The molecular genetics of Huntington's disease.

The past year has witnessed outstanding developments in research on Huntington's disease (HD). A gene was identified that contains an expanded CAG trinucleotide repeat on HD chromosomes. Patterns of expression of this gene and the nature of two transcripts were identified. CAG repeat size ranges between 36 and 121 in affected persons, and it is highly sensitive and specific marker for HD. A correlation between CAG repeat size and the age of onset of HD was demonstrated. Identification of this mutation has facilitated direct approaches to predictive testing for HD. The new mutation rate, previously deemed to be exceedingly rare, is now shown to be responsible for up to 3% of affected persons. Although the mechanism by which CAG repeat length induces neuronal death is not known, there is evidence that the pathogenesis involves a gain of function in the HD gene.