2021 Post-doctoral Clinical Fellowship
Using genetic modifiers to investigate the molecular mechanisms of repeat expansion in Huntington’s disease
Huntington’s disease (HD) is a degenerative disorder of the brain characterised by progressive involuntary movements, psychiatric problems, and eventually dementia. It affects about 1 in 8,000 people in the UK and is untreatable, leading to premature death after 10-20 years of debilitating decline. HD is an inherited condition caused by an abnormally long stretch of consecutive ‘CAG’ repeats in the DNA. The more repeats you have, the earlier in life the disease starts- but there is considerable variation. Repeats also expand further in the brains of people with HD, and this process probably causes earlier onset of disease symptoms. It is driven by factors like DNA repair proteins MSH3 and MLH1 but is not well understood. If we could understand the biochemical reactions that cause CAG repeats to expand, we could develop new drugs to target this process and potentially slow onset and progression of HD. My Fellowship project takes two approaches to understanding repeat biology. First, we will use induced pluripotent stem cells from a patient with 109 CAG repeats as a model system of repeat expansion. When we grow these cells in the laboratory the repeats expand, allowing us to discover the critical factors that drive this pathogenic process. We will use specific antibodies to pull out MLH1 and MSH3 proteins from these cells before identifying attached proteins that might be novel factors, and potential drug targets, in repeat expansions. Secondly, we will use extracts from these cells on artificial DNA substrates with CAG repeats to develop a rapid laboratory test of expansions that we hope will speed up research and aid therapeutic development.
Thomas was awarded the MRC Clinician Scientist Fellowship in 2023. He is also a group leader in the UK DRI at Cardiff .
Publications
Exome sequencing of individuals with Huntington’s disease implicates FAN1 nuclease activity in slowing CAG expansion and disease onset
Nature Neuroscience 25, 446-457; doi: 10.1038/s41593-022-01033-5
2022
Huntington’s disease age at motor onset is modified by the tandem hexamer repeat in TCERG1
NPJ Genomic Medicine, 7, 53, https://doi.org/10.1038/s41525-022-00317-w
2022
Repeat Detector: versatile sizing of expanded tandem repeats and identification of interrupted alleles from targeted DNA sequencing
NAR Genomics and Bioinformatics, Volume 4, Issue 4, December 2022, lqac089, https://doi.org/10.1093/nargab/lqac089
2022
Genetic modifiers of Huntington disease differentially influence motor and cognitive domains
American Society of Human Genetics 2022 May 5;109(5):885-899. doi: 10.1016/j.ajhg.2022.03.004. Epub 2022 Mar 23. PMID: 35325614; PMCID: PMC9118113.
2022
Neurological consultation with an autistic patient
Practical Neurology 22, 120-125. doi: 10.1136/practneurol-2020-002856
2022
Author Response: Timing and Impact of Psychiatric, Cognitive, and Motor Abnormalities in Huntington Disease
Neurology, 98, 515. doi: 10.1212/WNL.0000000000200162
2022