Review article

Proteostasis in Huntington’s disease: disease mechanisms and therapeutic opportunities

Authors: Rachel J HARDING1, Yu-feng TONG1,2
1 Structural Genomics Consortium, University of Toronto, MaRS South Tower, Suite 700, 101 College Street, Toronto, Ontario M5G 1L7, Canada
2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario M5G 1L7, Canada
Corresponding to: Yu-feng TONG:,
DOI: 10.1038/aps.2018.11
Received: 31 October 2017
Accepted: 18 February 2018
Advance online: 5 April 2018


Many neurodegenerative diseases are characterized by impairment of protein quality control mechanisms in neuronal cells. Ineffective clearance of misfolded proteins by the proteasome, autophagy pathways and exocytosis leads to accumulation of toxic protein oligomers and aggregates in neurons. Toxic protein species affect various cellular functions resulting in the development of a spectrum of different neurodegenerative proteinopathies, including Huntington’s disease (HD). Playing an integral role in proteostasis, dysfunction of the ubiquitylation system in HD is progressive and multi-faceted with numerous biochemical pathways affected, in particular, the ubiquitin-proteasome system and autophagy routes for protein aggregate degradation. Unravelling the molecular mechanisms involved in HD pathogenesis of proteostasis provides new insight in disease progression in HD as well as possible therapeutic avenues. Recent developments of potential therapeutics are discussed in this review.
Keywords: Huntington’s disease; neurodegenerative diseases; proteostasis; autophagy; ubiquitylation; proteasomal degradation