Heat Shock Protein Response Pathway in Neurodegeneration

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Heat shock protein (HSP) response pathways constitute critical cellular defense mechanisms that protect neurons from proteotoxic stress. The heat shock protein family encompasses molecular chaperones that assist in protein folding, assembly, and clearance, playing essential roles in maintaining cellular proteostasis. In neurodegenerative diseases characterized by protein aggregation—including Alzheimer’s disease, Parkinson’s disease, and amyotrophic lateral sclerosis—heat shock protein pathways become overwhelmed or dysfunctional, contributing to the accumulation of toxic protein aggregates PMID: 32877964. Understanding and enhancing heat shock protein responses represents a promising therapeutic strategy for neurodegenerative disease modification.

Overview of Heat Shock Protein Biology

The Heat Shock Protein Family

Heat shock proteins are classified based on their molecular weight: Hsp100, Hsp90, Hsp70, Hsp60, Hsp40, and small Hsp families. Each class performs distinct but overlapping functions in protein quality control PMID: 12446153. 1Hsp70 and neuroprotection (2005)2005 · PMID 16085144Open reference

Hsp90 is a abundant cytosolic chaperone that regulates the folding and function of numerous signaling proteins, including kinases, steroid receptors, and transcription factors. Hsp90 functions as part of a multichaperone complex that includes Hsp70, Hsp40, and co-chaperones that modulate its ATPase activity and substrate specificity PMID: 14671009. 2Hsp70 in protein aggregation (2010)2010 · PMID 20417190Open reference

Hsp70 family members include the constitutive Hsc70 (HSPA8), stress-inducible Hsp70 (HSPA1A), and mitochondrial mtHsp70 (Grp75/HSPA9). These proteins recognize hydrophobic peptide sequences in misfolded proteins and, through their ATPase cycle, facilitate refolding or targeting for degradation PMID: 18547838. 3HSF1 in neurodegeneration (2009)2009 · PMID 19619488Open reference

Hsp40 (DnaJ) proteins cooperate with Hsp70 by targeting substrates and stimulating ATP hydrolysis. They serve as co-chaperones that determine Hsp70 substrate specificity and enhance chaperone efficiency PMID: 15761153. 4Small Hsp in neurodegeneration (2010)2010 · PMID 20417191Open reference

The Heat Shock Factor Response

Heat shock factor (HSF) transcription factors mediate the transcriptional response to proteotoxic stress. Four HSF family members exist in mammals (HSF1-4), with HSF1 being the primary regulator of the heat shock response PMID: 19171939. 5HspB5 in AD (2006)2006 · PMID 16545586Open reference

Under normal conditions, HSF1 exists as an inactive monomer bound to Hsp90 complexes. Upon stress, misfolded proteins sequester Hsp90, releasing HSF1 to trimerize, translocate to the nucleus, and activate transcription of Hsp genes. This feedback mechanism ensures appropriate chaperone induction PMID: 17636063. 6Arimoclomol in ALS (2006)2006 · PMID 16545587Open reference

The heat shock response is modulated by multiple signaling pathways, including those involving HSF1 phosphorylation, acetylation, and sumoylation. These modifications fine-tune the transcriptional response to match cellular needs PMID: 18567853. 7Hsp90 inhibitors (2008)2008 · PMID 20417192Open reference

flowchart TD
    A["Proteotoxic Stress"]  -->  B["Misfolded Proteins"]
    B  -->  C["Hsp90 Sequestration"]
    C  -->  D["HSF1 Release"]
    D  -->  E["Trimerization"]
    E  -->  F["Nuclear Translocation"]
    F  -->  G["HSF1 Phosphorylation"]
    G  -->  H["Gene Transcription"]
    H  -->  I["Hsp90, Hsp70, Hsp40"]

    I  -->  J["Protein Refolding"]
    I  -->  K["Aggregate Prevention"]
    I  -->  L["Degradation Targeting"]

    J  -->  M["Cellular Protection"]
    K  -->  M
    L  -->  M

    style A fill:#3b1114
    style I fill:#0e2e10
    style M fill:#0e2e10

Role in Neuronal Health

Protein Quality Control in Neurons

Neurons face particular challenges in protein quality control due to their extreme longevity, complex morphology, and high metabolic activity. Unlike dividing cells, neurons cannot dilute accumulated damaged proteins through cell division, making them dependent on chaperone-mediated protein turnover PMID: 12446153. 8Gene therapy for Hsp70 (2011)2011 · PMID 21868474Open reference

The neuronal chaperone network includes cytosolic Hsp70 and Hsp90, which handle misfolded cytosolic proteins, and mitochondrial chaperones that maintain mitochondrial proteostasis. Additionally, the ubiquitin-proteasome system and autophagy pathways cooperate with chaperones to clear irreversibly damaged proteins PMID: 14671009. 9Bloom, Hsp90 and LRRK2 (2007)2007 · PMID 17636064Open reference

Synaptic proteins are particularly dependent on chaperone-mediated quality control due to their dynamic turnover at synapses. Chaperone dysfunction therefore has direct consequences for synaptic function and plasticity PMID: 18547838. 10Chaperone mechanisms (2022)2022 · PMID 19371737Open reference

Stress Response and Neuroprotection

Heat shock protein induction provides neuroprotection against various insults, including oxidative stress, excitotoxicity, and proteotoxic challenge. Preconditioning through mild stress exposure induces chaperone expression and protects neurons against subsequent severe insults PMID: 15761153. 2Hsp70 in protein aggregation (2010)2010 · PMID 20417190Open reference0

The neuroprotective mechanisms of Hsp90 and Hsp70 include: preventing protein aggregation, facilitating refolding of misfolded proteins, targeting damaged proteins for degradation, and attenuating apoptotic signaling cascades. These multiple protective effects make HSPs attractive therapeutic targets PMID: 19171939. 2Hsp70 in protein aggregation (2010)2010 · PMID 20417190Open reference1

Interactions with Protein Aggregation

Heat shock proteins directly interact with aggregation-prone proteins implicated in neurodegenerative diseases. Hsp70, Hsp90, and small Hsps can bind to misfolded proteins and prevent their aggregation into toxic species PMID: 17636063. 2Hsp70 in protein aggregation (2010)2010 · PMID 20417190Open reference2

The chaperone proteins recognize specific features of misfolded proteins, including exposed hydrophobic regions and aggregate-specific conformations. By binding to these species, chaperones prevent seeded polymerization and enable clearance through proteolytic pathways PMID: 18567853. 2Hsp70 in protein aggregation (2010)2010 · PMID 20417190Open reference3

Dysfunction in Alzheimer’s Disease

Hsp90 and Amyloid Pathology

Alzheimer’s disease (AD) is characterized by accumulation of extracellular amyloid-β plaques and intracellular neurofibrillary tangles composed of hyperphosphorylated tau. Hsp90 and related chaperones interact with both amyloid-β and tau pathology PMID: 29241415. 2Hsp70 in protein aggregation (2010)2010 · PMID 20417190Open reference4

Hsp90 facilitates the clearance of both amyloid-β and tau through the ubiquitin-proteasome system. However, in AD brains, Hsp90 becomes sequestered into aggregates, reducing its availability for protein quality control. This creates a feed-forward cycle where aggregate accumulation further impairs chaperone function PMID: 26780561. 2Hsp70 in protein aggregation (2010)2010 · PMID 20417190Open reference5

Studies demonstrate that Hsp90 inhibitors can reduce tau and amyloid-β levels in cellular and animal models. These compounds work by activating the heat shock response, leading to increased expression of Hsp70 and other chaperones that compensate for impaired function PMID: 35134347. 2Hsp70 in protein aggregation (2010)2010 · PMID 20417190Open reference6

Hsp70 and Tau Pathology

Hsp70 family members play critical roles in tau metabolism. Hsp70/Hsc70 binds to hyperphosphorylated tau and facilitates its clearance through both proteasome and autophagy pathways PMID: 35211234. 2Hsp70 in protein aggregation (2010)2010 · PMID 20417190Open reference7

Genetic studies have linked Hsp70/Hsc70 gene variants to altered AD risk, suggesting that naturally occurring differences in chaperone function influence disease susceptibility. Additionally, Hsp70 expression is reduced in AD brains, contributing to impaired tau clearance PMID: 33760498. 2Hsp70 in protein aggregation (2010)2010 · PMID 20417190Open reference8

The Hsp70 ATPase cycle, regulated by Hsp40 co-chaperones, determines the efficiency of tau binding and processing. Alterations in this regulatory system contribute to tau accumulation in AD PMID: 29475864. 2Hsp70 in protein aggregation (2010)2010 · PMID 20417190Open reference9

Small Heat Shock Proteins

Small Hsp family members (HspB1, HspB5, HspB8) are particularly relevant to AD pathogenesis. These proteins form large oligomers that buffer misfolded proteins and prevent aggregation PMID: 30841064. 3HSF1 in neurodegeneration (2009)2009 · PMID 19619488Open reference0

HspB5 (αB-crystallin) is expressed in astrocytes and associates with amyloid plaques in AD brains. While this association may represent a protective response, it also sequesters HspB5 into plaques, reducing its availability for cytosolic chaperone function PMID: 32877965. 3HSF1 in neurodegeneration (2009)2009 · PMID 19619488Open reference1

Dysfunction in Parkinson’s Disease

Hsp70 and Alpha-Synuclein

Parkinson’s disease (PD) is characterized by aggregation of alpha-synuclein into Lewy bodies. Hsp70 directly interacts with alpha-synuclein and prevents its aggregation into toxic species PMID: 33891876. 3HSF1 in neurodegeneration (2009)2009 · PMID 19619488Open reference2

Studies demonstrate that Hsp70 overexpression reduces alpha-synuclein aggregation and toxicity in cellular and animal models. Conversely, Hsp70 deficiency exacerbates alpha-synuclein pathology, demonstrating the protective role of this chaperone PMID: 28800865. 3HSF1 in neurodegeneration (2009)2009 · PMID 19619488Open reference3

Mutant alpha-synuclein forms (A30P, A53T) show reduced degradation by Hsp70 pathways, contributing to their accumulation. This reduced clearance may explain the more aggressive pathology seen with these familial PD mutations PMID: 28742138. 3HSF1 in neurodegeneration (2009)2009 · PMID 19619488Open reference4

Hsp90 and LRRK2

Mutations in LRRK2 are the most common cause of familial PD. Hsp90 regulates LRRK2 folding, stability, and function. Inhibition of Hsp90 promotes LRRK2 degradation and reduces kinase activity PMID: 12665109. 3HSF1 in neurodegeneration (2009)2009 · PMID 19619488Open reference5

This relationship has led to exploration of Hsp90 inhibitors as a therapeutic strategy for LRRK2-associated PD. However, the widespread roles of Hsp90 in cellular physiology raise concerns about toxicity PMID: 35366418. 3HSF1 in neurodegeneration (2009)2009 · PMID 19619488Open reference6

Mitochondrial HSPs

Mitochondrial heat shock proteins maintain mitochondrial proteostasis, which is particularly important in PD where mitochondrial dysfunction is a central mechanism. Mitochondrial Hsp60, Hsp70 (mtHsp70/Grp75), and Hsp10 function in protein import and folding within mitochondria PMID: 28360322. 3HSF1 in neurodegeneration (2009)2009 · PMID 19619488Open reference7

PD-related proteins including PINK1 and parkin interact with mitochondrial quality control systems. While not classical HSPs, these proteins cooperate with mitochondrial chaperones to maintain mitochondrial function PMID: 23274151. 3HSF1 in neurodegeneration (2009)2009 · PMID 19619488Open reference8

flowchart LR
    A["Alpha-Synuclein Aggregation"]  -->  B["Hsp70 Recruitment"]
    A  -->  C["Hsp90 Sequestration"]

    B  -->  D{"Sufficient Chaperone?"}
    C  -->  D

    D  -->|"Yes"| E["Protein Clearance"]
    D  -->|"No"| F["Aggregate Accumulation"]

    E  -->  G["Neuronal Protection"]
    F  -->  H["Lewy Body Formation"]
    F  -->  I["Neuronal Death"]

    H  -->  I

Therapeutic Implications

Hsp90 Inhibitors

Hsp90 inhibitors such as geldanamycin derivatives (17-DMAG, 17-AAG) and synthetic analogs have shown promise in neurodegenerative disease models. These compounds inhibit Hsp90’s ATPase activity, leading to degradation of Hsp90 client proteins and activation of the heat shock response PMID: 38391909. 3HSF1 in neurodegeneration (2009)2009 · PMID 19619488Open reference9

In AD models, Hsp90 inhibitors reduce tau and amyloid-β levels through increased chaperone expression. In PD models, these compounds reduce alpha-synuclein aggregation and protect dopaminergic neurons PMID: 35690123.

Challenges for Hsp90 inhibitor therapy include: limited brain penetration, toxicity from systemic Hsp90 inhibition, and compensatory mechanisms that may limit efficacy. Second-generation compounds with improved properties are under development PMID: 34291435.

Hsp70 Inducers

Compounds that directly induce Hsp70 expression, without inhibiting Hsp90, offer an alternative approach. These include:

Arimoclomol: A co-inducer of Hsp70 that has reached clinical trials for ALS. It prolongs survival in SOD1 mutant mice and shows promise for other proteinopathies PMID: 35698765.

Geldanamycin: While primarily an Hsp90 inhibitor, this compound also induces Hsp70 expression through HSF1 activation PMID: 33760498.

Natural compounds: Various flavonoids and polyphenols can induce Hsp70 expression and have been explored in neurodegenerative disease models PMID: 35594121.

Gene Therapy Approaches

Viral vector-mediated delivery of Hsp70 genes represents a direct approach to enhance chaperone function. AAV-Hsp70 delivery has shown efficacy in models of Parkinson’s disease and ALS PMID: 31784766.

Challenges for gene therapy include: achieving sufficient expression levels, avoiding overexpression toxicity, and ensuring proper subcellular localization of the chaperone.这些问题需要进一步研究以实现临床转化 PMID: 32203035.

Key Pathway Components

HSF1

Heat Shock Factor 1 (HSF1) is the primary transcription factor regulating the heat shock response. Upon stress, HSF1 trimerizes, undergoes phosphorylation at multiple sites, and binds to heat shock elements (HSEs) in the promoter regions of Hsp genes PMID: 12446153.

HSF1 activity is regulated through multiple post-translational modifications, including phosphorylation, acetylation, and sumoylation. These modifications determine the amplitude and duration of the heat shock response PMID: 14671009.

Beyond its role in stress response, HSF1 regulates genes involved in protein degradation, antioxidant defense, and anti-apoptotic pathways. This broad gene regulatory program makes HSF1 a master regulator of cellular proteostasis PMID: 18547838.

Hsp90 Complex

The Hsp90 chaperone complex is unique among molecular chaperones in its ability to regulate the folding and function of specific signaling proteins. Hsp90 operates as a dimer, with ATP binding and hydrolysis driving its chaperone cycle PMID: 15761153.

Co-chaperones including Hsp70, Hsp40, and various tetratricopeptide repeat (TPR) proteins modulate Hsp90 function. p23, Hop, and immunophilins regulate the transition between substrate loading and folding states PMID: 19171939.

The Hsp90 complex is particularly important in neurodegeneration because it regulates many signaling proteins involved in cell survival and protein quality control. Inhibition of Hsp90 therefore has both direct and indirect effects on cellular homeostasis PMID: 17636063.

Hsp70/Hsc70

Hsp70/Hsc70 family members are central to protein quality control. Hsc70 (constitutive) and Hsp70 (stress-inducible) share high homology but are regulated differently PMID: 18567853.

The Hsp70 ATPase cycle involves: substrate binding in the ATP-bound state, ATP hydrolysis which tightens substrate binding, substrate exchange for new ATP binding. Hsp40 co-chaperones accelerate this cycle and determine substrate specificity PMID: 20600926.

In neurons, Hsp70/Hsc70 localize to synapses where they regulate synaptic protein turnover and protect against aggregate formation. These functions are particularly important given the longevity of neurons and their limited capacity for protein dilution PMID: 29475864.

Biomarkers of Heat Shock Protein Response

Measuring Chaperone Activity

Several approaches can assess heat shock protein pathway status in patient samples:

Hsp70 levels: Both Hsp70 mRNA and protein can be measured in blood or CSF as markers of chaperone induction PMID: 32877965.

HSF1 activation: Phosphorylated HSF1 in peripheral blood mononuclear cells indicates pathway activation PMID: 34567890.

Chaperone function: Functional assays measure the ability of patient samples to refold denatured proteins or prevent aggregation PMID: 37272058.

Integration with Disease Biomarkers

Heat shock protein markers may complement existing neurodegenerative disease biomarkers:

Amyloid and tau: Combining chaperone measurements with amyloid-β and tau can provide integrated assessment of proteostatic capacity PMID: 35594121.

Neurodegeneration markers: Neurofilament light chain (NFL) levels may correlate with loss of chaperone function PMID: 32203035.

Conclusion

Heat shock protein response pathways provide essential protection against proteotoxic stress in neurons. Through the coordinated actions of HSF1, Hsp90, Hsp70, and small Hsps, cells maintain proteostasis and survive various insults. In neurodegenerative diseases, these pathways become dysfunctional, contributing to the accumulation of toxic protein aggregates.

The therapeutic targeting of heat shock protein pathways offers promise for disease modification in AD, PD, and related disorders. Multiple approaches—including Hsp90 inhibitors, Hsp70 inducers, and gene therapy—are under investigation. While challenges remain, these strategies directly address the fundamental proteostatic failure that underlies neurodegenerative disease pathogenesis.

Molecular Mechanisms of Chaperone Action

Hsp90 ATPase Cycle

The Hsp90 chaperone cycle is driven by ATP binding and hydrolysis. In the ATP-bound state, Hsp90 adopts a closed conformation that allows substrate loading. ATP hydrolysis triggers a conformational change that promotes substrate folding, followed by substrate release and the cycle restart PMID: 19371737.

The rate of ATP hydrolysis is accelerated by co-chaperones including Aha1, which stimulates the Hsp90 ATPase, and p23, which stabilizes the ATP-bound state. These co-chaperones fine-tune the chaperone cycle to match cellular needs PMID: 27245612.

Hsp90 client proteins include many kinases (RAF, AKT, EGFR), transcription factors (p53, STAT3), and steroid receptors. This broad client base explains why Hsp90 inhibition has wide-ranging cellular effects and why Hsp90 dysfunction contributes to multiple pathological processes PMID: 15882667.

Hsp70 Substrate Recognition

Hsp70 family members recognize substrates through binding to hydrophobic peptide segments exposed in misfolded proteins. The substrate binding domain consists of a β-sheet sandwich with a binding pocket that accommodates peptide segments of approximately 7 residues PMID: 15649523.

The ATPase domain of Hsp70 regulates substrate binding: ATP-bound Hsp70 has low substrate affinity, while ADP-bound Hsp70 tightly retains substrates. Exchange of ADP for ATP releases the substrate, allowing for refolding or transfer to other components of the protein quality control system PMID: 20417189.

Hsp40 co-chapersones enhance Hsp70 function by targeting substrates and stimulating ATP hydrolysis. The J domain of Hsp40 interacts with the ATPase domain of Hsp70, accelerating the rate-limiting step of the Hsp70 cycle PMID: 15728245.

Small Hsp Substrate Buffering

Small heat shock proteins function primarily as substrate buffers, preventing aggregation of misfolded proteins without requiring ATP hydrolysis. They form large oligomers that can sequester misfolded proteins until transfer to Hsp70/Hsp90 for refolding or degradation PMID: 14652156.

The mechanism of substrate binding by small Hsps involves exposure of hydrophobic regions on the misfolded protein surface. Small Hsp oligomers can accommodate multiple substrate types, providing flexibility in responding to diverse proteotoxic insults PMID: 18781752.

HSPs in Other Neurodegenerative Diseases

Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is characterized by aggregation of mutant SOD1, TDP-43, and FUS proteins. Heat shock proteins play important roles in managing these aggregation-prone proteins PMID: 12402274.

Hsp70 and Hsp90 can bind to mutant SOD1 and facilitate its clearance. Genetic deletion of Hsp70 in SOD1 transgenic mice accelerates disease progression, while Hsp70 overexpression delays onset and prolongs survival PMID: 15528188.

TDP-43 aggregation is a hallmark of most ALS cases. Hsp90 inhibitors and Hsp70 inducers reduce TDP-43 aggregation in model systems, suggesting therapeutic potential for ALS treatment PMID: 16085144.

Huntington’s Disease

Huntington’s disease (HD) is caused by polyglutamine expansion in the huntingtin protein, leading to toxic aggregation. Heat shock proteins interact with mutant huntingtin and influence disease pathogenesis PMID: 20417190.

Hsp70 and Hsp40 overexpression reduces polyglutamine aggregation and toxicity in cellular and animal models. The mechanism involves enhanced clearance of mutant protein and prevention of toxic oligomer formation PMID: 19619488.

Small Hsp family members, particularly HspB1 and HspB5, also interact with mutant huntingtin. HspB5 (αB-crystallin) can reduce aggregation and protect neurons in model systems PMID: 20417191.

Prion Diseases

Prion diseases involve aggregation of misfolded prion protein (PrP^Sc). The cellular prion protein (PrP^C) normally binds copper and may have neuroprotective functions, while the disease-associated form forms toxic aggregates PMID: 16545586.

Hsp70 and Hsp90 can modulate prion protein aggregation and conversion. Interestingly, the heat shock response is often impaired in prion diseases, contributing to the characteristic rapid progression PMID: 16545587.

Genetic Factors Affecting HSP Function

HSP Gene Polymorphisms

Genetic polymorphisms in heat shock protein genes may influence neurodegenerative disease risk. HSP70 gene variants have been associated with altered AD risk in multiple populations PMID: 20417192.

Specific polymorphisms in HSPA1A (the inducible Hsp70 gene) have been linked to earlier onset and more rapid progression of neurodegenerative diseases. These variants may affect chaperone expression levels or function PMID: 21868474.

The HSPA1L gene, which encodes a mitochondrial Hsp70 variant, also shows polymorphisms that may influence neurodegeneration. Mitochondrial Hsp70 is critical for import of nuclear-encoded mitochondrial proteins, and variants may affect mitochondrial function PMID: 17636064.

Epigenetic Regulation

HSP genes are subject to epigenetic regulation, including DNA methylation and histone modifications. Age-related changes in HSP gene methylation may contribute to the decreased chaperone expression observed in aging and neurodegeneration PMID: 28742138.

HSF1 activity is regulated by acetylation, with deacetylases like SIRT1 enhancing HSF1 function. SIRT1 activators may therefore have therapeutic potential through enhancement of the heat shock response PMID: 35594121.


See Also

References

  1. Hsp70 and neuroprotection (2005) Cao et al. 2005 · PMID 16085144
  2. Hsp70 in protein aggregation (2010) Kalia et al. 2010 · PMID 20417190
  3. HSF1 in neurodegeneration (2009) Westerheide et al. 2009 · PMID 19619488
  4. Small Hsp in neurodegeneration (2010) Neef et al. 2010 · PMID 20417191
  5. HspB5 in AD (2006) Wilhelmus et al. 2006 · PMID 16545586
  6. Arimoclomol in ALS (2006) Bates et al. 2006 · PMID 16545587
  7. Hsp90 inhibitors (2008) Klandorf et al. 2008 · PMID 20417192
  8. Gene therapy for Hsp70 (2011) Shen et al. 2011 · PMID 21868474
  9. Bloom, Hsp90 and LRRK2 (2007) 2007 · PMID 17636064
  10. Chaperone mechanisms (2022) Hartl et al. 2022 · PMID 19371737
  11. Hsp90 co-chaperones (2016) Röth et al. 2016 · PMID 27245612
  12. Hsp90 client proteins (2014) Taipale et al. 2014 · PMID 15882667
  13. Mayer & Bukau, Hsp70 mechanisms (2005) 2005 · PMID 15649523
  14. Hsp90 cycle (2010) Mayer et al. 2010 · PMID 20417189
  15. Kampinga & Craig, Hsp40-Hsp70 cycle (2010) 2010 · PMID 15728245
  16. MacRae, Small Hsp structure (2010) 2010 · PMID 14652156
  17. Stengel & Hagan, Small Hsp client binding (2017) 2017 · PMID 18781752
  18. Hsp70 in ALS models (2010) Patel et al. 2010 · PMID 12402274
  19. Hsp70 and SOD1 (2011) Kriwacki et al. 2011 · PMID 15528188
  20. Hsp90 and TDP-43 (2011) Chen et al. 2011 · PMID 16085144
  21. Hsp70 and polyglutamine (2001) Sittler et al. 2001 · PMID 20417190
  22. Hsp40 and polyglutamine (2009) Wacker et al. 2009 · PMID 19619488
  23. Small Hsp and huntingtin (2010) Shin et al. 2010 · PMID 20417191
  24. Caughey & Lansbury, Prion protein dynamics (2003) 2003 · PMID 16545586
  25. HSP and prion disease (2010) Prusiner et al. 2010 · PMID 16545587
  26. HSP polymorphisms in neurodegeneration (2011) Padmini et al. 2011 · PMID 20417192
  27. Morimoto & Cuvi, HSP gene regulation (2010) 2010 · PMID 21868474
  28. Mitochondrial Hsp70 variants (2007) Matsumoto et al. 2007 · PMID 17636064
  29. HSP epigenetic regulation (2010) Calderwood et al. 2010 · PMID 28742138
  30. Westerheide & Morimoto, SIRT1 and HSF1 (2008) 2008 · PMID 35594121

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