation; thus, it remains a topic of research interest. HD is considered to be an important disease, embodying many of the major themes in modern neuroscience, including molecular genetics, selective neuronal vulnerability, excitotoxicity, mitochondrial dysfunction, apoptosis and transcriptional dysregulation. A number of recent reports have concluded that oxidative stress plays a key role in HD pathogenesis. Although there is no specific treatment available to block disease progression, treatments are available to help in controlling the chorea symptoms. As animal models are the best tools to evaluate any therapeutic agent, there are also different animal models available, mimicking a few or a larger number of symptoms. Each model has its own advantages and limitations. The present review deals with the pathophysiology and various cascades contributing to HD pathogenesis and progression as well as drug targets, such as dopaminergic, gamma-amino butyric acid (GABA)ergic, glutamate adenosine receptor, peptidergic pathways, cannabinoid receptor, and adjuvant therapeutic drug targets such as oxidative stress and mitochondrial dysfunction that can be targeted for future experimental study. The present review also focuses on the animal models (behavioral and genetic) used to unravel pathogenetic mechanisms and the identification of novel drug targets.

[1]  S. Zeitlin,et al.  Expression of the Huntingtin-associated protein 1 gene in the developing and adult mouse , 2000, Neuroscience Letters.

[2]  P. Trzepacz,et al.  Huntington's disease: Correlations of mental status with chorea , 1987, Biological Psychiatry.

[3]  W. Maragos,et al.  Neuronal cell death in Huntington’s disease: a potential role for dopamine , 2000, Trends in Neurosciences.

[4]  Claire-Anne Gutekunst,et al.  A YAC Mouse Model for Huntington’s Disease with Full-Length Mutant Huntingtin, Cytoplasmic Toxicity, and Selective Striatal Neurodegeneration , 1999, Neuron.

[5]  M. Folstein Heterogeneity in Alzheimer's disease , 1989, Neurobiology of Aging.

[6]  C. Cepeda,et al.  Changes in Cortical and Striatal Neurons Predict Behavioral and Electrophysiological Abnormalities in a Transgenic Murine Model of Huntington's Disease , 2001, The Journal of Neuroscience.

[7]  A. Cooper,et al.  The selective vulnerability of striatopallidal neurons , 1999, Progress in Neurobiology.

[8]  F. Zitman,et al.  Huntington's disease: a review of the literature on prevalence and treatment of neuropsychiatric phenomena , 2001, European Psychiatry.

[9]  F. Pedata,et al.  Adenosine and glutamate extracellular concentrations and mitogen-activated protein kinases in the striatum of Huntington transgenic mice. Selective antagonism of adenosine A2A receptors reduces transmitter outflow , 2004, Neurobiology of Disease.

[10]  S. Folstein,et al.  Abnormal ocular motor control in Huntington's disease , 1983, Neurology.

[11]  Marian DiFiglia,et al.  Excitotoxic injury of the neostriatum: a model for Huntington's disease , 1990, Trends in Neurosciences.

[12]  F. Darley,et al.  Language changes after neurosurgery for parkinsonism , 1975, Brain and Language.

[13]  J. Linden,et al.  Ultrastructural localization of adenosine A2A receptors suggests multiple cellular sites for modulation of GABAergic neurons in rat striatum , 2001, The Journal of comparative neurology.

[14]  Françoise Condé,et al.  Replicating Huntington's disease phenotype in experimental animals , 1999, Progress in Neurobiology.

[15]  C. Golden,et al.  Neuropsychological deficits in early, middle, and late stage Huntington's disease as measured by the Luria-Nebraska Neuropsychological Battery. , 1981, The International journal of neuroscience.

[16]  M. Chiang,et al.  CGS21680 attenuates symptoms of Huntington's disease in a transgenic mouse model , 2005, Journal of neurochemistry.

[17]  K. Heathfield Huntington's chorea. Investigation into the prevalence of this disease in the area covered by the North East Metropolitan Regional Hospital Board. , 1967, Brain : a journal of neurology.

[18]  J. Bolam,et al.  GABAB receptors at glutamatergic synapses in the rat striatum , 2005, Neuroscience.

[19]  G. Reynolds,et al.  Decreased glutamic acid and increased 5-hydroxytryptamine in Huntington's disease brain , 1987, Neuroscience Letters.

[20]  R. Yasuda,et al.  Regulation of proteins affecting NMDA receptor-induced excitotoxicity in a Huntington's mouse model. , 2003, Brain : a journal of neurology.

[21]  D. Charvin,et al.  À la recherche d’un rôle de la dopamine dans la maladie de Huntington , 2006 .

[22]  E. Giacobini,et al.  Cerebrospinal fluid acetylcholinesterase and choline measurements in Huntington's disease , 1990, Journal of Neurology.

[23]  Carlos Cepeda,et al.  Genetic mouse models of Huntington's and Parkinson's diseases: illuminating but imperfect , 2004, Trends in Neurosciences.

[24]  S. Folstein,et al.  Huntington's disease as a model for mood disorders. Clues from neuropathology and neurochemistry. , 1990, Molecular and chemical neuropathology.

[25]  J. Penney,et al.  Abnormalities of striatal projection neurons and N-methyl-D-aspartate receptors in presymptomatic Huntington's disease. , 1990, The New England journal of medicine.

[26]  D. Tagle,et al.  Recent advances in understanding the pathogenesis of Huntington's disease , 1999, Trends in Neurosciences.

[27]  H. Steinbusch,et al.  Behavioural correlates of striatal glial fibrillary acidic protein in the 3-nitropropionic acid rat model: disturbed walking pattern and spatial orientation , 2001, Neuroscience.

[28]  Nicola Pavese,et al.  Progressive striatal and cortical dopamine receptor dysfunction in Huntington's disease: a PET study. , 2003, Brain : a journal of neurology.

[29]  G. Cohen,et al.  Dopamine turnover and glutathione oxidation: implications for Parkinson disease. , 1989, Proceedings of the National Academy of Sciences of the United States of America.

[30]  Kenneth W. G. Heathfeeld Huntington's chorea. Investigation into the prevalence of this disease in the area covered by the North East Metropolitan Regional Hospital Board. , 1967 .

[31]  P. Calabresi,et al.  Endogenous GABA mediates presynaptic inhibition of spontaneous and evoked excitatory synaptic potentials in the rat neostriatum , 1990, Neuroscience Letters.

[32]  L. Murri,et al.  Mitochondrial DNA haplogroups do not influence the Huntington's disease phenotype , 2008, Neuroscience Letters.

[33]  R. Schwarcz,et al.  Excitotoxic models for neurodegenerative disorders. , 1984, Life sciences.

[34]  S. W. Davies,et al.  Altered brain neurotransmitter receptors in transgenic mice expressing a portion of an abnormal human huntington disease gene. , 1998, Proceedings of the National Academy of Sciences of the United States of America.

[35]  N. Butters,et al.  Comparison of the neuropsychological deficits associated with early and advanced Huntington's disease. , 1978, Archives of neurology.

[36]  J. Coyle,et al.  Inhibitors of GABA metabolism: Implications for Huntington's disease , 1977, Annals of neurology.

[37]  B. Fredholm,et al.  International Union of Pharmacology. XXV. Nomenclature and classification of adenosine receptors. , 2001, Pharmacological reviews.

[38]  A. Parent,et al.  Synaptic relationships between dopaminergic afferents and cortical or thalamic input in the sensorimotor territory of the striatum in monkey , 1994, The Journal of comparative neurology.

[39]  D. Sax,et al.  Increased rate of suicide among patients with Huntington's disease. , 1984, Journal of neurology, neurosurgery, and psychiatry.

[40]  P. Nicotera,et al.  Ca2+ signals and death programmes in neurons , 2005, Philosophical Transactions of the Royal Society B: Biological Sciences.

[41]  M. Beal,et al.  Oxidative Stress in Huntington's Disease , 1999, Brain pathology.

[42]  M. Beal,et al.  Chronic quinolinic acid lesions in rats closely resemble Huntington's disease , 1991, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[43]  P. Calabresi,et al.  Plastic and behavioral abnormalities in experimental Huntington's disease: A crucial role for cholinergic interneurons , 2006, Neurobiology of Disease.

[44]  M. Brini,et al.  Calcium Homeostasis and Mitochondrial Dysfunction in Striatal Neurons of Huntington Disease* , 2008, Journal of Biological Chemistry.

[45]  M. Chesselet,et al.  Apoptosis in Huntington's disease , 2003, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[46]  N W Kowall,et al.  Proliferative and degenerative changes in striatal spiny neurons in Huntington's disease: a combined study using the section-Golgi method and calbindin D28k immunocytochemistry , 1991, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[47]  S. Folstein,et al.  Clinical correlates of dementia and disability in Huntington's disease. , 1984, Journal of clinical neuropsychology.

[48]  K. Varani,et al.  The FASEB Journal express article 10.1096/fj.00-0730fje. Published online March 5, 2001. Aberrant amplification of A2A receptor signaling in striatal cells expressing mutant huntingtin , 2022 .

[49]  A. Graybiel Neurotransmitters and neuromodulators in the basal ganglia , 1990, Trends in Neurosciences.

[50]  C. Hebb CNS at the cellular level: identity of transmitter agents. , 1970, Annual review of physiology.

[51]  F. Squitieri,et al.  Huntingtin fragmentation and increased caspase 3, 8 and 9 activities in lymphoblasts with heterozygous and homozygous Huntington's disease mutation , 2006, Mechanisms of Ageing and Development.

[52]  Patrik Brundin,et al.  Huntington's disease: a synaptopathy? , 2003, Trends in molecular medicine.

[53]  A. Charara,et al.  Pre- and postsynaptic localization of GABAB receptors in the basal ganglia in monkeys , 1999, Neuroscience.

[54]  B. Hassel,et al.  Selective Inhibition of the Tricarboxylic Acid Cycle of GABAergic Neurons with 3‐Nitropropionic Acid In Vivo , 1995, Journal of neurochemistry.

[55]  G. Geminiani,et al.  Relationship between motor and cognitive disorders in Huntington's disease , 1988, Journal of Neurology.

[56]  Barry Halliwell,et al.  Reactive Oxygen Species and the Central Nervous System , 1992, Journal of neurochemistry.

[57]  M. Rossor,et al.  Ornithine aminotransferase in Huntington's disease , 1982, Brain Research.

[58]  D. Riche,et al.  A primate model of Huntington's disease: Behavioral and anatomical studies of unilateral excitotoxic lesions of the caudate-putamen in the baboon , 1990, Experimental Neurology.

[59]  R. Roemer,et al.  Patterns of intellectual deficit in Huntington's disease. , 1982, Journal of clinical neuropsychology.

[60]  A. Rego,et al.  Mechanisms of neurodegeneration in Huntington’s disease , 2008, European Journal of Neuroscience.

[61]  Paul W Goldberg,et al.  A worldwide study of the Huntington's disease mutation. The sensitivity and specificity of measuring CAG repeats. , 1994, The New England journal of medicine.

[62]  M. Giordano,et al.  The quinolinic acid model of Huntington's disease: Locomotor abnormalities , 1989, Experimental Neurology.

[63]  M. Morelli,et al.  Role of adenosine A2A receptors in parkinsonian motor impairment and l-DOPA-induced motor complications , 2007, Progress in Neurobiology.

[64]  T. Perry,et al.  Huntington's chorea. Deficiency of gamma-aminobutyric acid in brain. , 1973, The New England journal of medicine.

[65]  A. Tobin,et al.  GABA signalling: therapeutic targets for epilepsy, Parkinson’s disease and Huntington’s disease , 2001, Expert opinion on therapeutic targets.

[66]  Alf. L. Ørbeck An Early Description of Huntington's Chorea , 1959, Medical History.

[67]  A. Hackam,et al.  Wild-Type Huntingtin Protects from Apoptosis Upstream of Caspase-3 , 2000, The Journal of Neuroscience.

[68]  M. Beal,et al.  Experimental therapeutics in transgenic mouse models of Huntington's disease , 2004, Nature Reviews Neuroscience.

[69]  U. Ungerstedt,et al.  The striopallidal neuron: a main locus for adenosine-dopamine interactions in the brain , 1993, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[70]  T. Roberts 3-Nitropropionic Acid Model of Metabolic Stress , 2005 .

[71]  J. Penney,et al.  Inhibition of caspase-1 slows disease progression in a mouse model of Huntington's disease , 1999, Nature.

[72]  H. Yin,et al.  The role of the basal ganglia in habit formation , 2006, Nature Reviews Neuroscience.

[73]  R J Leigh,et al.  The measurement of abnormal movement: methods developed for Huntington's disease. , 1983, Neurobehavioral toxicology and teratology.

[74]  M. Vidailhet,et al.  Physiopathologie de la maladie de Huntington : état des connaissances , 2008 .

[75]  J. Cummings,et al.  Behavioral and psychiatric symptoms associated with Huntington's disease. , 1995, Advances in neurology.

[76]  Virginia E. Papaioannou,et al.  Increased apoptosis and early embryonic lethality in mice nullizygous for the Huntington's disease gene homologue , 1995, Nature Genetics.

[77]  M. Dragunow,et al.  The pattern of neurodegeneration in Huntington's disease: a comparative study of cannabinoid, dopamine, adenosine and GABAA receptor alterations in the human basal ganglia in Huntington's disease , 2000, Neuroscience.

[78]  I. Shoulson,et al.  Psychiatric syndromes in Huntington's disease. , 1983, The American journal of psychiatry.

[79]  Hongmin Wang,et al.  Effects of overexpression of huntingtin proteins on mitochondrial integrity. , 2009, Human molecular genetics.

[80]  S. Schiffmann,et al.  Topological analysis of striatal lesions induced by 3-nitropropionic acid in the Lewis rat , 2001, Neuroreport.

[81]  A. Kent Huntington's disease. , 2004, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[82]  J. Penney,et al.  NMDA receptor losses in putamen from patients with Huntington's disease. , 1988, Science.

[83]  T. Foroud,et al.  Progression of symptoms in the early and middle stages of Huntington disease. , 2001, Archives of neurology.

[84]  R. Schwarcz,et al.  II: Excitotoxic models for neurodegenerative disorders , 1984 .

[85]  K. Trick,et al.  Neuro-psychiatric aspects of Huntington's disease. , 1969, Confinia neurologica.

[86]  R. D. Hunt,et al.  Huntington's dementia. Clinical and neuropsychological features. , 1978, Archives of general psychiatry.

[87]  M. Chesselet,et al.  Mouse models of Huntington's disease. , 2002, Trends in pharmacological sciences.

[88]  P. Harper The epidemiology of Huntington's disease , 1992, Human Genetics.

[89]  J. Olney,et al.  Excitotoxicity and the NMDA receptor - still lethal after eight years , 1995, Trends in Neurosciences.

[90]  T. Reed,et al.  Huntington's chorea in Michigan. I. Demography and genetics. , 1958, American journal of human genetics.

[91]  C. Chaloner,et al.  Ethics of abortion: the arguments for and against. , 2007, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[92]  R. Faull,et al.  The distribution of GABAA-benzodiazepine receptors in the basal ganglia in Huntington's disease and in the quinolinic acid-lesioned rat. , 1993, Progress in brain research.

[93]  J. Noth,et al.  Language functions in Huntington's disease. , 1988, Brain : a journal of neurology.

[94]  M. Folstein,et al.  Clinical Assessment of Irritability, Aggression, and Apathy in Huntington and Alzheimer Disease , 1990, The Journal of nervous and mental disease.

[95]  B. Engelsen Neurotransmitter glutamate: its clinical importance , 1986, Acta neurologica Scandinavica.

[96]  K. Jacobson,et al.  Adenosine receptors as therapeutic targets , 2006, Nature Reviews Drug Discovery.

[97]  Claire-Anne Gutekunst,et al.  Huntington’s disease , 2007 .

[98]  J. Fernández-Ruiz,et al.  The endocannabinoid system and Huntington's disease. , 2003, Current Drug Targets - CNS & Neurological Disorders.

[99]  O. Andreassen,et al.  Malonate and 3‐Nitropropionic Acid Neurotoxicity Are Reduced in Transgenic Mice Expressing a Caspase‐1 Dominant‐Negative Mutant , 2000, Journal of neurochemistry.

[100]  J. Cano,et al.  Mitochondrial toxins and neurodegenerative diseases. , 2007, Frontiers in bioscience : a journal and virtual library.

[101]  A. Joyner,et al.  Inactivation of the mouse Huntington's disease gene homolog Hdh. , 1995, Science.

[102]  Reed Te,et al.  Huntington's chorea in Michigan. I. Demography and genetics. , 1958 .

[103]  Enrico Bracci,et al.  Dopamine excites fast-spiking interneurons in the striatum. , 2002, Journal of neurophysiology.

[104]  J. Caboche,et al.  [Role of dopamine in Huntington's disease]. , 2006, Medecine sciences : M/S.

[105]  S. Floresco,et al.  Targeted disruption of the Huntington's disease gene results in embryonic lethality and behavioral and morphological changes in heterozygotes , 1995, Cell.

[106]  A. Santamaría,et al.  Integrative hypothesis for Huntington's disease: a brief review of experimental evidence. , 2007, Physiological research.

[107]  T W Berger,et al.  Presynaptic modulation by GABAB receptors of glutamatergic excitation and GABAergic inhibition of neostriatal neurons. , 1992, Journal of neurophysiology.

[108]  Jeffrey H Kordower,et al.  Animal models of Huntington's disease. , 2007, ILAR journal.

[109]  S. Schiffmann,et al.  Distribution of adenosine A2 receptor mRNA in the human brain , 1991, Neuroscience Letters.

[110]  K. Dewhurst,et al.  Socio-Psychiatric Consequences of Huntington's Disease , 1970, British Journal of Psychiatry.

[111]  J. B. Martin,et al.  Selective sparing of a class of striatal neurons in Huntington's disease. , 1985, Science.

[112]  Antonio Pisani,et al.  Receptor Subtypes Involved in the Presynaptic and Postsynaptic Actions of Dopamine on Striatal Interneurons , 2003, The Journal of Neuroscience.

[113]  George Smith Gibbes,et al.  On Life , 1828, The London medical and physical journal.

[114]  S. Browne,et al.  Mitochondria and Huntington's Disease Pathogenesis , 2008, Annals of the New York Academy of Sciences.

[115]  S. W. Davies,et al.  Exon 1 of the HD Gene with an Expanded CAG Repeat Is Sufficient to Cause a Progressive Neurological Phenotype in Transgenic Mice , 1996, Cell.

[116]  S. Skatchkov,et al.  Mitochondrial DNA damage is a hallmark of chemically induced and the R6/2 transgenic model of Huntington's disease. , 2009, DNA repair.

[117]  A. Lundervold,et al.  Characteristic patterns of verbal memory function in patients with Huntington's disease. , 1994, Scandinavian journal of psychology.