Time-resolved FRET screening identifies small molecular modifiers of mutant Huntingtin conformational inflexibility in patient-derived cells

Huntingtons disease (HD) is the most common monogenic neurodegenerative disease and is fatal. CAG repeat expansions in mutant Huntingtin (mHTT) exon 1 encode for polyglutamine (polyQ) stretches and influence age of onset and disease severity, depending on their length. mHTT is more structured compared to wild-type (wt) HTT, resulting in a decreased N-terminal conformational flexibility. mHTT inflexibility may contribute to both gain of function toxicity, due to increased mHTT aggregation propensity, but also to loss of function phenotypes, due to decreased interactions with binding partners. High-throughput-screening techniques to identify mHTT flexibility states and potential flexibility modifying small molecules are currently lacking. Here, we propose a novel approach for identifying small molecules that restore mHTTs conformational flexibility in human patient fibroblasts. We applied an antibody-based time-resolved Forster resonance energy transfer (TR-FRET) immunoassay, measuring endogenous HTT flexibility using two validated HTT-specific antibodies. The ratio of TR-FRET signal at 4{degrees}C and 20{degrees}C differs between wtHTT and mHTT and allowed to perform a high-throughput screening using HTT flexibility as a read-out. We identified several small molecules that can partially rescue mHTT inflexibility, presumably by altering HTT post-translational modifications. This novel screening approach has the potential to identify previously unknown HD drugs and drug targets.