Trends in Molecular Medicine
Volume 7, Issue 11, 1 November 2001, Pages 479-482
Journal home page for Trends in Molecular Medicine

Research update
Expansion explosion: new clues to the pathogenesis of repeat expansion neurodegenerative diseases

https://doi.org/10.1016/S1471-4914(01)02179-7Get rights and content

Abstract

The expansion in the identification of repeat expansion neurodegenerative diseases is leading to an increase in our understanding of their molecular mechanisms. Neuronal cell death is likely to be caused mainly by genetic gain-of-function mechanisms, with possible contribution from loss-of-function mechanisms as well. Postulated mechanisms involve abnormalities of protein folding, chaperone interactions, alterations in gene transcription, loss of neurotrophic support, and involvement of signal transduction pathways. Understanding the pathogenesis in these diseases is leading to the development of therapeutic strategies.

Section snippets

SCA17 and glutamine expansion in TBP

The recent report that an expansion in the gene encoding the TATA binding protein (TBP) causes a form of SCA (Ref. 2) brings the number of dominant SCAs with distinct genetic loci to 17 (Table 1), with others rumored to be on the way. SCA17 is representative of the diseases involving expansion of polyglutamine. It is characterized by prominent spinocerebellar degeneration, but also basal ganglia, thalamic and cortical degeneration. The normal range of the TBP repeat is 25–42 glutamines, whereas

Toxic gain-of-function hypothesis

The major pathogenic mechanism of these diseases is believed to arise from a genetic gain of function relating to abnormal conformation of the elongated polyglutamine tracts. Other than the polyglutamine repeats, the disease proteins are unrelated to each other. Nevertheless, they all cause neuronal degeneration, in overlapping, although distinct, regions of the brain 4. All the polyglutamine expansion diseases are dominantly inherited [spinal and bulbar muscular atrophy (SBMA) is X-linked,

Why neurons?

Why do the polyglutamine disorders selectively affect neurons? This remains a major unanswered question. Part of the explanation might lie with unique aspects of polyglutamine toxicity. For example, some of the transcription factors sequestered in polyglutamine aggregates or some of the proteosome subunits that are vulnerable to deactivation by polyglutamine might be specifically expressed in neurons. Less specific factors, thought to play a role in neurodegeneration from many causes, could

A loss-of-function model

Although a gain-of-function best fits the genetic evidence, and most models of the polyglutamine diseases, it is possible that a loss of the normal functions of proteins with an expanded polyglutamine also contributes to disease pathogenesis. For example, polyglutamine expansions might reduce the normal capacity of huntingtin to stimulate BDNF, a neuronal growth factor with neuroprotective properties 19. Whether this finding will be replicated in other systems and other diseases remains to be

Non-glutamine expansions

Curiously, several of the SCAs, phenotypically similar to the others, are associated with expansions that do not encode glutamine. SCA8 involves a CTG expansion in a 5′ exon of an apparently untranslated transcript that could function as an antisense regulator of a gene encoded on the opposite DNA strand 20. The high rate of nonpenetrance of the SCA8 mutation within affected families, and the frequency with which expansions are found in the normal population, has complicated the molecular and

Conclusions

The rapid development of models for the polyglutamine diseases has led to optimism that therapeutic approaches can be devised. Academic–industrial collaboration towards that end has already emerged 25. Recently, the National Institute of Neurological Disorders and Stroke, in conjunction with several private foundations, has launched an initiative to fund individual investigators to screen a collection of FDA approved compounds for efficacy against models of neurodegenerative diseases. Nearly

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