Brás Inês Caldeira, Xie Yuanyun, Southwell Amber Lee
bioRxiv. 2025 Jul 21:2025.07.17.665403. doi: 10.1101/2025.07.17.665403.
Huntington disease (HD) is a neurodegenerative disease caused by a trinucleotide repeat expansion in the HTT gene encoding an elongated polyglutamine tract in the huntingtin (HTT) protein. The use of biomarkers has become a major component in preclinical studies focusing on HTT lowering strategies. Quantification of soluble mutant HTT (mHTT) in cerebrospinal fluid (CSF) has served as a pharmacodynamic readout and as potential disease progression biomarker. However, development of future assays for HTT measurement from other biofluids, such as blood, will facilitate the access to human samples since CSF collection is an invasive outpatient procedure. Brain cells, in particular neurons, secrete extracellular vesicles (EVs) that cross the blood-brain barrier and circulate in blood. Importantly, EVs have been identified to be involved in HTT export from cells to the extracellular space. However, it is unknow which vesicle subtype correlates better with HD progression. Our work investigates the potential of EVs as non-invasive sources of clinical biomarkers in liquid biopsies. We developed an optimized ultracentrifugation protocol for the purification of ectosomes and exosomes from human samples and plasma of humanized HD mouse models. Ectosomes are larger vesicles that bud from the plasma membrane of cells, whereas exosomes originate from multivesicular bodies and are afterwards released to the extracellular space. Consistent with previous published data in other model systems, ectosomes isolated from plasma of the Hu97/18 mouse model contain both wild-type (wt) and mHTT in higher levels than in exosomes. Similar results were observed in media from HD induced pluripotent stem cells (iPSCs)-differentiated neurons and in Hu97/18 primary neuronal cultures. Interestingly, we also found higher levels of HTT transcripts in this EV subtype. We further demonstrate that initial storage of the samples using a slow freezing protocol preserves HTT and EV protein marker levels, highlighting the importance of sample preparation for EV isolation and analysis. Our results also show that plasma contains vesicles originated from neuronal cells that can be isolated using neuron-specific markers, such as ATPase Na+/K+ transporting subunit alpha 3 (ATP1A3), allowing the evaluation of HTT levels in the brain through vesicles circulating in the blood. Overall, our results demonstrate that HTT protein measurement from EVs isolated from blood can be a potential less-invasive disease biomarker. We also demonstrate that EVs subtypes contain different HTT protein and RNA levels, important for the development of consistent and reliable biomarkers. Further characterization of neuron-specific EVs content from patient-derived biofluids will lead to the development of novel clinical biomarkers and for evaluation of therapeutic strategies.
亨廷顿病(HD)是一种神经退行性疾病,由HTT基因中的三核苷酸重复序列扩增引起,该基因编码亨廷顿蛋白(HTT)中一段延长的多聚谷氨酰胺序列。生物标志物的应用已成为聚焦于降低HTT策略的临床前研究的一个主要组成部分。脑脊液(CSF)中可溶性突变型HTT(mHTT)的定量已用作药效学读数和潜在的疾病进展生物标志物。然而,开发用于从其他生物流体(如血液)中测量HTT的未来检测方法,将有助于获取人类样本,因为脑脊液采集是一种侵入性的门诊操作。脑细胞,尤其是神经元,会分泌穿过血脑屏障并在血液中循环的细胞外囊泡(EVs)。重要的是,已确定EVs参与了HTT从细胞向细胞外空间的输出。然而,尚不清楚哪种囊泡亚型与HD进展的相关性更好。我们的工作研究了EVs作为液体活检中临床生物标志物的非侵入性来源的潜力。我们开发了一种优化的超速离心方案,用于从人源化HD小鼠模型的人样本和血浆中纯化外切体和外泌体。外切体是从细胞膜上芽生的较大囊泡,而外泌体起源于多囊泡体,随后释放到细胞外空间。与其他模型系统中先前发表的数据一致,从Hu97/18小鼠模型血浆中分离的外切体中野生型(wt)和mHTT的含量均高于外泌体。在HD诱导多能干细胞(iPSC)分化神经元的培养基以及Hu97/18原代神经元培养物中也观察到了类似结果。有趣的是,我们还在这种EV亚型中发现了更高水平的HTT转录本。我们进一步证明,使用缓慢冷冻方案对样本进行初始保存可保留HTT和EV蛋白标志物水平,突出了样本制备对于EV分离和分析的重要性。我们的结果还表明,血浆中含有源自神经元细胞的囊泡,这些囊泡可以使用神经元特异性标志物(如ATP酶Na+/K+转运亚基α3(ATP1A3))进行分离,从而通过血液中循环的囊泡评估大脑中的HTT水平。总体而言,我们的结果表明,从血液中分离的EVs中测量HTT蛋白可能是一种潜在的侵入性较小的疾病生物标志物。我们还证明,EVs亚型含有不同水平的HTT蛋白和RNA,这对于开发一致且可靠的生物标志物很重要。对患者来源生物流体中神经元特异性EVs内容的进一步表征将有助于开发新型临床生物标志物并评估治疗策略。
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