Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, PO Box 11099, 21944, Taif, Saudi Arabia.
Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Taif University, PO Box 11099, 21944, Taif, Saudi Arabia.
Arch Pharm Res. 2024 Jun;47(6):571-595. doi: 10.1007/s12272-024-01499-w. Epub 2024 May 19.
Huntington's disease (HD) is a paradigm of a genetic neurodegenerative disorder characterized by the expansion of CAG repeats in the HTT gene. This extensive review investigates the molecular complexities of HD by highlighting the pathogenic mechanisms initiated by the mutant huntingtin protein. Adverse outcomes of HD include mitochondrial dysfunction, compromised protein clearance, and disruption of intracellular signaling, consequently contributing to the gradual deterioration of neurons. Numerous therapeutic strategies, particularly precision medicine, are currently used for HD management. Antisense oligonucleotides, such as Tominersen, play a leading role in targeting and modulating the expression of mutant huntingtin. Despite the promise of these therapies, challenges persist, particularly in improving delivery systems and the necessity for long-term safety assessments. Considering the future landscape, the review delineates promising directions for HD research and treatment. Innovations such as Clustered regularly interspaced short palindromic repeats associated system therapies (CRISPR)-based genome editing and emerging neuroprotective approaches present unprecedented opportunities for intervention. Collaborative interdisciplinary endeavors and a more insightful understanding of HD pathogenesis are on the verge of reshaping the therapeutic landscape. As we navigate the intricate landscape of HD, this review serves as a guide for unraveling the intricacies of this disease and progressing toward transformative treatments.
亨廷顿病 (HD) 是一种遗传性神经退行性疾病的范例,其特征是 HTT 基因中的 CAG 重复序列扩展。本综述通过强调突变亨廷顿蛋白引发的致病机制,深入研究了 HD 的分子复杂性。HD 的不良后果包括线粒体功能障碍、蛋白质清除受损以及细胞内信号转导中断,从而导致神经元逐渐恶化。目前有许多治疗策略,特别是精准医学,用于 HD 的管理。反义寡核苷酸,如 Tominersen,在靶向和调节突变亨廷顿蛋白的表达方面发挥着主导作用。尽管这些疗法有希望,但仍存在挑战,特别是在改善递送系统和需要长期安全性评估方面。考虑到未来的前景,该综述描绘了 HD 研究和治疗的有希望的方向。创新技术,如基于 Clustered regularly interspaced short palindromic repeats associated system 疗法 (CRISPR) 的基因组编辑和新兴的神经保护方法,为干预提供了前所未有的机会。协作的跨学科努力和对 HD 发病机制的更深入理解,即将重塑治疗领域。在我们探索 HD 复杂的领域时,本综述为揭示该疾病的复杂性并推进变革性治疗提供了指导。