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Chin H, Cho J, Kim WJ, Kim SY, Lim BC, Kim KJ, Chae JH. A Case of Multiple Mitochondrial Dysfunctions Syndrome 4 with Novel ISCA2 Variants, Mimicking Post-Infectious Encephalitis. Child Neurol Open 2023; 10:2329048X231210421. [PMID: 37915614 PMCID: PMC10617010 DOI: 10.1177/2329048x231210421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/08/2023] [Accepted: 10/11/2023] [Indexed: 11/03/2023] Open
Abstract
ISCA2 loss of function leads to leukodystrophy and developmental regression (multiple mitochondrial dysfunctions syndrome 4 (MMDS4)). We present a first Korean case of MMDS4 presenting with rapid developmental regression and leukodystrophy after febrile episode, mimicking post-infectious encephalitis. The patient had displayed normal development until 12 months of age. At 13 months of age, one month after experiencing a post-vaccination fever, she quickly progressed to being unable to sit unassisted nor speak any words. Analysis of the cerebrospinal fluid (CSF) revealed lympho-dominant pleocytosis. Amino acid analysis of both the serum and CSF demonstrated elevated glycine exclusively in the CSF. Diffuse leukodystrophy was noted in the brain magnetic resonance image. Whole exome sequencing revealed compound heterozygous ISCA2 variants of c.166T>G, p.C56G and c.422A>C, p.Q141P. No evidence of mitochondrial disease other than bilateral optic atrophy was noted. In cases of early onset rapid developmental regression with leukodystrophy, MMDS4 should be considered.
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Affiliation(s)
- Hyungjin Chin
- Department of Pediatrics, Seoul National University College of Medicine, Jongno-gu, Korea
| | - Jaeso Cho
- Department of Genomic Medicine, Seoul National University Hospital, Jongno-gu, Korea
| | - Woo Joong Kim
- Department of Pediatrics, Seoul National University College of Medicine, Jongno-gu, Korea
| | - Soo Yeon Kim
- Department of Genomic Medicine, Seoul National University Hospital, Jongno-gu, Korea
| | - Byung Chan Lim
- Department of Pediatrics, Seoul National University College of Medicine, Jongno-gu, Korea
| | - Ki Joong Kim
- Department of Pediatrics, Seoul National University College of Medicine, Jongno-gu, Korea
| | - Jong Hee Chae
- Department of Pediatrics, Seoul National University College of Medicine, Jongno-gu, Korea
- Department of Genomic Medicine, Seoul National University Hospital, Jongno-gu, Korea
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Kaiyrzhanov R, Zaki MS, Lau T, Sen S, Azizimalamiri R, Zamani M, Sayin GY, Hilander T, Efthymiou S, Chelban V, Brown R, Thompson K, Scarano MI, Ganesh J, Koneev K, Gülaçar IM, Person R, Sadykova D, Maidyrov Y, Seifi T, Zadagali A, Bernard G, Allis K, Elloumi HZ, Lindy A, Taghiabadi E, Verma S, Logan R, Kirmse B, Bai R, Khalaf SM, Abdel‐Hamid MS, Sedaghat A, Shariati G, Issa M, Zeighami J, Elbendary HM, Brown G, Taylor RW, Galehdari H, Gleeson JJ, Carroll CJ, Cowan JA, Moreno‐De‐Luca A, Houlden H, Maroofian R. Phenotypic continuum of NFU1-related disorders. Ann Clin Transl Neurol 2022; 9:2025-2035. [PMID: 36256512 PMCID: PMC9735368 DOI: 10.1002/acn3.51679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 12/14/2022] Open
Abstract
Bi-allelic variants in Iron-Sulfur Cluster Scaffold (NFU1) have previously been associated with multiple mitochondrial dysfunctions syndrome 1 (MMDS1) characterized by early-onset rapidly fatal leukoencephalopathy. We report 19 affected individuals from 10 independent families with ultra-rare bi-allelic NFU1 missense variants associated with a spectrum of early-onset pure to complex hereditary spastic paraplegia (HSP) phenotype with a longer survival (16/19) on one end and neurodevelopmental delay with severe hypotonia (3/19) on the other. Reversible or irreversible neurological decompensation after a febrile illness was common in the cohort, and there were invariable white matter abnormalities on neuroimaging. The study suggests that MMDS1 and HSP could be the two ends of the NFU1-related phenotypic continuum.
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Affiliation(s)
- Rauan Kaiyrzhanov
- Department of Neuromuscular DisordersUCL Queen Square Institute of NeurologyLondonWC1N 3BGUK
| | - Maha S. Zaki
- Human Genetics and Genome Research Division, Clinical Genetics DepartmentNational Research CentreCairoEgypt
| | - Tracy Lau
- Department of Neuromuscular DisordersUCL Queen Square Institute of NeurologyLondonWC1N 3BGUK
| | - Sambuddha Sen
- Department of Chemistry and BiochemistryThe Ohio State University100 West 18th AvenueColumbusOhio43210USA
| | - Reza Azizimalamiri
- Department of Paediatric Neurology, Golestan, Medical, Educational, and Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Mina Zamani
- Department of Biology, Faculty of ScienceShahid Chamran University of AhvazAhvazIran
| | - Gözde Yeşil Sayin
- Department of Medical Genetics, Istanbul Faculty of MedicineIstanbul UniversityIstanbul34098Turkey
| | - Taru Hilander
- Genetics Section, Molecular and Clinical SciencesSt George's, University of LondonLondonUK
| | - Stephanie Efthymiou
- Department of Neuromuscular DisordersUCL Queen Square Institute of NeurologyLondonWC1N 3BGUK
| | - Viorica Chelban
- Department of Neuromuscular DisordersUCL Queen Square Institute of NeurologyLondonWC1N 3BGUK
| | - Ruth Brown
- Oxford Medical Genetics LaboratoriesThe Churchill HospitalOxfordOX3 7LJUK
| | - Kyle Thompson
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research InstituteFaculty of Medical Sciences Newcastle UniversityNewcastle upon TyneNE2 4HHUK
| | - Maria Irene Scarano
- Division of Genetics, Cooper Health SystemChildren's Regional HospitalSheridan Pavilion CamdenNew Jersy08103USA
| | - Jaya Ganesh
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Kairgali Koneev
- Department of Neurology and NeurosurgeryAsfendiyarov Kazakh National Medical UniversityAlmaty050000Kazakhstan
| | - Ismail Musab Gülaçar
- Department of Medical Genetics, Istanbul Faculty of MedicineIstanbul UniversityIstanbul34098Turkey
- Department of GeneticsInstitute of Graduate Studies in Health Sciences, Istanbul UniversityIstanbul34098Turkey
| | | | | | - Yerdan Maidyrov
- Department of Neurology and NeurosurgeryAsfendiyarov Kazakh National Medical UniversityAlmaty050000Kazakhstan
| | - Tahereh Seifi
- Department of Biology, Faculty of ScienceShahid Chamran University of AhvazAhvazIran
| | - Aizhan Zadagali
- L.N. Gumilyov Eurasian National UniversityNur‐SultanKazakhstan
| | - Geneviève Bernard
- Departments of Neurology and Neurosurgery, Pediatrics and Human GeneticsMcGill UniversityMontrealCanada
- Division of Medical Genetics, Department Specialized MedicineMcGill University Health CentreMontrealCanada
- Child Health and Human Development ProgramResearch Institute of the McGill University Health CentreMontrealCanada
| | | | | | | | - Ehsan Taghiabadi
- Skin and Stem Cell Research Center, Tehran University of Medical SciencesTehranIran
| | - Sumit Verma
- Department of NeurologyEmory University School of MedicineGeorgiaAtlantaUSA
| | - Rachel Logan
- Division of NeurosciencesChildren's Healthcare of AtlantaAtlantaGeorgiaUSA
| | - Brian Kirmse
- Division of GeneticsUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | | | | | - Mohamed S. Abdel‐Hamid
- Medical Molecular Genetics DepartmentHuman Genetics and Genome Research Institute, National Research CentreCairoEgypt
| | - Alireza Sedaghat
- Health Research Institute, Diabetes Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Gholamreza Shariati
- Department of Medical Genetics, Faculty of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran
- Narges Medical Genetics and Prenatal Diagnosis LaboratoryEast Mihan Ave., KianparsAhvazIran
| | - Mahmoud Issa
- Human Genetics and Genome Research Division, Clinical Genetics DepartmentNational Research CentreCairoEgypt
| | - Jawaher Zeighami
- Narges Medical Genetics and Prenatal Diagnosis LaboratoryEast Mihan Ave., KianparsAhvazIran
| | - Hasnaa M. Elbendary
- Human Genetics and Genome Research Division, Clinical Genetics DepartmentNational Research CentreCairoEgypt
| | - Garry Brown
- Oxford Medical Genetics LaboratoriesThe Churchill HospitalOxfordOX3 7LJUK
| | - Robert W. Taylor
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research InstituteFaculty of Medical Sciences Newcastle UniversityNewcastle upon TyneNE2 4HHUK
- NHS Highly Specialised Service for Rare Mitochondrial DisordersNewcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneNE1 4LPUK
| | - Hamid Galehdari
- Department of Biology, Faculty of ScienceShahid Chamran University of AhvazAhvazIran
| | - Joseph J. Gleeson
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCalifornia92093USA
- Rady Children's Institute for Genomic MedicineSan DiegoCalifornia92025USA
| | - Christopher J. Carroll
- Genetics Section, Molecular and Clinical SciencesSt George's, University of LondonLondonUK
| | - James A. Cowan
- Department of Chemistry and BiochemistryThe Ohio State University100 West 18th AvenueColumbusOhio43210USA
| | - Andres Moreno‐De‐Luca
- Department of RadiologyAutism & Developmental Medicine Institute, Genomic Medicine InstituteGeisingerDanvillePennsylvania17822USA
| | - Henry Houlden
- Department of Neuromuscular DisordersUCL Queen Square Institute of NeurologyLondonWC1N 3BGUK
| | - Reza Maroofian
- Department of Neuromuscular DisordersUCL Queen Square Institute of NeurologyLondonWC1N 3BGUK
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Camponeschi F, Ciofi-Baffoni S, Calderone V, Banci L. Molecular Basis of Rare Diseases Associated to the Maturation of Mitochondrial [4Fe-4S]-Containing Proteins. Biomolecules 2022; 12:biom12071009. [PMID: 35883565 PMCID: PMC9313013 DOI: 10.3390/biom12071009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 02/04/2023] Open
Abstract
The importance of mitochondria in mammalian cells is widely known. Several biochemical reactions and pathways take place within mitochondria: among them, there are those involving the biogenesis of the iron–sulfur (Fe-S) clusters. The latter are evolutionarily conserved, ubiquitous inorganic cofactors, performing a variety of functions, such as electron transport, enzymatic catalysis, DNA maintenance, and gene expression regulation. The synthesis and distribution of Fe-S clusters are strictly controlled cellular processes that involve several mitochondrial proteins that specifically interact each other to form a complex machinery (Iron Sulfur Cluster assembly machinery, ISC machinery hereafter). This machinery ensures the correct assembly of both [2Fe-2S] and [4Fe-4S] clusters and their insertion in the mitochondrial target proteins. The present review provides a structural and molecular overview of the rare diseases associated with the genes encoding for the accessory proteins of the ISC machinery (i.e., GLRX5, ISCA1, ISCA2, IBA57, FDX2, BOLA3, IND1 and NFU1) involved in the assembly and insertion of [4Fe-4S] clusters in mitochondrial proteins. The disease-related missense mutations were mapped on the 3D structures of these accessory proteins or of their protein complexes, and the possible impact that these mutations have on their specific activity/function in the frame of the mitochondrial [4Fe-4S] protein biogenesis is described.
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Affiliation(s)
- Francesca Camponeschi
- Magnetic Resonance Center CERM, University of Florence, 50019 Sesto Fiorentino, Italy; (F.C.); (L.B.)
- Consorzio Interuniversitario Risonanze Magnetiche di Metalloproteine (CIRMMP), 50019 Sesto Fiorentino, Italy
| | - Simone Ciofi-Baffoni
- Magnetic Resonance Center CERM, University of Florence, 50019 Sesto Fiorentino, Italy; (F.C.); (L.B.)
- Consorzio Interuniversitario Risonanze Magnetiche di Metalloproteine (CIRMMP), 50019 Sesto Fiorentino, Italy
- Department of Chemistry, University of Florence, 50019 Sesto Fiorentino, Italy
- Correspondence: (S.C.-B.); (V.C.); Tel.: +39-055-4574192 (S.C.-B.); +39-055-4574276 (V.C.)
| | - Vito Calderone
- Magnetic Resonance Center CERM, University of Florence, 50019 Sesto Fiorentino, Italy; (F.C.); (L.B.)
- Consorzio Interuniversitario Risonanze Magnetiche di Metalloproteine (CIRMMP), 50019 Sesto Fiorentino, Italy
- Department of Chemistry, University of Florence, 50019 Sesto Fiorentino, Italy
- Correspondence: (S.C.-B.); (V.C.); Tel.: +39-055-4574192 (S.C.-B.); +39-055-4574276 (V.C.)
| | - Lucia Banci
- Magnetic Resonance Center CERM, University of Florence, 50019 Sesto Fiorentino, Italy; (F.C.); (L.B.)
- Consorzio Interuniversitario Risonanze Magnetiche di Metalloproteine (CIRMMP), 50019 Sesto Fiorentino, Italy
- Department of Chemistry, University of Florence, 50019 Sesto Fiorentino, Italy
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Finsterer J. Tongue Root Cyst as a Manifestation of the Variant m.3243A>G. Cureus 2021; 13:e19060. [PMID: 34853765 PMCID: PMC8608676 DOI: 10.7759/cureus.19060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2021] [Indexed: 11/06/2022] Open
Abstract
There are indications that the frequency of cyst formation is increased in mitochondrial disorders (MIDs). Cysts can be found in various organs of MID patients but tongue root cysts have not been reported as a manifestation of a MID. In a 56-year-old male with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) manifesting with recurrent stroke-like episodes, seizures, cognitive impairment, ataxia, psychiatric abnormalities, bilateral visual impairment, bilateral hypoacusis, pre-diabetes, hyperlipidemia, myopathy, and lactic acidosis, an asymptomatic, pre-epiglottic cyst with 1 cm in diameter and protein-rich content in the right tongue root was accidentally detected on ultrasound and confirmed by MRI at the age of 50 years. The patient did not complain about dysarthria or dysphagia but had a mild cerebellar speech. The cyst was confirmed on an MRI six years later, without having changed in diameter, extension, or symptomatology. Due to the atypical location, a branchiogenic cyst was excluded. In conclusion, tongue root cysts may be a manifestation of the m.3243A>G variant.
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A Review of Multiple Mitochondrial Dysfunction Syndromes, Syndromes Associated with Defective Fe-S Protein Maturation. Biomedicines 2021; 9:biomedicines9080989. [PMID: 34440194 PMCID: PMC8393393 DOI: 10.3390/biomedicines9080989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 11/25/2022] Open
Abstract
Mitochondrial proteins carrying iron-sulfur (Fe-S) clusters are involved in essential cellular pathways such as oxidative phosphorylation, lipoic acid synthesis, and iron metabolism. NFU1, BOLA3, IBA57, ISCA2, and ISCA1 are involved in the last steps of the maturation of mitochondrial [4Fe-4S]-containing proteins. Since 2011, mutations in their genes leading to five multiple mitochondrial dysfunction syndromes (MMDS types 1 to 5) were reported. The aim of this systematic review is to describe all reported MMDS-patients. Their clinical, biological, and radiological data and associated genotype will be compared to each other. Despite certain specific clinical elements such as pulmonary hypertension or dilated cardiomyopathy in MMDS type 1 or 2, respectively, nearly all of the patients with MMDS presented with severe and early onset leukoencephalopathy. Diagnosis could be suggested by high lactate, pyruvate, and glycine levels in body fluids. Genetic analysis including large gene panels (Next Generation Sequencing) or whole exome sequencing is needed to confirm diagnosis.
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Muthiah A, Housley GD, Klugmann M, Fröhlich D. The Leukodystrophies HBSL and LBSL-Correlates and Distinctions. Front Cell Neurosci 2021; 14:626610. [PMID: 33574740 PMCID: PMC7870476 DOI: 10.3389/fncel.2020.626610] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/21/2020] [Indexed: 12/16/2022] Open
Abstract
Aminoacyl-tRNA synthetases (ARSs) accurately charge tRNAs with their respective amino acids. As such, they are vital for the initiation of cytosolic and mitochondrial protein translation. These enzymes have become increasingly scrutinized in recent years for their role in neurodegenerative disorders caused by the mutations of ARS-encoding genes. This review focuses on two such genes-DARS1 and DARS2-which encode cytosolic and mitochondrial aspartyl-tRNA synthetases, and the clinical conditions associated with mutations of these genes. We also describe attempts made at modeling these conditions in mice, which have both yielded important mechanistic insights. Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL) is a disease caused by a range of mutations in the DARS2 gene, initially identified in 2003. Ten years later, hypomyelination with brainstem and spinal cord involvement and leg spasticity (HBSL), caused by mutations of cytosolic DARS1, was discovered. Multiple parallels have been drawn between the two conditions. The Magnetic Resonance Imaging (MRI) patterns are strikingly similar, but still set these two conditions apart from other leukodystrophies. Clinically, both conditions are characterized by lower limb spasticity, often associated with other pyramidal signs. However, perhaps due to earlier detection, a wider range of symptoms, including peripheral neuropathy, as well as visual and hearing changes have been described in LBSL patients. Both HBSL and LBSL are spectrum disorders lacking genotype to phenotype correlation. While the fatal phenotype of Dars1 or Dars2 single gene deletion mouse mutants revealed that the two enzymes lack functional redundancy, further pursuit of disease modeling are required to shed light onto the underlying disease mechanism, and enable examination of experimental treatments, including gene therapies.
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Affiliation(s)
| | | | | | - Dominik Fröhlich
- Translational Neuroscience Facility and Department of Physiology, School of Medical Sciences, UNSW Sydney, Kensington, NSW, Australia
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