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A pathogenic proteolysis–resistant huntingtin isoform induced by an antisense oligonucleotide maintains huntingtin function
Hyeongju Kim, … , Pontus Klein, Ji-Joon Song
Hyeongju Kim, … , Pontus Klein, Ji-Joon Song
Published August 9, 2022
Citation Information: JCI Insight. 2022;7(17):e154108. https://doi.org/10.1172/jci.insight.154108.
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Research Article Neuroscience

A pathogenic proteolysis–resistant huntingtin isoform induced by an antisense oligonucleotide maintains huntingtin function

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Abstract

Huntington’s disease (HD) is a late-onset neurological disorder for which therapeutics are not available. Its key pathological mechanism involves the proteolysis of polyglutamine-expanded (polyQ-expanded) mutant huntingtin (mHTT), which generates N-terminal fragments containing polyQ, a key contributor to HD pathogenesis. Interestingly, a naturally occurring spliced form of HTT mRNA with truncated exon 12 encodes an HTT (HTTΔ12) with a deletion near the caspase-6 cleavage site. In this study, we used a multidisciplinary approach to characterize the therapeutic potential of targeting HTT exon 12. We show that HTTΔ12 was resistant to caspase-6 cleavage in both cell-free and tissue lysate assays. However, HTTΔ12 retained overall biochemical and structural properties similar to those of wt-HTT. We generated mice in which HTT exon 12 was truncated and found that the canonical exon 12 was dispensable for the main physiological functions of HTT, including embryonic development and intracellular trafficking. Finally, we pharmacologically induced HTTΔ12 using the antisense oligonucleotide (ASO) QRX-704. QRX-704 showed predictable pharmacology and efficient biodistribution. In addition, it was stable for several months and inhibited pathogenic proteolysis. Furthermore, QRX-704 treatments resulted in a reduction of HTT aggregation and an increase in dendritic spine count. Thus, ASO-induced HTT exon 12 splice switching from HTT may provide an alternative therapeutic strategy for HD.

Authors

Hyeongju Kim, Sophie Lenoir, Angela Helfricht, Taeyang Jung, Zhana K. Karneva, Yejin Lee, Wouter Beumer, Geert B. van der Horst, Herma Anthonijsz, Levi C.M. Buil, Frits van der Ham, Gerard J. Platenburg, Pasi Purhonen, Hans Hebert, Sandrine Humbert, Frédéric Saudou, Pontus Klein, Ji-Joon Song

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Figure 7

Biodistribution and pharmacology of HTTΔ12-activating oligonucleotide QRX-704.

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Biodistribution and pharmacology of HTTΔ12-activating oligonucleotide QR...
(A) Biodistribution of QRX-704 or artificial CSF (aCSF; vehicle) administered by a single i.c.v. bolus injection (500 μg) in wt mice, analyzed at 7, 14, or 28 days by FISH. Upper panels show tissue distribution in sagittal sections of mouse brain, lower panels are high magnification images of striatum showing cellular uptake. Scale bars: upper panels 2 mm, lower panels 20 μm. (B) QRX-704 PKs after either a single dose of 50 μg (blue) or 10 doses in 3-day intervals (red) in brain tissues as depicted, collected at time points between 1 hour and 102 days after last dose. Terminal elimination half-life was calculated by linear regression between the last 3 sample points on pool of tissues, displayed with 95% CIs. (C) Single-dose (50–400 μg) PK-PD 2 weeks after dosing, depicting HTTΔ12 mRNA as percentage of total HTT mRNA in indicated brain tissues sampled from the right hemisphere, and corresponding tissue samples of the left hemisphere analyzed for QRX-704 concentration, 4-point logistic regression of pooled samples. (D) Single-dose (200 μg) PK-PD analyzed 7–112 days after dosing, analyzed as in C. n = 4 animals per group and time point for all panels; however, several PK data points are unavailable due to samples not meeting bioanalysis acceptance criteria.

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