In investigating the role of metal ions in the pathogenesis of Huntington's disease, we examined the effects of clioquinol, a metal-binding compound currently in clinical trials for Alzheimer's disease treatment, on mutant huntingtin-expressing cells. We found that PC12 cells expressing polyglutamine-expanded huntingtin exon 1 accumulated less mutant protein and showed decreased cell death when treated with clioquinol. This effect was polyglutamine-length-specific and did not alter mRNA levels or protein degradation rates. Clioquinol treatment of transgenic Huntington's mice (R6͞2) improved behavioral and pathologic phenotypes, including decreased huntingtin aggregate accumulation, decreased striatal atrophy, improved rotarod performance, reduction of weight loss, normalization of blood glucose and insulin levels, and extension of lifespan. Our results suggest that clioquinol is a candidate therapy for Huntington's disease and other polyglutamine-expansion diseases.polyglutamine ͉ small-molecule therapeutics ͉ R6/2 transgenic mice H untington's disease (HD) is an autosomal dominant neurological disorder that causes progressive cognitive, motor, and psychiatric dysfunction over a 10-to 20-year disease course, leading to death (1, 2). HD is caused by CAG-repeat expansion (3) in the 5Ј region of the IT15 gene that encodes the ubiquitously expressed 350-kDa protein huntingtin (Htt). The expanded-CAG region encodes polyglutamine (polyQ). When the polyQ region is 40 residues or more, there is virtually 100% penetrance of the disease phenotype (4). The physiologic roles of Htt are not fully understood; however, it was recently found to be important for vesicular transport of brain-derived neurotrophic factor in axons (5).The toxicity of polyQ-Htt appears to involve a gain-offunction (6) mechanism with possible adjunct involvement of impairment of physiologic Htt function (7). Recent studies suggest that diffusely distributed mono-or oligomeric Htt is the predominant toxic form and not the highly aggregated forms present in inclusion bodies (8-11). New toxic activities may occur because the region containing the expanded polyQ tract binds to itself and other polyQ-containing proteins, especially when cleaved from the full-length protein (12), and may sequester and deactivate transcription factors such as TBP (13), CBP (14), Sp1, and TAFII130 (15). Mutant Htt is also implicated in mitochondrial function defects, including initiation of the mitochondrial permeability transition (16, 17) and loss of trophic support due to decreased production (18, 19) and dominant-negative inhibition of transport of brain-derived neurotrophic factor (5). However, the relative contributions to pathogenesis of the many potentially toxic effects of polyQ expansion of Htt have yet to be determined.Ongoing synthesis of mutant protein appears necessary to drive the pathogenic process. Yamamoto et al. (20), using a tetregulatable transgenic system, found that when expression of polyQ-htt exon 1 was inhibited in symptomatic mice, the neuropatholog...