Huntington’s disease (HD) is a devastating autosomal dominant neurodegenerative disease that is characterized clinically by psychiatric disturbances, cognitive dysfunction, and loss of motor control. The disease is caused by an expanded CAG repeat in exon 1 of the HTT gene that results in an expanded glutamine tract in the HTT protein. In addition to severe striatal degeneration, cortical atrophy is a key pathology and reduced cortico-striatal functional connectivity has been defined in HD patient’s years before clinical onset(Unschuld et al., 2012). Stem cell derived neurons provide insights into early dysfunction that may inform optimal therapeutic intervention. Several groups, including our own, have shown using human pluripotent stem cells (hPSC’s) differentiated towards striatal and cortical neuronal lineages, that HD lines display phenotypic and molecular alterations at multiple stages of differentiation. While these studies provide valuable insight into potential disease mechanisms, they primarily involve a snapshot from a single assay in multiple patient lines and variability between cell lines and differentiation methods can make the data difficult to interpret and reproduce. In Chapter 1 we used an embryonic stem cell isogenic series(Ruzo et al., 2018), engineered to express a range of CAG repeat lengths or HTT knockout (KO), to generate integrated cell signatures for pluripotent stem cells and differentiated cortical neurons. By integrating multiple omics datasets, e.g. transcriptomics, epigenomics, and proteomics, into coherent biological pathways to generate hypotheses about network level dysfunction we provide a baseline for further validation and perturbation. These networks associated with CAG expansion were then compared to those generated for total HTT loss to understand the contribution of HTT loss of function compared to gain of function given that the HD mutation results in both loss of normal HTT function as well as gain of aberrant toxic functions. We used this comparative analysis to gain insight into the extent to which each of these contribute to disease progression.
Neuroinflammation and activated microglia are also implicated in disease progression. Microglial activation correlates with severity of striatal neuron loss in post-mortem HD brains, and PET imaging also indicates an elevation of inflammatory markers in pre-clinical patient brains. Expression of mutant HTT (mHTT) in mouse microglia results in a cell-autonomous upregulation of pro-inflammatory gene expression. In addition to this innate inflammatory phenotype, functional dysregulation in HD microglia may have deleterious consequences in the HD brain. HD patient blood monocytes are hyper-reactive and display impairments in phagocytosis and chemotaxis. Multiple studies have reported that, similar to patient monocytes, human HD iPSC derived microglia are hyper-reactive to LPS stimulation and have elevated toxic reactive oxygen species release; however, functional deficits have not consistently been observed. There remains a major gap in defining molecular and functional responses in iPSC-derived microglia like cells (iMG). In Chapter 2 we use patient-derived as well as CRISPR modified isogenic iPS cell lines differentiated into microglia to determine how mHTT expression affects homeostatic microglial functions including phagocytosis and chemotaxis. Similar to previously reported studies, we were unable to reproducibly detect impairments in homeostatic microglial function. We also examined the effects mHTT expressing microglia on iPSC derived MSNs in co-culture. We investigated the effect on inhibitory synapse number in the MSNs by immunocytochemistry and electrical activity using the Axion microelectrode array. We did not observe any changes in synapse number or firing rate for MSNs as a result of co-culture with mHTT expressing microglia.
The effects of mHTT expression on early disease progression may be more subtle than what can be detected using the functional assays of Chapter 2. In Chapter 3 we focused first on determining if there is an altered transcriptome in human iPSC derived mHTT expressing microglia (iMGs). While significant cell line variation was observed, upregulation of classical immune response and autoimmune associates’ pathways were observed for each HD patient line. We examined whether this cell autonomous inflammatory transcriptome exerts an effect upon an unaffected mouse brain using single nuclei sequencing of MITRGxFIRE mouse brains transplanted with expanded CAG and control iMGs. Variation was observed based on the cell line transplanted and the sex of the animal that likely reflects differences observed in HD mouse models and patients. Despite these differences, our data indicates that mHTT expressing iMGs affect transcriptional differences in pathways associated with synaptic vesicle release and with apoptosis in MSNs. In turn, synaptic plasticity may be negatively affected in cortical neurons. Additionally, we observe widespread downregulation of genes associated with primary cilia, organelles that are important for relaying environmental signals to the cell.