Enhancement of brain-type creatine kinase activity ameliorates neuronal deficits in Huntington's disease

Huntington's disease (HD) is a hereditary neurodegenerative disorder caused by a CAG repeat expansion in the huntingtin (HTT) gene. Brain-type creatine kinase (CKB) is an enzyme involved in energy homeostasis via the phosphocreatine–creatine kinase system. Although downregulation of CKB was previously reported in brains of HD mouse models and patients, such regulation and its functional consequence in HD are not fully understood. In the present study, we demonstrated that levels of CKB found in both the soma and processes were markedly reduced in primary neurons and brains of HD mice. We show for the first time that mutant HTT (mHTT) suppressed the activity of the promoter of the CKB gene, which contributes to the lowered CKB expression in HD. Exogenous expression of wild-type CKB, but not a dominant negative CKB mutant, rescued the ATP depletion, aggregate formation, impaired proteasome activity, and shortened neurites induced by mHTT. These findings suggest that negative regulation of CKB by mHTT is a key event in the pathogenesis of HD and contributes to the neuronal dysfunction associated with HD. In addition, besides dietary supplementation with the CKB substrate, strategies aimed at increasing CKB expression might lead to the development of therapeutic treatments for HD.

► CKB exists in the soma and neuronal processes of neurons.
► Mutant Huntingtin suppresses the promoter of the CKB gene.
► Overexpression of a functional CKB rescues the proteasome activity and neuritogenesis impaired by mutant Huntingtin.
► Creatine supplementation increases CKB expression and ameliorates major symptoms of HD.
► Strategies aimed at increasing the expression of CKB might lead to the development of therapeutic treatments for HD.