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Huntington’s disease pathogenesis involves a genetic gain-of-function toxicity mechanism triggered by the expanded HTT CAG repeat. Current therapeutic efforts aim to suppress expression of total or mutant huntingtin, though the relationship of huntingtin’s normal activities to the gain-of-function mechanism and what the effects of huntingtin-lowering might be are unclear. Here, we have re-investigated a rare family segregating two presumed HTT loss-of-function (LoF) variants associated with the developmental disorder, Lopes-Maciel-Rodan syndrome (LOMARS), using whole-genome sequencing of DNA from cell lines, in conjunction with analysis of mRNA and protein expression. Our findings correct the muddled annotation of these HTT variants, reaffirm they are the genetic cause of the LOMARS phenotype and demonstrate that each variant is a huntingtin hypomorphic mutation. The NM_002111.8: c.4469+1G>A splice donor variant results in aberrant (exon 34) splicing and severely reduced mRNA, whereas, surprisingly, the NM_002111.8: c.8157T>A NP_002102.4: Phe2719Leu missense variant results in abnormally rapid turnover of the Leu2719 huntingtin protein. Thus, although rare and subject to an as yet unknown LoF intolerance at the population level, bona fide HTT LoF variants can be transmitted by normal individuals leading to severe consequences in compound heterozygotes due to huntingtin deficiency.

Vascular malformations, affecting ≈1% to 1.5% of the population, comprise a spectrum of developmental patterning defects of capillaries, arteries, veins, and/or lymphatics. The majority of vascular malformations occur sporadically; however, inherited malformations exist as a part of complex congenital diseases. The malformations, ranging from birthmarks to life-threatening conditions, are present at birth, but may reveal signs and symptoms—including pain, bleeding, disfigurement, and functional defects of vital organs—in infancy, childhood, or adulthood. Vascular malformations often exhibit recurrent patterns at affected sites due to the lack of curative treatments. This review series provides a state-of-the-art assessment of vascular malformation research at basic, clinical, genetic, and translational levels.

The polyQ-expansion at the N-terminus of huntingtin (HTT) is the prime cause of Huntington’s disease. The recent cryo-EM structure of HTT with HAP40 provides information on the protein’s prominent HEAT-repeats. Here, we present analyses of the impact of polyQ-length on the conformation of HTT by cryo-EM, the domain-interactions by cross-linking mass spectrometry and the phosphorylation of HTT. The cryo-EM analysis of normal (Q23-) and disease (Q78-) type HTTs in their apo forms shows that the structures of apo HTTs significantly differ from the structure of HTT-HAP40, and that the polyQ expansion induces global structural changes consisting of significant domain movements of the C-HEAT domain relative to the N-HEAT domain. In addition, we show that the polyQ-expansion alters the phosphorylation pattern across the full-length HTT and that the specific phosphorylation (Ser2116p) in turn affects the global structure of HTT, which influences the activity of polyQ-expanded HTT. These results provide a molecular basis for the effect of the N-terminal polyQ segment on HTT structure and activity, that may be important for the cell-selective toxicity of mutant HTT.

The polyglutamine expansion in huntingtin protein causes Huntington’s disease. Here, we investigated structural and biochemical properties of huntingtin and the effect of the polyglutamine expansion using various biophysical experiments including circular dichroism, single-particle electron microscopy and cross-linking mass spectrometry. Huntingtin is likely composed of five distinct domains and adopts a spherical α-helical solenoid where the amino-terminal and carboxyl-terminal regions fold to contain a circumscribed central cavity. Interestingly, we showed that the polyglutamine expansion increases α-helical properties of huntingtin and affects the intramolecular interactions among the domains. Our work delineates the structural characteristics of full-length huntingtin, which are affected by the polyglutamine expansion, and provides an elegant solution to the apparent conundrum of how the extreme amino-terminal polyglutamine tract confers a novel property on huntingtin, causing the disease. DOI: http://dx.doi.org/10.7554/eLife.11184.001, eLife digest Huntington’s disease is an inherited disorder that occurs in adulthood and sometimes in children. It causes progressive damage to the brain and people with the condition develop memory loss, movement difficulties, confusion, and other symptoms of mental decline. Eventually, the disease leads to death. Mutations in the gene that encodes a protein called huntingtin cause Huntington’s disease. Individuals who inherit just one copy of the mutated gene develop the condition. No treatments currently exist that can slow or stop disease progression. Genetic and molecular studies are beginning to shed light on how mutations in the gene encoding huntingtin cause the disease. Normally, the protein has a section near its tail end made up of the amino acid glutamine repeated around 23 times. Mutations that increase the number of glutamines to more than 38 cause Huntington’s disease. The more extra glutamines there are in this region of the protein, the earlier in life the disease symptoms begin. But it was not clear how these extra glutamines near the tail of huntingtin affect the structure and behavior of a protein that is more than 3,000 amino acids long. Now, Vijayvargia et al. have revealed why the tail end of huntingtin is so important. Several biophysical methods were used to determine the three-dimensional structure of the huntingtin protein. These methods revealed that the protein folds up into a hollow sphere and that its tail end is able to interact with the entire length of the protein and physically touches its opposite end. To see this in more detail, Vijayvargia et al. used another experimental technique called crosslinking mass spectrometry to confirm which parts of the huntingtin protein are in close contact with each other. Together with the structural data, these experiments suggest that the stretch of glutamines is in the position to bring about subtle, but widespread, changes throughout the huntingtin protein. That is to say, that having more glutamines slightly changes the curve of the sphere and alters the way different parts of the protein interact. Together the new findings explain why mutations that alter the tail of huntingtin affect the rest of the protein. Further work will now aim to provide a more-detailed structure of the huntingtin protein and to investigate what other roles of huntingtin are affected by the increased number of glutamines in the protein’s tail. These insights may help scientists understand how the mutated protein causes brain decline. DOI: http://dx.doi.org/10.7554/eLife.11184.002