mTOR inhibition in Q175 Huntington’s disease model mice facilitates neuronal autophagy and mutant huntingtin clearance

Reviewer #1 (Public review):

This study investigates alterations in the autophagic-lysosomal pathway in the Q175 HD knock-in model crossed with the TRGL autophagy reporter mouse. The findings provide valuable insights into autophagy dynamics in HD and the potential therapeutic benefits of modulating this pathway. The study suggests that autophagy stimulation may offer therapeutic benefits in the early stages of HD progression, with mTOR inhibition showing promise in ameliorating lysosomal pathology and reducing mutant huntingtin accumulation.

However, the data raises concerns regarding the strength of the evidence. The observed changes in autophagic markers, such as autolysosome and lysosome numbers, are relatively modest, and the Western blot results do not fully match the quantitative results. These discrepancies highlight the need for further validation and more pronounced effects to strengthen the conclusions. While the study suggests the potential of autophagy regulation as a long-term therapeutic strategy, additional experiments and more reliable data are necessary to confirm the broader applicability of the TRGL/Q175 mouse model.

Furthermore, the 2004 publication by Ravikumar et al. demonstrated that inhibition of mTOR by rapamycin or the rapamycin ester CCI-779 induces autophagy and reduces the toxicity of polyglutamine expansions in fly and mouse models of Huntington's disease. mTOR is a key regulator of autophagy, and its inhibition has been explored as a therapeutic strategy for various neurodegenerative diseases, including HD. Studies suggest that inhibiting mTOR enhances autophagy, leading to the clearance of mHTT aggregates. Given that dysfunction of the autophagic-lysosomal pathway and lysosomal function in HD is already well-established, and that mTOR inhibition as a therapeutic approach for HD is also known, this study does not present entirely novel findings.

Major Concerns:

(1) In Figure 3A1 and A2, delayed and/or deficient acidification of AL causes deficits in the reformation of LY to replenish the LY pool. However, in Figure S2D, there is no difference in AL formation or substrate degradation, as shown by the Western blotting results for CTSD and CTSB. How can these discrepancies be explained?

(2) The results demonstrate that in the brain sections of 17-month-old TRGL/Q175 mice, there was an increase in the number of acidic autolysosomes (AL), including poorly acidified autolysosomes (pa-AL), alongside a decrease in lysosome (LY) numbers. These AL/pa-AL changes were not significant in 2-month-old or 7-month-old TRGL/Q175 mice, where only a reduction in lysosome numbers was observed. This indicates that these changes, representing damage to the autophagy-lysosome pathway (ALP), manifest only at later stages of the disease. Considering that the ALP is affected predominantly in the advanced stages of the disease (e.g., at 17 months), why were 6-month-old TRGL/Q175 mice selected for oral mTORi INK treatment, and why was the treatment duration restricted to just 3 weeks?

(3) Is the extent of motor dysfunction in TRGL/Q175 mice comparable to that in Q175 mice? Does the administration of mTORi INK improve these symptoms?

(4) Why is eGFP expression not visible in Fig. 6A in TRGL-Veh mice? Additionally, why do normal (non-poly-Q) mice have fewer lysosomes (LY) than TRGL/Q175-INK mice? IHC results also show that CTSD levels are lower in TRGL mice compared to TRGL/Q175-INK mice. Does this suggest lysosome dysfunction in TRGL-Veh mice?

(5) In Figure 5A, the phosphorylation of ATG14 (S29) shows minimal differences in Western blotting, which appears inconsistent with the quantitative results. A similar issue is observed in the quantification of Endo-LC3.

(6) In Figure S2A and Figure S2B, 17-month-old TRGL/Q175 mice show a decrease in p-p70S6K and the p-ULK1/ULK1 ratio, but no changes are observed in autophagy-related markers. Do these results indicate only a slight change in autophagy at this stage in TRGL/Q175 mice? Since the mTOR pathway regulates multiple cellular mechanisms, could mTOR also influence other processes? Is it possible that additional mechanisms are involved?

Reviewer #2 (Public review):

Summary:

In this manuscript, the authors have explored the beneficial effect of autophagy upregulation in the context of HD pathology in a disease stage-specific manner. The authors have observed functional autophagy lysosomal pathway (ALP) and its machineries at the early stage in the HD mouse model, whereas impairment of ALP has been documented at the later stages of the disease progression. Eventually, the authors took advantage of the operational ALP pathway at the early stage of HD pathology, in order to upregulate ALP and autophagy flux by inhibiting mTORC1 in vivo, which ultimately reverted back to multiple ALP-related abnormalities and phenotypes. Therefore, this manuscript is a promising effort to shed light on the therapeutic interventions with which HD pathology can be treated at the patient level in the future.

Strengths:

The study has shown the alteration of ALP in the HD mouse model in a very detailed manner. Such stage-dependent in vivo study will be informative and has not been done before. Also, this research provides possible therapeutic interventions for patients in the future.

Weaknesses:

Some constructive comments and suggestions in order to reflect the key aspects and concepts better in the manuscript :

(1) The authors have observed lysosome number alteration in a temporally regulated disease stage-specific manner. In this scenario investigation of regulation, localization, and level of TFEB, the transcription factor required for lysosome biogenesis, would be interesting and informative.

(2) For the general scientific community better clarification of the short forms will be useful. For example, in line 97, page 4, AP full form would be useful. Also 'metabolized via autophagy' can be replaced by 'degraded via autophagy'.

(3) The nuclear vs cytosolic localization of HTT aggregates shown in Figure 2, are very interesting. The increase in cytosolic HTT aggregate formation at 10 months compared to 6 months probably suggests spatio-temporal regulation of aggregate formation. The authors could comment in a more elaborate manner, on the reason and impact of this kind of regulation of aggregate formation in the context of HD pathology.

(4) In this manuscript, the authors have convincingly shown that mTOR inhibition is inducing autophagy in the HD mouse model in vivo. On the other hand, mTOR inhibition would also reduce overall cellular protein translation. This aspect of mTOR inhibition can also potentially contribute to the alleviation of disease phenotype and disease symptoms by reducing protein overload in HD pathology. The authors' comments regarding this aspect would be appreciated.

(5) The authors have shown nuclear inclusion formation and aggregation of mHTT and also commented on its potential removal with the UPS system (proteasomal degradation) in vivo. As there is also a reciprocal relationship present between autophagy and proteasomal machineries, upon upregulation of autophagy machinery by mTOR inhibition proteasomal activity may decrease. How nuclear proteasomal activity increases to tackle nuclear mHTT IBs, would be interesting to understand in the context of HD pathology. Comments from the authors in this aspect would clarify the role of multiple degradation pathways in handling mutant HTT protein in HD pathology.

(6) For the treatment of neurodegenerative disorders taking the temporal regulation into consideration is extremely important, as that will determine the success rate of the treatments in patients. The authors in this manuscript have clearly discussed this scenario. However, for neurodegenerative disordered patients, in most cases, the symptom manifestation is a late onset scenario. In that case, it will be complicated to initiate an early treatment regime in HD patients. If the authors can comment on and discuss the practicality of the early treatment regime for therapeutic purposes that would be impactful.