Targeted 3’-end RNA sequencing uncovers cryptic polyadenylation in Huntington’s disease linked to somatic instability and CAG repeat purity

ABSTRACT Huntington’s disease (HD) is a progressive neurodegenerative disorder caused by expanded CAG repeats in the first exon of the HTT gene, which encodes for huntingtin (HTT) protein. Full-penetrance is established at 40 repeats, but beyond, somatic repeat instability in the brain and CAG repeat purity modulate disease onset and severity. Previous studies have described that expanded repeats induce the incomplete splicing of HTT intron 1 to express the most pathogenic HTT isoform, known as HTT1a. Yet, the lack of a robust and sensitive method to evaluate HTT RNA-misprocessing has limited our understanding of HTT1a expression in HD pathophysiology. Here we describe a targeted RNA sequencing approach, known as 3’-end targeted RNA sequencing or 3TRS, to simultaneously quantify multiple HTT transcripts generated by canonical and cryptic polyadenylation in several HD models. We show that activation of HTT cryptic polyadenylation is highly selective and requires long and uninterrupted CAG repeat expansions. In HD knock-in mice and human postmortem brain, cryptic HTT expression strongly correlates with brain-specific somatic repeat instability, supporting a model where ultralong and unstable CAG repeats drive toxicity by activating HTT RNA-misprocessing. Overall, 3TRS provides a robust framework to investigate HTT1a biogenesis and expression and to evaluate HTT -lowering therapeutic strategies. GRAPHICAL ABSTRACT