Huntington’s discovery- it’s the protein,not the aggregation

This news about Huntington’s Disease was announced yesterday. Excerpts: “Scientists have solved a mystery surrounding a horrific illness: Why people with Huntington’s disease harbor a faulty protein throughout their bodies but it destroys only certain brain cells. … [That’s] the connection to other brain-destroying diseases… Most are distinguished by clumps of some type of faulty protein, and there’s a raging debate among scientists about whether the clumps, also called ‘aggregates,’ are the cause of brain destruction or a frantic attempt by the brain to save itself. ‘The answers in one disease may have implications for another,’ noted Koroshetz of NIH’s National Institute of Neurological Disorders and Stroke. ‘There’s been people on both sides of the fence. This story plays to the role of the aggregates as not being the major problem but the soluble protein as being the major problem’.”

The protein involved in PSP and CBD is tau.

Two, similar articles are copied below. (I read one on an MSA-related online discussion group.)

http://hosted.ap.org/dynamic/stories/U/ … NS_MYSTERY

Jun 4, 2:00 PM EDT

Scientists uncover culprit in Huntington’s disease
By LAURAN NEERGAARD
AP Medical Writer

WASHINGTON (AP) — Scientists have solved a mystery surrounding a horrific illness: Why people with Huntington’s disease harbor a faulty protein throughout their bodies but it destroys only certain brain cells.

The discovery may provide a long-awaited target for developing treatments for the incurable killer – and also may have ramifications for more common brain diseases like Alzheimer’s.

“Up until now, nobody had the vaguest notion of what was the cause of the brain damage and the death,” said Dr. Solomon Snyder of Johns Hopkins University, whose team reported the findings in Friday’s edition of the journal Science.

“This is a significant step forward,” said Dr. Walter Koroshetz, deputy director of the National Institutes of Health’s brain division.

Huntington’s is a rare inherited disease – there are an estimated 30,000 U.S. patients – that typically strikes in the late 30s or early 40s. What starts as uncontrollable twitches and jerks and deterioration of mental abilities inexorably worsens until patients can barely eat, speak or walk. Death occurs a decade or more after symptoms begin.

One mutated gene is the cause. A child of a Huntington’s patient has a 50-50 chance of inheriting that gene, and anyone who does will develop symptoms at some point if they live long enough. Scientists discovered the gene in 1993, giving families the hard choice of whether to be tested to learn who escaped that fate and who didn’t.

But 16 years later, there is only one treatment to ease the writhing movements and little progress toward the bigger goal – finding some way of slowing or stopping the disease from carving a hole in patients’ brains.

Enter the new research. The bad Huntington’s gene creates a faulty protein that’s found in all cells. Yet the only cells that die are certain neurons, mostly those in a movement-controlling brain region called the corpus striatum that by the time patients die is so ravaged that it’s tissue-paper thin.

Why? A second protein is the culprit, Snyder’s team discovered. It’s a little-known molecule named Rhes that is found almost exclusively in the striatum. When Rhes mixes with the mutated Huntington’s protein it sparks a chemical reaction, the researchers reported.

First came a simple experiment: They used human embryonic cells and brain cells taken from mice. To each, they mixed in different combinations of the mutated Huntington’s protein, its normal version, and Rhes. Only when both the mutant protein and Rhes were in the same cells did those cells start dying.

Then the researchers teased out just what made the chemical reaction, named sumoylation, so toxic. It seems that cells may try to deal with the mutated protein by clumping it out of the way, almost like creating a garbage heap. Adding Rhes led to less clumping along with cell death, suggesting that it’s the soluble form of the faulty protein that’s dangerous.

And that’s the connection to other brain-destroying diseases like Alzheimer’s. Most are distinguished by clumps of some type of faulty protein, and there’s a raging debate among scientists about whether the clumps, also called “aggregates,” are the cause of brain destruction or a frantic attempt by the brain to save itself.

“The answers in one disease may have implications for another,” noted Koroshetz of NIH’s National Institute of Neurological Disorders and Stroke. “There’s been people on both sides of the fence. This story plays to the role of the aggregates as not being the major problem but the soluble protein as being the major problem.”

Dr. Nancy Wexler of the Hereditary Disease Foundation, who helped lead the Huntington’s gene discovery, called the work a “fabulous experiment” and praised the Hopkins team for quickly publishing the Rhes reaction so that other researchers could start hunting ways to block it.

“This is a very promising avenue,” she said.

One next step is to see whether removing Rhes from mice with Huntington’s disease slows or prevents the brain cell death without causing too many side effects. If so, the quest would be for a drug to block that protein.

© 2009 The Associated Press.

http://www.sciencedaily.com/releases/20 … 144330.htm

Mystery Solved: Tiny Protein-activator Responsible For Brain Cell Damage In Huntington Disease

ScienceDaily (June 5, 2009) — Johns Hopkins brain scientists have figured out why a faulty protein accumulates in cells everywhere in the bodies of people with Huntington’s disease (HD), but only kills cells in the part of the brain that controls movement, causing negligible damage to tissues elsewhere. The answer, reported this week in Science, lies in one tiny protein called “Rhes” that’s found only in the part of the brain that controls movement. The findings, according to the Hopkins scientists, explain the unique pattern of brain damage in HD and its symptoms, as well as offer a strategy for new therapy.

HD itself is caused by a genetic defect that produces a mutant version of the protein “huntingtin” that gathers in all cells of the body, but only seems to affect the brain. Passed from parent to child through an alteration of a normal gene, HD over time causes irreversible uncontrolled movement, loss of intellectual function, emotional disturbances and death.

“It’s always been a mystery why, if the protein made by the HD gene is seen in all cells of the body, only the brain, and only a particular part of the brain, the corpus striatum, deteriorates,” says Solomon H. Snyder, M.D., professor of neuroscience at Johns Hopkins. “By finding the basic culprit, the potential is there to develop drugs that target it and either prevent symptoms or slow them down.”

Curious about the huntingtin protein’s striatal-specific effect, Snyder’s research team, led by Srinivasa Subramaniam, Ph.D., a postdoctoral fellow, searched for proteins that interacted locally, specifically and exclusively with huntingtin in the corpus striatum, guessing that the molecular answer to the mystery most likely would be found there.

The protein Rhes caught their attention because they already were studying a related protein for other reasons. Rhes was known to be found almost exclusively in the corpus striatum.

Conducting tests using human and mouse cells, they found that Rhes interacted with both healthy and mutant versions of huntingtin protein, but bound much more strongly to mutant huntingtin, also known as mHtt.

“Touching or binding is one matter, but death is altogether another,” said Snyder, so the next step was to see whether and how Rhes plus mHtt could kill brain cells in the corpus striatum.

Using human embryonic cells and brain cells taken from mice the researchers added different combinations of normal and mutant huntingtin and Rhes, and examined the cells over the next week to see if any cells died.

While each protein alone didn’t change the number of cells in the dishes, when both mHtt and Rhes were present in the same cells, half the cells died within 48 hours.

“Here’s the Rhes protein, we’ve known about it for years, nobody ever really knew what it did in the brain or anywhere else,” says Snyder. “And it turns out it looks like the key to Huntington’s disease.”

Snyder’s team then went on to tackle another mystery surrounding the disease, the solution to this one adding further evidence for the role Rhes plays in HD.

“We’ve known for a long time that abnormal huntingtin proteins aggregate and form clumps in all cells of the body, but the corpus striatum of HD patients seems to have fewer of these clumps than other brain regions or the rest of the body,” says Subramaniam in describing the mystery. “This has led to much controversy: Are the clumps toxic, or is it the lack of clumps that’s toxic to these brain cells?”

In their experiment, adding Rhes to cells with abnormal huntingtin led to fewer clumps, but the cells died. The results, says Subramaniam, suggest that Rhes might be responsible for unclumping mutant huntingtin protein and this somehow kills cells. “Since Rhes is highly found in the corpus striatum, clumping somehow protects cells in other tissues of the body from dying,” says Subramaniam.

Subramaniam and the rest of Snyder’s research team currently are exploring whether removing Rhes from mice with Huntington’s disease can slow or stop brain cells from dying.

“Now that we’ve uncovered the role of Rhes, it’s possible that drugs can be designed that specifically target Rhes to treat or even prevent the disease,” says Snyder.

This study was funded by a U.S. Public Health Service grant and Research Scientist Award.

Authors on the paper are Srinivasa Subramaniam, Katherine Sixt, Roxanne Barrow and Solomon H. Snyder, all of Johns Hopkins.

Adapted from materials provided by Johns Hopkins Medical Institutions, via EurekAlert!, a service of AAAS.

“Taking Care of Our Parents”

This article by a San Francisco Bay Area author was mentioned in today’s newsletter from the Northwest Parkinson’s Foundation (nwpf.org).
Robin

http://www.directawakenings.com/pages/article33.html

Taking Care of Our Parents
By Stephen Ruppenthal, Ph.D.
Author of The Path of Direct Awakening: Passages for Meditation
2006

It is almost a truism to say that, since our parents gave us life and devoted themselves to our care when we were helpless, now as they struggle, physically or mentally, our duty is to give back. If your parents are entering the phase where they need your care or soon will be, here are five ways that will help you make wiser decisions about their care and your involvement with it.

(1) Be mentally and emotionally ready: It’s hard to watch those we have been very close to and loved so dearly begin their decline. We were on the ferry ride to the island where Ruppenthals from all over the world were to gather in a family reunion when my mom told me, “Steve, I have been diagnosed with Parkinson’s.” Though these words shocked me, I could not properly process the repercussions, as I could have no idea how wrenching paralysis was going to replace all the fun we had had relating together as adults. That is why I say, be ready to change gears and turn on a dime. If you are fortunate, your mom or dad will not develop a serious disease, but be mindful that the time will come when they will switch from being an active, loving companion in your life to being needy of your time and care. Start getting ready for this change, as it’s a big one. No one, however wise, can process its magnitude without deep and conflicting feelings.

(2) As your parents slow down, include them but be ready for surprises: in this transitional time, your folks will no longer be able to keep up. In my case, my son and I took my mom to Hawaii one year. But we soon found that time in the sun, which she used to love, now exhausted her quickly. I would say to include your parents in activities that everyone enjoys, but when you do, be prepared for your all day surfing trip to be shortened drastically. So make sure you have other times when you spend quality time with your partner and kids that won’t be interrupted; Mom and Dad can happily relax at home or at the hotel.

(3) Be prepared for more trips to the doctor. If your parents no longer drive and you have siblings in the area, try to divide up tasks like meal preparation and visits to the clinic. If this burden falls solely on you, try to get help for the cooking and housekeeping, as the medical visits will probably require your presence, particularly if important decisions need to be made. And don’t just take the doctor’s recommendations blindly; some research will help you see that no one has a monopoly on what exactly your parents need at any particular point. I even took my mom to a Chinese herbalist and acupuncturist, when Western medicine had no answer for her except more drugs. Remember that it’s really you who are in charge, using highly skilled helpers from the medical field.

(4) Find a way to bring up relevant financial concerns: Unless you or your parents have built up enormous savings, hard financial decisions will have to be made. Does your mom or dad need the continual care of a rest home or a board and care facility? If so, it may mean making the hard decision to sell the house and invest the proceeds until room opens up at the right facility. Or, if they come to live with you, how will the funds be freed for you to pay housecleaners and caretakers when you need them to get absolutely essential free time to care for yourself? So far away was financial reality in my family that my dad only was willing to discuss such issues if I invited a third party, a friend of mine whose father had made a considerable fortune, over for the discussion. If your family is like mine, find a way to break the logjam, as finances will be critical to any decision you make.

(5) In those last years, will your parents be more comfortable with you or in a rest home? If you are lucky, your family includes one kid—perhaps yourself– with a deeply caring attitude towards the elderly, and they will want your mom or dad to move in with them. In that case, offer to visit your sister or brother and spell them frequently, as anyone in charge of full care will desperately need time for themselves. If the rest home is the better alternative, visit the possible facilities and see what level attention the residents really get. Study the financial arrangements you will have to make and weigh it all against having your parents age in place, with round the clock caretakers if necessary. We took the round the clock route with my mom, who elected at the end of her life to spend six weeks at a full care facility. But when the time came to decide whether to connect her to tubes to prolong her life, my mom said, “How can you speak of tubes? I want to go home,” and that is where she died, amidst the warmth and love of her hired caretakers and of our family.

Stephen Ruppenthal, Ph.D. is the author of The Path of Direct Awakening: Passages for Meditation. He is also the co-author of Eknath Easwaran’s edition of The Dhammapada and the author of Keats and Zen. He has taught meditation and courses on Han Shan at UC Berkeley and San Francisco State University. Dr. Ruppenthal is an international workshop leader in passage meditation and in courses for those looking for end of life spiritual care and for the spiritual step component of twelve step programs. Visit Stephen’s work at www.directawakenings.com.

Mayo Clinic Rochester Protocol and Shipping Instructions

Brain Support Network helps families make arrangements to donate a loved one’s brain for research and so the neurological diagnosis can be confirmed.

Occasionally, the Mayo Clinic in Rochester, Minnesota (“Mayo Rochester”) is the brain bank where brains are donated.  In general, Brain Support Network only assists Mayo Rochester with brain donation for multiple system atrophy (MSA) cases.

Below, we will keep the latest research protocol for Mayo Rochester along with their shipping instructions.  Note that the whole brain is donated.  The family may also decide to donate the spinal cord.

In short, the Mayo Rochester protocol requires that the whole brain (and possibly the spinal cord) be removed within 24 hours of death.  The clinic asks if a two small samples can be taken, which are frozen.  The remaining brain (and spinal cord) are fully immersed in formalin buffered to 10%, and fixed for 10-14 days.  Mayo Rochester provides containers and dry ice, and pays for shipping.

Plus, we list below Brain Support Network’s shipping suggestions.  These have been developed over many years of stories using FedEx as the shipping agent.

Robin
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Mayo Clinic Rochester – Research Protocol
Last Updated:  April 2017 (about frozen samples)

We greatly appreciate your help in obtaining brain tissue for our study on central degenerative autonomic disorders.  Enclosed please find a copy of a personal directive for autopsy that your patient will sign to advise his/her family that an autopsy be done at the time of death (original sent to patient).

Our group is engaged in the study of patients with multiple system atrophy (Shy-Drager syndrome), Parkinson’s disease, or dementia with Lewy bodies.  We are particularly interested in pathological alterations in the brainstem of these patients and have a NIH-funded grant to study immunocytochemically-defined cell groups in the medulla, hypothalamus and, spinal cord when available.

We would appreciate it if you can assist us in the study of this patient’s brain by informing us at the time of this patient’s death.  Given the lability of immunocytochemical techniques to postmortem delay and fixation we require that the tissue be harvested within 24 hours of death.  In order to facilitate handling of the brain, we request the following:

It is highly desirable to examine the entire brain and spinal cord, if possible.

Please remove 1cm3 of right frontal lobe, and 1cm3 of cerebellum in the area of the vermis, freeze and ship separately on dry ice. We can provide coolers if needed. 

Carotid artery in the area of the bifurcation, base of heart with attached great vessels, abdominal aorta with mesenteric ganglia/vessels, distal esophagus/stomach junction, and distal colon (3 inches) is also highly desirable. 

The brain (minus frozen samples) should be immersed in 10% formalin for 7-10 days.

We understand that this protocol is different from others you may have encountered; this is due to the nature of our research.  We greatly appreciate your assistance in this informative study.  If there are any questions or concerns, please contact one of us directly please call Ann first: Ms. Ann Schmeichel, my research technician (daytime phone: 507-284-8597, evening phone: 507-584-0201, cell phone 507-219-1652, fax: 507-284-3133).  Please follow this protocol as closely as possible.  Thank you for your assistance.

Sincerely,
Phillip A. Low, M.D.

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Mayo Clinic Rochester – Shipping Instructions
Last Updated:  2017

1. The brain (minus frozen samples) should be immersed in 10% formalin for 7-10 days, double bagged, and boxed.

2.  Please ship by Federal Express to

Ann Schmeichel
Neurophysiology Laboratory
Mayo Clinic
805 Guggenheim Building
200 First Street SW
Rochester, MN 55905

Please contact Ann either by phone or email at [email protected] and she will make sure that you have labels for shipping.

3.  We will cover all expenses involved in autopsy, handling, and mailing of the material.

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Brain Support Network’s Notes about Mayo Rochester’s Protocol
Last Updated:  April 2017

1.  We believe Mayo Rochester’s instructions about the frozen samples are rather skimpy but hopefully pathology service providers can figure things out!  If not, contact Ann Schmeichel at Mayo Rochester.  She will provide shipping containers and dry ice for the frozen samples.

2.  Many pathology service providers prefer to send the frozen samples as soon as possible. Given our experience with FedEx, we suggest shipping out the frozen samples on a Monday or Tuesday only.  Under no circumstances should wet ice be used.

3.  Note that some pathology service providers have reported that FedEx has been unwilling to pick up or accept containers with dry ice.  Please double-check with FedEx delivery staff who pick up from a usual location as to whether they have a problem with this.  Regular FedEx locations will accept containers with dry ice; however, many FedEx Office locations will not.

4.  The formalin fixed whole brain should be double-bagged for shipping.  Take care not to over-fill the “inside” bag with formalin as leakage/spoilage was a recent problem that resulted in FedEx suspending transport of a shipment.  Any good quality Styrofoam shipping container can be used.  Mayo Rochester will provide a container.

5.  Before shipping, please check the FedEx website for service alerts to be sure that there are no weather conditions in Florida, Tennessee (FedEx hub), or other locations that would delay shipping.  FedEx’s webpage is:

www.fedex.com/us/servicealerts/index.html 

FedEx has a link on its website to the National Weather Service’s weather map, showing severe weather.

6.  Before shipping, consult with Ann Schmeichel at Mayo Rochester to be sure she is in the office or someone is accepting packages.

7.  We’ve also had the situation where FedEx has accepted a container with dry ice, only to return it or delay delivery.  Once, in January 2016, a regular FedEx location accepted the package containing dry ice and then returned it to the pathology specialist’s address a few hours later, offering no explanation as to why it had been accepted earlier at the FedEx location only to be rejected later.  Twice in May 2016, FedEx delayed the delivery to Mayo of two containers where the label showed dry ice (“ICE”) was included.  Fortunately in both cases, tissue was shipped out on a Monday so we had a couple of days’ leeway to address the problem with FedEx.

8.  Immediately after shipping, please send a cell phone photo via text to Robin Riddle (cell phone 650-814-0848 – accepts texts) of the tracking numbers of the frozen containers and the fixed container.  Or, send an email containing the tracking numbers to Brain Support Network.  This way Brain Support Network can monitor the shipments.  It is best that the pathology service provider monitor the shipments as well, in case any issues arise during transit.

9.  Around the year-end holidays, Mayo will often request that shipment be delayed.  It is best around the year-end to check with Mayo or Brain Support Network in advance of shipping.