Somatic CAG repeat instability in intermediate alleles of the HTT gene and its potential association with a clinical phenotype

Huntington disease (HD) is a neurodegenerative disorder caused by ≥36 CAGs in the HTT gene. Intermediate alleles (IAs) (27–35 CAGs) are not considered HD-causing, but their potential association with neurocognitive symptoms remains controversial. As HTT somatic CAG expansion influences HD onset, we...

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Detalles Bibliográficos
Autores: Ruiz de Sabando, Ainara, Ciosi, Marc, Galbete Jiménez, Arkaitz, Cumming, Sarah A., Monckton, Darren G., Ramos Arroyo, María A., Álvarez, Victoria, Martínez-Descals, Asunción, Mila, Montserrat, Trujillo-Tiebas, María José, López-Sendón, José Luis, Fenollar-Cortés, María, Legarda, Inés, Bernal Noguera, Sara, Millán, J. M., Durán-Herrera, C., Ruíz-Martínez, Javier, Ruiz Onandi, Rebeca
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2024
País:España
Institución:Universidad Pública de Navarra
Repositorio:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
OAI Identifier:oai:academica-e.unavarra.es:2454/51618
Acceso en línea:https://hdl.handle.net/2454/51618
Access Level:acceso abierto
Palabra clave:Huntington disease
Intermediate alleles
Somatic CAG expansion
Genotype-phenotype analysis
Neurocognitive symptoms
HTT gene
Descripción
Sumario:Huntington disease (HD) is a neurodegenerative disorder caused by ≥36 CAGs in the HTT gene. Intermediate alleles (IAs) (27–35 CAGs) are not considered HD-causing, but their potential association with neurocognitive symptoms remains controversial. As HTT somatic CAG expansion influences HD onset, we hypothesised that IAs are somatically unstable, and that somatic CAG expansion may drive phenotypic presentation in some IA carriers. We quantified HTT somatic CAG expansions by MiSeq sequencing in the blood DNA of 164 HD subjects and 191 IA (symptomatic and control) carriers, and in the brain DNA of a symptomatic 33 CAG carrier. We also performed genotype-phenotype analysis. The phenotype of symptomatic IA carriers was characterised by motor (85%), cognitive (27%) and/or behavioural (29%) signs, with a late (58.7 ± 18.6 years), but not CAG-dependent, age at onset. IAs displayed somatic expansion that were CAG and age-dependent in blood DNA, with 0.4% and 0.01% of DNA molecules expanding by CAG and year, respectively. Somatic expansions of +1 and +2 CAGs were detected in the brain of the individual with 33 CAGs, with the highest expansion frequency in the putamen (10.3%) and the lowest in the cerebellum (4.8%). Somatic expansion in blood DNA was not different in symptomatic vs. control IA carriers. In conclusion, we show that HTT IAs are somatically unstable, but we found no association with HD-like phenotypes. It is plausible, however, that some IAs, close to the HD pathological threshold and with a predisposing genetic background, could manifest with neurocognitive symptoms.