HTT

Chr 4ADAR

huntingtin

Serotonin transporter that cotransports serotonin with one Na(+) ion in exchange for one K(+) ion and possibly one proton in an overall electroneutral transport cycle. Transports serotonin across the plasma membrane from the extracellular compartment to the cytosol thus limiting serotonin intercellular signaling (PubMed:10407194, PubMed:12869649, PubMed:21730057, PubMed:27049939, PubMed:27756841, PubMed:34851672). Essential for serotonin homeostasis in the central nervous system. In the developing somatosensory cortex, acts in glutamatergic neurons to control serotonin uptake and its trophic functions accounting for proper spatial organization of cortical neurons and elaboration of sensory circuits. In the mature cortex, acts primarily in brainstem raphe neurons to mediate serotonin uptake from the synaptic cleft back into the pre-synaptic terminal thus terminating serotonin signaling at the synapse (By similarity). Modulates mucosal serotonin levels in the gastrointestinal tract through uptake and clearance of serotonin in enterocytes. Required for enteric neurogenesis and gastrointestinal reflexes (By similarity). Regulates blood serotonin levels by ensuring rapid high affinity uptake of serotonin from plasma to platelets, where it is further stored in dense granules via vesicular monoamine transporters and then released upon stimulation (PubMed:17506858, PubMed:18317590). Mechanistically, the transport cycle starts with an outward-open conformation having Na1(+) and Cl(-) sites occupied. The binding of a second extracellular Na2(+) ion and serotonin substrate leads to structural changes to outward-occluded to inward-occluded to inward-open, where the Na2(+) ion and serotonin are released into the cytosol. Binding of intracellular K(+) ion induces conformational transitions to inward-occluded to outward-open and completes the cycle by releasing K(+) possibly together with a proton bound to Asp-98 into the extracellular compartment. Na1(+) and Cl(-) ions remain bound throughout the transport cycle (PubMed:10407194, PubMed:12869649, PubMed:21730057, PubMed:27049939, PubMed:27756841, PubMed:34851672). Additionally, displays serotonin-induced channel-like conductance for monovalent cations, mainly Na(+) ions. The channel activity is uncoupled from the transport cycle and may contribute to the membrane resting potential or excitability (By similarity)

Primary Disease Associations & Inheritance

Huntington diseaseMIM #143100
AD
Lopes-Maciel-Rodan syndromeMIM #617435
AR
351
ClinVar variants
63
Pathogenic / LP
1.00
pLI score· haploinsufficient
12
Active trials
Clinical SummaryHTT
🧬
Gene-Disease Validity (ClinGen)
Huntington disease · ADDefinitive

Definitive — sufficient evidence for diagnostic panels

Population Constraint (gnomAD)
Highly constrained gene — heterozygous loss-of-function variants are very rare in the population (pLI 1.00). One damaged copy is likely sufficient to cause disease.
📋
ClinVar Variants
63 Pathogenic / Likely Pathogenic· 33 VUS of 351 total submissions
💊
Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available
Some data sources returned errors (1)

ncbi: Error: NCBI fetch failed: 429 https://eutils.ncbi.nlm.nih.gov/entrez/eutils/esummary.fcgi

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

LoF intolerant — likely haploinsufficient
LoF Constraint?LOEUF (Loss-of-function Observed/Expected Upper bound Fraction) is the upper bound of the 90% CI for LoF OE — the preferred gnomAD v4 metric. Lower = more intolerant to LoF. LOEUF < 0.35 = highly constrained.
0.18LOEUF
pLI 1.000
Z-score 10.27
OE 0.12 (0.080.18)
Highly constrained

Highly LoF-intolerant (top ~10% of genes)

Missense Constraint?Missense Z-score: standard deviations fewer missense variants observed vs. expected. Z > 3.09 (p < 0.001) = gene does not tolerate missense variation. OE missense < 0.6 is also considered constrained.
2.78Z-score
OE missense 0.81 (0.780.85)
1404 obs / 1729.3 exp
Mild constraint

Moderately missense-constrained (top ~2.5%)

Observed / Expected Ratios?Shaded band = 90% confidence interval. Vertical tick = point estimate. Grey threshold line = gnomAD constraint cutoff for that variant class.
LoF OE?Ratio of observed to expected LoF variants. Upper CI bound (LOEUF) ≤ 0.35 = strong LoF constraint signal.0.12 (0.080.18)
00.351.4
Missense OE?Ratio of observed to expected missense variants. OE ≤ 0.6 = fewer missense variants than expected by chance.0.81 (0.780.85)
00.61.4
Synonymous OE?Control metric — synonymous variants are largely neutral and expected near OE = 1.0. Significant deviation may indicate annotation issues.1.10
01.21.6
LoF obs/exp: 19 / 158.6Missense obs/exp: 1404 / 1729.3Syn Z: -2.04

ClinVar Variant Classifications

351 submitted variants in ClinVar

Classification Summary

Pathogenic56
Likely Pathogenic7
VUS33
Likely Benign214
Benign40
Conflicting1
56
Pathogenic
7
Likely Pathogenic
33
VUS
214
Likely Benign
40
Benign
1
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
0
0
56
0
56
Likely Pathogenic
3
0
4
0
7
VUS
1
24
6
2
33
Likely Benign
1
9
78
126
214
Benign
0
10
15
15
40
Conflicting
1
Total543159143351

LoF = frameshift, stop gained/lost, canonical splice · Counts from ClinVar esearch · Updated hourly

View in ClinVar →

Protein Context — Lollipop Plot

HTT · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

OMIM — Genotype-Phenotype Relationships

1 OMIM entry

HUNTINGTIN; HTT
MIM #613004 · *

Huntington disease

MIM #143100

Molecular basis of disorder known

Autosomal dominant

Lopes-Maciel-Rodan syndrome

MIM #617435

Molecular basis of disorder known

Autosomal recessive
📖
GeneReview available — HTT
Authoritative clinical overview · NCBI Bookshelf · Recommended first read
Open GeneReview ↗
Clinical Literature
Landmark / reviewRecent case evidence
Key Publications
Landmark & review papers · by relevance
PubMed
Polyglutamine diseases.
Bunting EL et al.·Curr Opin Neurobiol
2022Review
Huntington's disease.
Roze E et al.·Adv Exp Med Biol
2010Review
Poly ADP-ribose signaling is dysregulated in Huntington disease.
Maiuri T et al.·Proc Natl Acad Sci U S A
2024
Therapeutic strategies for Huntington's disease.
Estevez-Fraga C et al.·Curr Opin Neurol
2020Review
Top 10 resultsSearch PubMed ↗

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Huntington Disease

Huntington's Disease Young Adult Study 2.0

ACTIVE NOT RECRUITING
NCT06391619University College, LondonStarted 2022-04-06
No intervention
Huntington Disease

Study of BDNF Pathway Biomarkers in the Cerebrospinal Fluid in Patients With Huntington's Disease

RECRUITING
NCT04012411Phase NAUniversity Hospital, MontpellierStarted 2020-03-03
Brain MRILumbar PunctionBlood sample
Postnatal Depression

Home-based Transcranial Direct Current Stimulation in Postpartum Depression: the Feasibility Study and Pilot Study

NOT YET RECRUITING
NCT05046405Phase NAAna Ganho ÁvilaStarted 2022-10-02
Transcranial Direct Current Stimulation
Huntington Disease

Gene Therapy Development and Validation for Huntington's Disease Fibro TG-HD

RECRUITING
NCT06444217Phase NAUniversity Hospital, AngersStarted 2024-09-23
skin biopsy
Invasive PreNatal Diagnosis in a Context of Family History of Single-gene Disorders, IncludingSickle Cell DiseaseCystic Fibrosis

Development of Non-Invasive Prenatal Diagnosis for Single Gene Disorders

RECRUITING
NCT06147414Assistance Publique - Hôpitaux de ParisStarted 2024-10-23
Blood sample
PregnancyPostpartumChildbirth

HIIT vs MICT During Pregnancy and Health and Birth Outcomes in Mothers and Children

RECRUITING
NCT05009433Phase NAGdansk University of Physical Education and SportStarted 2021-06-24
High intensity interval training program for pregnant womenModerate intensity continuous training program for pregnant womenStandard obstetric care with extended education on healthy lifestyle
Premature Ejaculation

Therapeutic Outcomes of Selective Serotonin Reuptake Inhibitors and Phosphodiesterase-5 Inhibitors Combination Therapy Versus Monotherapy

NOT YET RECRUITING
NCT07057011Phase NASouth Valley UniversityStarted 2025-07-01
Paroxetine 20 Mg Oral Tablet
Huntington's Disease

Safety and Proof-of-Concept (POC) Study With AMT-130 in Adults With Early Manifest Huntington's Disease

ACTIVE NOT RECRUITING
NCT04120493Phase PHASE1, PHASE2UniQure Biopharma B.V.Started 2019-09-06
intra-striatal rAAV5-miHTTImitation (sham) surgery
Huntington Disease

A Randomised Controlled Trial, Of N-Acetyl Cysteine (NAC), for Premanifest Huntingtin Gene Expansion Carriers

RECRUITING
NCT05509153Phase PHASE2Western Sydney Local Health DistrictStarted 2024-06-01
NACPlacebo
Huntington's Disease

HDClarity: a Multi-site Cerebrospinal Fluid Collection Initiative to Facilitate Therapeutic Development for Huntington's Disease

RECRUITING
NCT02855476University College, LondonStarted 2017-01-01
Huntington's Disease

A Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of RG6496 in Huntington's Disease

RECRUITING
NCT07246941Phase PHASE1Hoffmann-La RocheStarted 2025-11-19
RG6496Placebo
Parkinson DiseaseParkinson'sParkinson's Disease

Serotonin Release in Premotor and Motor PD

RECRUITING
NCT05516732University of ExeterStarted 2022-07-01
Positron Emission Tomography (PET) scan using CIMBI-36 tracerMagnetic Resonance Imaging (MRI) ScanPositron Emission Tomography (PET) scan using DASB tracer