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Shim G, Youn YS. Precise subcellular targeting approaches for organelle-related disorders. Adv Drug Deliv Rev 2024; 212:115411. [PMID: 39032657 DOI: 10.1016/j.addr.2024.115411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/14/2024] [Accepted: 07/14/2024] [Indexed: 07/23/2024]
Abstract
Pharmacological research has expanded to the nanoscale level with advanced imaging technologies, enabling the analysis of drug distribution at the cellular organelle level. These advances in research techniques have contributed to the targeting of cellular organelles to address the fundamental causes of diseases. Beyond navigating the hurdles of reaching lesion tissues upon administration and identifying target cells within these tissues, controlling drug accumulation at the organelle level is the most refined method of disease management. This approach opens new avenues for the development of more potent therapeutic strategies by delving into the intricate roles and interplay of cellular organelles. Thus, organelle-targeted approaches help overcome the limitations of conventional therapies by precisely regulating functionally compartmentalized spaces based on their environment. This review discusses the basic concepts of organelle targeting research and proposes strategies to target diseases arising from organelle dysfunction. We also address the current challenges faced by organelle targeting and explore future research directions.
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Affiliation(s)
- Gayong Shim
- School of Systems Biomedical Science and Integrative Institute of Basic Sciences, Soongsil University, Seoul 06978, Republic of Korea
| | - Yu Seok Youn
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, 16419, Republic of Korea.
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2
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Liang KX. The application of brain organoid for drug discovery in mitochondrial diseases. Int J Biochem Cell Biol 2024; 170:106556. [PMID: 38423381 DOI: 10.1016/j.biocel.2024.106556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/02/2024]
Abstract
Mitochondrial diseases are difficult to treat due to the complexity and multifaceted nature of mitochondrial dysfunction. Brain organoids are three-dimensional (3D) structures derived from human pluripotent stem cells designed to mimic brain-like development and function. Brain organoids have received a lot of attention in recent years as powerful tools for modeling human diseases, brain development, and drug screening. Screening compounds for mitochondrial diseases using brain organoids could provide a more physiologically relevant platform for drug discovery. Brain organoids offer the possibility of personalized medicine because they can be derived from patient-specific cells, allowing testing of drugs tailored to specific genetic mutations. In this article, we highlight how brain organoids offer a promising avenue for screening compounds for mitochondrial diseases and address the challenges and limitations associated with their use. We hope this review will provide new insights into the further progress of brain organoids for mitochondrial screening studies.
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Linnoila JJ, Rapalino O, Walker MA, Martinez-Lage M. Case 12-2024: A 58-Year-Old Woman with Confusion, Aphasia, and Abnormal Head Imaging. N Engl J Med 2024; 390:1421-1430. [PMID: 38631006 DOI: 10.1056/nejmcpc2312732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Affiliation(s)
- Jenny J Linnoila
- From the Department of Neurology, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh (J.J.L.); and the Departments of Radiology (O.R.), Neurology (M.A.W.), and Pathology (M.M.-L.), Massachusetts General Hospital, and the Departments of Radiology (O.R.), Neurology (M.A.W.), and Pathology (M.M.-L.), Harvard Medical School - both in Boston
| | - Otto Rapalino
- From the Department of Neurology, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh (J.J.L.); and the Departments of Radiology (O.R.), Neurology (M.A.W.), and Pathology (M.M.-L.), Massachusetts General Hospital, and the Departments of Radiology (O.R.), Neurology (M.A.W.), and Pathology (M.M.-L.), Harvard Medical School - both in Boston
| | - Melissa A Walker
- From the Department of Neurology, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh (J.J.L.); and the Departments of Radiology (O.R.), Neurology (M.A.W.), and Pathology (M.M.-L.), Massachusetts General Hospital, and the Departments of Radiology (O.R.), Neurology (M.A.W.), and Pathology (M.M.-L.), Harvard Medical School - both in Boston
| | - Maria Martinez-Lage
- From the Department of Neurology, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh (J.J.L.); and the Departments of Radiology (O.R.), Neurology (M.A.W.), and Pathology (M.M.-L.), Massachusetts General Hospital, and the Departments of Radiology (O.R.), Neurology (M.A.W.), and Pathology (M.M.-L.), Harvard Medical School - both in Boston
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Sanchez-Lechuga B, Salvucci M, Ng N, Kinsley B, Hatunic M, Kennelly M, Edwards J, Fleming A, Byrne B, Byrne MM. A retrospective cohort study evaluating pregnancy outcomes in women with MIDD. Acta Diabetol 2024; 61:323-331. [PMID: 37907768 DOI: 10.1007/s00592-023-02202-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023]
Abstract
AIMS The most common pathogenic mitochondrial mutation associated with mitochondrial disease is m.3243A>G. Increased obstetric complications, such as spontaneous abortion, gestational diabetes (GDM), preterm delivery, and preeclampsia, have been reported in women carrying this mutation. We aimed to determine the fetal and maternal outcomes in pregnant women with mitochondrial disease. METHODS We retrospectively studied the obstetric and perinatal outcomes in 88 pregnancies of 26 women with genetically confirmed mitochondrial disease (m.3243A>G in the MTTL1 gene (n = 25); m.12258C>A in the MT-TS2 gene (n = 1)). Outcomes included pregnancy related complications, mode of delivery, gestational age at delivery and birthweight. RESULTS Mean heteroplasmy rate was 18%. The miscarriage rate was higher than background at 25%. 21 pregnancies (24%) were complicated by GDM; 9 pregnancies (13.6%) had a preterm delivery and 2 of them (3%) an extreme premature delivery < 32 weeks. One woman had preeclampsia and one had a postpartum hemorrhage. The caesarean section (CS) rate was 20%. For every unit increase in maternal heteroplasmy levels there was a 26% increased risk of undergoing an assisted operative vaginal delivery (OR 1.26, 95% CI 1.04-1.53, P = 0.002, Bonferroni corrected P = 0.005) and an 18% increased risk of undergoing a CS (OR 1.18, 95% CI 1.01-1.39, P = 0.01, Bonferroni corrected P = 0.03) compared to a spontaneous vaginal delivery. There was a statistical significant correlation between maternal and offspring heteroplasmy levels. Spearman correlation rho = 0.96, 95% CI 0.78-0.99, P = 0.0002. CONCLUSION Women with mitochondrial disease appear to have more frequent obstetric complications including miscarriage and GDM. Pre-pregnancy diagnosis of m.3243A>G will enable the counseling of women and increase awareness of possible obstetric complications.
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Affiliation(s)
- B Sanchez-Lechuga
- Department of Diabetes and Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland.
- Rotunda Maternity Hospital, Dublin, Ireland.
| | - M Salvucci
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - N Ng
- Department of Diabetes and Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
- Rotunda Maternity Hospital, Dublin, Ireland
| | - B Kinsley
- Department of Diabetes and Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
- Coombe Women and Infants University Hospital, Dublin, Ireland
| | - M Hatunic
- Department of Diabetes and Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
- National Maternity Hospital, Dublin, Ireland
| | - M Kennelly
- Rotunda Maternity Hospital, Dublin, Ireland
| | - J Edwards
- Rotunda Maternity Hospital, Dublin, Ireland
| | - A Fleming
- Rotunda Maternity Hospital, Dublin, Ireland
| | - B Byrne
- Coombe Women and Infants University Hospital, Dublin, Ireland
| | - M M Byrne
- Department of Diabetes and Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
- Rotunda Maternity Hospital, Dublin, Ireland
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Arias-Peso B, Calero-Ramos ML, López-Ladrón García de la Borbolla C, López-Domínguez M, Morillo-Sánchez MJ, Méndez-Martínez S, Sánchez-Gómez S, Rodríguez-de-la-Rúa E. Multidisciplinary approach to inherited causes of dual sensory impairment. Graefes Arch Clin Exp Ophthalmol 2024; 262:701-715. [PMID: 37341837 DOI: 10.1007/s00417-023-06153-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/29/2023] [Accepted: 06/13/2023] [Indexed: 06/22/2023] Open
Abstract
PURPOSE This article presents a review of the main causes of inherited dual sensory impairment (DSI) with an emphasis on the multidisciplinary approach. METHODS A narrative review of English literature published before January 2023 was conducted using PubMed, Medline, and Scopus databases. The different causes of inherited DSI are discussed from a multidisciplinary perspective. RESULTS There are a wide range of dual sensory impairment (DSI), commonly referred to as blindness and deafness. While Usher syndrome is the most frequent genetic cause, other genetic syndromes such as Alport syndrome or Stickler syndrome can also lead to DSI. Various retinal phenotypes, including pigmentary retinopathy as seen in Usher syndrome, vitreoretinopathy as in Stickler syndrome, and macular dystrophy as in Alport syndrome, along with type of hearing loss (sensorineural or conductive) and additional systemic symptoms can aid in diagnostic suspicion. A thorough ophthalmologic and otorhinolaryngologic examination can help guide diagnosis, which can then be confirmed with genetic studies, crucial for determining prognosis. Effective hearing rehabilitation measures, such as hearing implants, and visual rehabilitation measures, such as low vision optical devices, are crucial for maintaining social interaction and proper development in these patients. CONCLUSIONS While Usher syndrome is the primary cause of inherited dual sensory impairment (DSI), other genetic syndromes can also lead to this condition. A proper diagnostic approach based on retinal phenotypes and types of hearing loss can aid in ruling out alternative causes. Multidisciplinary approaches can assist in reaching a definitive diagnosis, which has significant prognostic implications.
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Affiliation(s)
- Borja Arias-Peso
- Department of Ophthalmology, Miguel Servet University Hospital, 1-3 Isabel la Católica Street, 50009, Zaragoza, Spain.
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain.
| | | | | | | | | | - Silvia Méndez-Martínez
- Department of Ophthalmology, Miguel Servet University Hospital, 1-3 Isabel la Católica Street, 50009, Zaragoza, Spain
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain
| | - Serafin Sánchez-Gómez
- Department of Otorhinolaryngology, Virgen Macarena University Hospital, Seville, Spain
| | - Enrique Rodríguez-de-la-Rúa
- Department of Ophthalmology, Virgen Macarena University Hospital, Seville, Spain
- Department of Surgery, Ophthalmology Area, University of Seville, Seville, Spain
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6
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Wang J, Yan D, Cui H, Zhang R, Ma X, Chen L, Hu C, Wu J. Identification of eight genomic protective alleles for mitochondrial diabetes by Kinship-graph convolutional network. J Diabetes Investig 2024; 15:52-62. [PMID: 38157301 PMCID: PMC10759726 DOI: 10.1111/jdi.14125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024] Open
Abstract
AIMS Nearly 85% of maternally inherited diabetes and deafness (MIDD) are caused by the m.3243A>G mutation in the mitochondrial DNA. However, the clinical phenotypes of MIDD may also be influenced by the nuclear genome, this study aimed to investigate nuclear genome variants that influence clinical phenotypes associated with m.3243A>G mutation in MIDD based on whole-genome sequencing of the patients belonging to pedigrees. MATERIALS AND METHODS We analyzed a whole-genome sequencing (WGS) dataset from blood samples of 38 MIDD patients with the m.3243A > G mutation belonging to 10 pedigrees, by developing a Kinship-graph convolutional network approach, called Ki-GCN, integrated with the conventional genome-wide association study (GWAS) methods. RESULTS We identified eight protective alleles in the nuclear genome that have protective effects against the onset of MIDD, related deafness, and also type 2 diabetes. Based on these eight protective alleles, we constructed an effective logistic regression model to predict the early or late onset of MIDD patients. CONCLUSIONS There are protective alleles in the nuclear genome that are associated with the onset-age of MIDD patients and might also provide protective effects on the deafness derived from MIDD patients.
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Affiliation(s)
- Jiahao Wang
- CAS Key Laboratory of Systems Biology, Center for Excellence in Molecular Cell ScienceChinese Academy of SciencesShanghaiChina
- College of Life SciencesUniversity of Chinese Academy of SciencesBeijingChina
| | - Dandan Yan
- Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Diabetes InstituteShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Haoyue Cui
- School of Life Science and TechnologyShanghaiTech UniversityShanghaiChina
| | - Rong Zhang
- Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Diabetes InstituteShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Xiaojing Ma
- Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Diabetes InstituteShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Luonan Chen
- CAS Key Laboratory of Systems Biology, Center for Excellence in Molecular Cell ScienceChinese Academy of SciencesShanghaiChina
- School of Life Science and TechnologyShanghaiTech UniversityShanghaiChina
- Key Laboratory of Systems Health Science of Zhejiang Province, Hangzhou Institute for Advanced StudyUniversity of Chinese Academy of SciencesHangzhouZhejiangChina
| | - Cheng Hu
- Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Centre for Diabetes, Shanghai Diabetes InstituteShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
- Institute for Metabolic DiseaseFengxian Central Hospital Affiliated to Southern Medical UniversityShanghaiChina
| | - Jiarui Wu
- CAS Key Laboratory of Systems Biology, Center for Excellence in Molecular Cell ScienceChinese Academy of SciencesShanghaiChina
- School of Life Science and TechnologyShanghaiTech UniversityShanghaiChina
- Key Laboratory of Systems Health Science of Zhejiang Province, Hangzhou Institute for Advanced StudyUniversity of Chinese Academy of SciencesHangzhouZhejiangChina
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7
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Ferreira F, Gonçalves Bacelar C, Lisboa-Gonçalves P, Paulo N, Quental R, Nunes AT, Silva R, Tavares I. Renal manifestations in adults with mitochondrial disease from the mtDNA m.3243A>G pathogenic variant. Nefrologia 2023; 43 Suppl 2:1-7. [PMID: 38355238 DOI: 10.1016/j.nefroe.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/15/2023] [Indexed: 02/16/2024] Open
Abstract
Mitochondrial diseases are a phenotype and genotype heterogeneous group of disorders that typically have a multisystemic involvement. The m.3243A>G pathogenic variant is the most frequent mitochondrial DNA defect, and it causes several different clinical syndromes, such as mitochondrial encephalopathy, lactic acidosis and stroke-like episodes (MELAS), and the maternally inherited diabetes and deafness (MIDD) syndromes. Not frequently reported, renal involvement in these diseases is probably underestimated, yet it increases morbidity. It generally manifests as subnephrotic proteinuria and progressive deterioration of kidney function. Adult presentation of mitochondrial diseases is hard to recognize, especially in oligosymptomatic patients or those with exclusive kidney involvement. However, suspicion should always arise when family history, particularly on the maternal side, and multisystemic symptoms, most often of the central nervous system and skeletal muscles, are present. In this review we discuss the clinical diagnosis and approach of patients with renal manifestations in the context of the mtDNA m.3243A>G pathogenic variant.
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Affiliation(s)
- Filipa Ferreira
- Serviço de Nefrologia, Centro Hospitalar e Universitário de São João, Porto, Portugal; Departamento de Medicina, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
| | | | - Pedro Lisboa-Gonçalves
- Serviço de Nefrologia, Centro Hospitalar e Universitário de São João, Porto, Portugal; Departamento de Medicina, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Núria Paulo
- Serviço de Nefrologia, Centro Hospitalar e Universitário de São João, Porto, Portugal; Departamento de Medicina, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Rita Quental
- Serviço de Genética Médica, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - Ana Teresa Nunes
- Serviço de Nefrologia, Centro Hospitalar e Universitário de São João, Porto, Portugal; Grupo de Investigação e Desenvolvimento em Nefrologia e Doenças Infeciosas, I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Roberto Silva
- Serviço de Anatomia Patológica, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - Isabel Tavares
- Serviço de Nefrologia, Centro Hospitalar e Universitário de São João, Porto, Portugal; Departamento de Medicina, Faculdade de Medicina, Universidade do Porto, Porto, Portugal; Grupo de Investigação e Desenvolvimento em Nefrologia e Doenças Infeciosas, I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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Mulyani DE, Maksum IP. Detection of Biomarker Using Aptasensors to Determine the Type of Diabetes. Diagnostics (Basel) 2023; 13:2035. [PMID: 37370930 DOI: 10.3390/diagnostics13122035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/04/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
Diabetes mellitus (DM) is a metabolic disorder characterized by elevated blood glucose levels. This disease is so serious that many experts refer to it as the "silent killer". The early detection of diabetes mellitus, whether type 1, type 2 or mitochondrial, is crucial because it can improve the success of treatment and the quality of life for patients. Aptamer-based biosensor diagnosis methods have been widely developed because they have high sensitivity and selectivity in detecting biomarkers of various diseases. Aptamers are short sequences of oligonucleotides or proteins that recognize specific ligands and bind to various target molecules, ranging from small ions to large proteins. They are promising diagnostic molecules due to their high sensitivity and selectivity, ease of modification, low toxicity, and high stability. This article aims to summarize the progress of detection methods, including detection principles, sensitivity, selectivity, and the performance of detection devices, to distinguish between types of diabetes mellitus using electrochemical aptasensors with biomarkers such as glucose, insulin, HbA1c, GHSA, and ATP.
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Affiliation(s)
- Dinda Exelsa Mulyani
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang 45363, Indonesia
| | - Iman Permana Maksum
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang 45363, Indonesia
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9
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Kyriakidou A, Hadjivassiliou M, Papapostolou A, Picolos MK. Maternally Inherited Diabetes and Deafness (MIDD) - Atypical Clinical Diabetes Features Leading to the Diagnosis. JCEM CASE REPORTS 2023; 1:luad047. [PMID: 37908567 PMCID: PMC10580451 DOI: 10.1210/jcemcr/luad047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Indexed: 11/02/2023]
Abstract
Maternally inherited diabetes and deafness (MIDD) syndrome refers to a rarely diagnosed disorder caused by pathogenic variants in mtDNA. It was first identified in 1992 and, to date, is considered underdiagnosed because of misclassification to type 1 or type 2 diabetes mellitus. MIDD reflects a multisystem metabolic syndrome commonly resulting in insulin-requiring diabetes and sensorineural deafness but can also lead to a broad range of other manifestations. The spectrum of pathology differs among individuals, likely because of varied degrees of heteroplasmy associated with mtDNA. Heteroplasmy also creates diagnostic difficulties, with a high index of suspicion required to diagnose MIDD in some cases. Here, we review a patient with MIDD who presented with an atypical clinical diabetes picture, additionally documenting his pedigree. To our knowledge, this is the first Cypriot reported with MIDD.
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Affiliation(s)
- Anna Kyriakidou
- School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, UK
| | - Marilena Hadjivassiliou
- Department of Cardiovascular Genetics and the Laboratory of Forensic Genetics, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
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10
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Genetics of mitochondrial diseases: Current approaches for the molecular diagnosis. HANDBOOK OF CLINICAL NEUROLOGY 2023; 194:141-165. [PMID: 36813310 DOI: 10.1016/b978-0-12-821751-1.00011-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Mitochondrial diseases are a genetically and phenotypically variable set of monogenic disorders. The main characteristic of mitochondrial diseases is a defective oxidative phosphorylation. Both nuclear and mitochondrial DNA encode the approximately 1500 mitochondrial proteins. Since identification of the first mitochondrial disease gene in 1988 a total of 425 genes have been associated with mitochondrial diseases. Mitochondrial dysfunctions can be caused both by pathogenic variants in the mitochondrial DNA or the nuclear DNA. Hence, besides maternal inheritance, mitochondrial diseases can follow all modes of Mendelian inheritance. The maternal inheritance and tissue specificity distinguish molecular diagnostics of mitochondrial disorders from other rare disorders. With the advances made in the next-generation sequencing technology, whole exome sequencing and even whole-genome sequencing are now the established methods of choice for molecular diagnostics of mitochondrial diseases. They reach a diagnostic rate of more than 50% in clinically suspected mitochondrial disease patients. Moreover, next-generation sequencing is delivering a constantly growing number of novel mitochondrial disease genes. This chapter reviews mitochondrial and nuclear causes of mitochondrial diseases, molecular diagnostic methodologies, and their current challenges and perspectives.
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11
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Li X, Zhang Y, Xu L, Wang A, Zou Y, Li T, Huang L, Chen W, Liu S, Jiang K, Zhang X, Wang D, Zhang L, Zhang Z, Zhang Z, Chen X, Jia W, Zhao A, Yan X, Zhou H, Zhu L, Ma X, Ju Z, Jia W, Wang C, Loscalzo J, Yang Y, Zhao Y. Ultrasensitive sensors reveal the spatiotemporal landscape of lactate metabolism in physiology and disease. Cell Metab 2023; 35:200-211.e9. [PMID: 36309010 PMCID: PMC10560847 DOI: 10.1016/j.cmet.2022.10.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/04/2022] [Accepted: 10/04/2022] [Indexed: 01/07/2023]
Abstract
Despite its central importance in cellular metabolism, many details remain to be determined regarding subcellular lactate metabolism and its regulation in physiology and disease, as there is sensitive spatiotemporal resolution of lactate distribution, and dynamics remains a technical challenge. Here, we develop and characterize an ultrasensitive, highly responsive, ratiometric lactate sensor, named FiLa, enabling the monitoring of subtle lactate fluctuations in living cells and animals. Utilizing FiLa, we demonstrate that lactate is highly enriched in mammalian mitochondria and compile an atlas of subcellular lactate metabolism that reveals lactate as a key hub sensing various metabolic activities. In addition, FiLa sensors also enable direct imaging of elevated lactate levels in diabetic mice and facilitate the establishment of a simple, rapid, and sensitive lactate assay for point-of-care clinical screening. Thus, FiLa sensors provide powerful, broadly applicable tools for defining the spatiotemporal landscape of lactate metabolism in health and disease.
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Affiliation(s)
- Xie Li
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China; Research Unit of New Techniques for Live-cell Metabolic Imaging, Chinese Academy of Medical Sciences, Beijing 100730, China; CAS Center for Excellence in Brain Science, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Yinan Zhang
- Center for Translational Medicine, The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Lingyan Xu
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, 500 Dongchuan Road, Shanghai 200241, China
| | - Aoxue Wang
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China; Research Unit of New Techniques for Live-cell Metabolic Imaging, Chinese Academy of Medical Sciences, Beijing 100730, China; CAS Center for Excellence in Brain Science, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Yejun Zou
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China; Research Unit of New Techniques for Live-cell Metabolic Imaging, Chinese Academy of Medical Sciences, Beijing 100730, China; CAS Center for Excellence in Brain Science, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Ting Li
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China; Research Unit of New Techniques for Live-cell Metabolic Imaging, Chinese Academy of Medical Sciences, Beijing 100730, China; CAS Center for Excellence in Brain Science, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Li Huang
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China
| | - Weicai Chen
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China
| | - Shuning Liu
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China
| | - Kun Jiang
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China
| | - Xiuze Zhang
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China
| | - Dongmei Wang
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, 500 Dongchuan Road, Shanghai 200241, China
| | - Lijuan Zhang
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China
| | - Zhuo Zhang
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China; Research Unit of New Techniques for Live-cell Metabolic Imaging, Chinese Academy of Medical Sciences, Beijing 100730, China; CAS Center for Excellence in Brain Science, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Zeyi Zhang
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China
| | - Xianjun Chen
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China; Research Unit of New Techniques for Live-cell Metabolic Imaging, Chinese Academy of Medical Sciences, Beijing 100730, China; CAS Center for Excellence in Brain Science, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Wei Jia
- Center for Translational Medicine, The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Aihua Zhao
- Center for Translational Medicine, The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Xinfeng Yan
- Translational Medical Center for Stem Cell Therapy, Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Haimeng Zhou
- Zhejiang Provincial Key Laboratory of Applied Enzymology, Yangtze Delta Region Institute of Tsinghua University, Jiaxing 314006, China
| | - Linyong Zhu
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China
| | - Xinran Ma
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, 500 Dongchuan Road, Shanghai 200241, China
| | - Zhenyu Ju
- Key Laboratory of Regenerative Medicine of Ministry of Education, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Institute of Aging and Regenerative Medicine, Jinan University, Guangzhou 510632, China
| | - Weiping Jia
- Center for Translational Medicine, The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China
| | - Congrong Wang
- Department of Endocrinology & Metabolism, Shanghai Fourth People's Hospital, Tongji University School of Medicine, Shanghai 200434, China.
| | - Joseph Loscalzo
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Yi Yang
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China; CAS Center for Excellence in Brain Science, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China.
| | - Yuzheng Zhao
- Optogenetics & Synthetic Biology Interdisciplinary Research Center, State Key Laboratory of Bioreactor Engineering, Shanghai Frontiers Science Center of Optogenetic Techniques for Cell Metabolism, School of Pharmacy, East China University of Science and Technology, 130 Mei Long Road, Shanghai 200237, China; Research Unit of New Techniques for Live-cell Metabolic Imaging, Chinese Academy of Medical Sciences, Beijing 100730, China.
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12
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Schultes B, Ernst B, Schmid SM. Treating hypercholesterinemia in a patient with maternally inherited diabetes and deafness (MIDD) by the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor alirocumab. Acta Diabetol 2021; 58:1575-1577. [PMID: 34370095 DOI: 10.1007/s00592-021-01776-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Bernd Schultes
- Metabolic Center St. Gallen, friendlyDocs Ltd, Lerchentalstreet 21, CH-9016, St. Gallen, Switzerland.
- Institute for Endocrinology and Diabetes, University of Lübeck, Lübeck, Germany.
| | - Barbara Ernst
- Metabolic Center St. Gallen, friendlyDocs Ltd, Lerchentalstreet 21, CH-9016, St. Gallen, Switzerland
| | - Sebastian M Schmid
- Institute for Endocrinology and Diabetes, University of Lübeck, Lübeck, Germany
- German Center for Diabetes Research, Neuherberg, Germany
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13
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Macken WL, Lucassen AM, Hanna MG, Pitceathly RDS. Mitochondrial DNA variants in genomic data: diagnostic uplifts and predictive implications. Nat Rev Genet 2021; 22:547-548. [PMID: 34050335 DOI: 10.1038/s41576-021-00381-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- William L Macken
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK.,Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Anneke M Lucassen
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK.,Clinical Ethics and Law Group (CELS), Faculty of Medicine, University of Southampton, Southampton, UK
| | - Michael G Hanna
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - Robert D S Pitceathly
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK.
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14
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Shin YH, Kim AJ, Ro H, Chang JH, Jung JY, Chung WK, Lee HH. Concomitant Mitochondrial Diabetes and Myopathy Mistook for Complications of Immunosuppressants After Kidney Transplant. EXP CLIN TRANSPLANT 2021; 19:736-738. [PMID: 34325625 DOI: 10.6002/ect.2020.0505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Posttransplant diabetes mellitus, presenile deafness, and myopathy are not commonly accompanied symptoms after kidney transplant. We report the case of a 48-year-old woman with diabetes mellitus, sensorineural hearing loss, and severe myopathy without neuropathy after deceased donor kidney transplant. ShehadamitochondrialDNApointmutation at position 3243 (A>G), and mitochondrial diseases such as maternally inherited diabetes deafness or mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodeswere suspected.Diabetes andother symptoms following kidney transplant can often be overlooked as complications of immunosuppressants taken after kidney transplant. However, in patients without a known cause of their symptoms, appropriate examinations and consultation for other diseases, including genetic diseases, should be considered.
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Affiliation(s)
- Yong Hoon Shin
- From the Department of Internal Medicine, College of Medicine, Gachon University, Incheon, Korea
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15
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Zhioua Braham I, Kaoual H, Grissa A, Boukari M, Ammous I, Zhioua R. [OCT-Angiography analysis in a case of maternally inherited diabetes and deafness]. J Fr Ophtalmol 2021; 44:e543-e546. [PMID: 34229892 DOI: 10.1016/j.jfo.2020.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 10/20/2022]
Affiliation(s)
- I Zhioua Braham
- Service d'ophtalmologie de l'hôpital Charles-Nicolle de Tunis, boulevard du 9-avril 1938, 1006 Tunis, Tunisie
| | - H Kaoual
- Service d'ophtalmologie de l'hôpital Charles-Nicolle de Tunis, boulevard du 9-avril 1938, 1006 Tunis, Tunisie.
| | - A Grissa
- Service d'ophtalmologie de l'hôpital Charles-Nicolle de Tunis, boulevard du 9-avril 1938, 1006 Tunis, Tunisie
| | - M Boukari
- Service d'ophtalmologie de l'hôpital Charles-Nicolle de Tunis, boulevard du 9-avril 1938, 1006 Tunis, Tunisie
| | - I Ammous
- Service d'ophtalmologie de l'hôpital Charles-Nicolle de Tunis, boulevard du 9-avril 1938, 1006 Tunis, Tunisie
| | - R Zhioua
- Service d'ophtalmologie de l'hôpital Charles-Nicolle de Tunis, boulevard du 9-avril 1938, 1006 Tunis, Tunisie
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16
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Mazzaccara C, Mirra B, Barretta F, Caiazza M, Lombardo B, Scudiero O, Tinto N, Limongelli G, Frisso G. Molecular Epidemiology of Mitochondrial Cardiomyopathy: A Search Among Mitochondrial and Nuclear Genes. Int J Mol Sci 2021; 22:ijms22115742. [PMID: 34072184 PMCID: PMC8197938 DOI: 10.3390/ijms22115742] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/18/2021] [Accepted: 05/22/2021] [Indexed: 12/23/2022] Open
Abstract
Mitochondrial Cardiomyopathy (MCM) is a common manifestation of multi-organ Mitochondrial Diseases (MDs), occasionally present in non-syndromic cases. Diagnosis of MCM is complex because of wide clinical and genetic heterogeneity and requires medical, laboratory, and neuroimaging investigations. Currently, the molecular screening for MCM is fundamental part of MDs management and allows achieving the definitive diagnosis. In this article, we review the current genetic knowledge associated with MDs, focusing on diagnosis of MCM and MDs showing cardiac involvement. We searched for publications on mitochondrial and nuclear genes involved in MCM, mainly focusing on genetic screening based on targeted gene panels for the molecular diagnosis of the MCM, by using Next Generation Sequencing. Here we report twelve case reports, four case-control studies, eleven retrospective studies, and two prospective studies, for a total of twenty-nine papers concerning the evaluation of cardiac manifestations in mitochondrial diseases. From the analysis of published causal mutations, we identified 130 genes to be associated with mitochondrial heart diseases. A large proportion of these genes (34.3%) encode for key proteins involved in the oxidative phosphorylation system (OXPHOS), either as directly OXPHOS subunits (22.8%), and as OXPHOS assembly factors (11.5%). Mutations in several mitochondrial tRNA genes have been also reported in multi-organ or isolated MCM (15.3%). This review highlights the main disease-genes, identified by extensive genetic analysis, which could be included as target genes in next generation panels for the molecular diagnosis of patients with clinical suspect of mitochondrial cardiomyopathies.
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Affiliation(s)
- Cristina Mazzaccara
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (B.M.); (F.B.); (B.L.); (O.S.); (N.T.); (G.F.)
- CEINGE Advanced Biotechnologies, 80145 Naples, Italy
- Correspondence: ; Tel.: +39-0817-462-422
| | - Bruno Mirra
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (B.M.); (F.B.); (B.L.); (O.S.); (N.T.); (G.F.)
- CEINGE Advanced Biotechnologies, 80145 Naples, Italy
| | - Ferdinando Barretta
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (B.M.); (F.B.); (B.L.); (O.S.); (N.T.); (G.F.)
- CEINGE Advanced Biotechnologies, 80145 Naples, Italy
| | - Martina Caiazza
- Monaldi Hospital, AO Colli, 80131 Naples, Italy; (M.C.); (G.L.)
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 80134 Naples, Italy
| | - Barbara Lombardo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (B.M.); (F.B.); (B.L.); (O.S.); (N.T.); (G.F.)
- CEINGE Advanced Biotechnologies, 80145 Naples, Italy
| | - Olga Scudiero
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (B.M.); (F.B.); (B.L.); (O.S.); (N.T.); (G.F.)
- CEINGE Advanced Biotechnologies, 80145 Naples, Italy
| | - Nadia Tinto
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (B.M.); (F.B.); (B.L.); (O.S.); (N.T.); (G.F.)
- CEINGE Advanced Biotechnologies, 80145 Naples, Italy
| | - Giuseppe Limongelli
- Monaldi Hospital, AO Colli, 80131 Naples, Italy; (M.C.); (G.L.)
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 80134 Naples, Italy
| | - Giulia Frisso
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (B.M.); (F.B.); (B.L.); (O.S.); (N.T.); (G.F.)
- CEINGE Advanced Biotechnologies, 80145 Naples, Italy
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17
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Oh JK, Lima de Carvalho JR, Nuzbrokh Y, Ryu J, Chemudupati T, Mahajan VB, Sparrow JR, Tsang SH. Retinal Manifestations of Mitochondrial Oxidative Phosphorylation Disorders. Invest Ophthalmol Vis Sci 2021; 61:12. [PMID: 33049060 PMCID: PMC7571321 DOI: 10.1167/iovs.61.12.12] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Purpose The purpose of this paper was to discuss manifestations of primary mitochondrial dysfunctions and whether the retinal pigment epithelium or the photoreceptors are preferentially affected. Methods A retrospective analysis was performed of patients with clinically and laboratory confirmed diagnoses of maternally inherited diabetes and deafness (MIDD) or Kearns–Sayre syndrome (KSS). Patients underwent full ophthalmic examination, full-field electroretinogram, and multimodal imaging studies, including short-wavelength autofluorescence, spectral domain-optical coherence tomography, and color fundus photography. Results A total of five patients with MIDD and four patients with KSS were evaluated at two tertiary referral centers. Mean age at initial evaluation was 50.3 years old. Nascent outer retinal tubulations corresponding with faint foci of autofluorescence were observed in two patients with MIDD. Characteristic features of this cohort included a foveal sparing phenotype observed in 13 of 18 eyes (72%), global absence of intraretinal pigment migration, and preserved retinal function on full-field electroretinogram testing in 12 of 16 eyes (75%). One patient diagnosed with MIDD presented with an unusual pattern of atrophy surrounding the parapapillary region and one patient with KSS presented with an atypical choroideremia-like phenotype. Conclusions MIDD and KSS are phenotypically heterogeneous disorders. Several features of disease suggest that primary mitochondrial dysfunction may first affect the retinal pigment epithelium followed by secondary photoreceptor loss. Similarities between primary mitochondrial degenerations and retinal disorders, such as age-related macular degeneration may suggest a primary role of mitochondria in the pathogenesis of these oligogenic disorders.
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Affiliation(s)
- Jin Kyun Oh
- Jonas Children's Vision Care, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States.,State University of New York at Downstate Medical Center, Brooklyn, New York, United States
| | - Jose Ronaldo Lima de Carvalho
- Jonas Children's Vision Care, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States.,Department of Ophthalmology, Empresa Brasileira de Servicos Hospitalares (EBSERH) - Hospital das Clinicas de Pernambuco (HCPE), Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil.,Department of Ophthalmology, Federal University of São Paulo (UNIFESP), São Paulo, São Paulo, Brazil
| | - Yan Nuzbrokh
- Jonas Children's Vision Care, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States.,Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, United States
| | - Joseph Ryu
- Jonas Children's Vision Care, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
| | - Teja Chemudupati
- Molecular Surgery Laboratory, Byers Eye Institute, Stanford University, Palo Alto, California, United States
| | - Vinit B Mahajan
- Molecular Surgery Laboratory, Byers Eye Institute, Stanford University, Palo Alto, California, United States.,Veterans Affairs Palo Alto Health Care System, Palo Alto, California, United States
| | - Janet R Sparrow
- Jonas Children's Vision Care, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States.,Department of Pathology and Cell Biology and Columbia Stem Cell Initiative (CSCI), Columbia University Irving Medical Center, New York, New York, United States
| | - Stephen H Tsang
- Jonas Children's Vision Care, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States.,Department of Pathology and Cell Biology and Columbia Stem Cell Initiative (CSCI), Columbia University Irving Medical Center, New York, New York, United States
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18
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Sazonova MA, Ryzhkova AI, Sinyov VV, Sazonova MD, Kirichenko TV, Doroschuk NA, Karagodin VP, Orekhov AN, Sobenin IA. Mutations of mtDNA in some Vascular and Metabolic Diseases. Curr Pharm Des 2021; 27:177-184. [PMID: 32867647 DOI: 10.2174/1381612826999200820162154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 06/05/2020] [Accepted: 06/12/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The present review article considers some chronic diseases of vascular and metabolic genesis, the causes of which may be mitochondrial dysfunction. Very often, in the long course of the disease, complications may occur, leading to myocardial infarction or ischemic stroke and, as a result, death. In particular, a large percentage of human deaths nowadays belongs to cardiovascular diseases, such as coronary heart disease (CHD), arterial hypertension, cardiomyopathies, and type 2 diabetes mellitus. OBJECTIVE The aim of the present review was the analysis of literature sources, devoted to an investigation of a link of mitochondrial DNA mutations with chronic diseases of vascular and metabolic genesis. RESULTS The analysis of literature indicates the association of the mitochondrial genome mutations with coronary heart disease, type 2 diabetes mellitus, hypertension, and various types of cardiomyopathies. CONCLUSION The detected mutations can be used to analyze the predisposition to chronic diseases of vascular and metabolic genesis. They can also be used to create molecular-cell models necessary to evaluate the effectiveness of drugs developed for the treatment of these pathologies. MtDNA mutations associated with the absence of diseases of vascular and metabolic genesis could be potential candidates for gene therapy of the said diseases.
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Affiliation(s)
- Margarita A Sazonova
- Laboratory of angiopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow, Russian Federation
| | - Anastasia I Ryzhkova
- Laboratory of angiopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow, Russian Federation
| | - Vasily V Sinyov
- Laboratory of angiopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow, Russian Federation
| | - Marina D Sazonova
- Laboratory of angiopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow, Russian Federation
| | - Tatiana V Kirichenko
- Laboratory of Cellular and Molecular Pathology of Cardiovascular System, Research Institute of Human Morphology, Moscow, Russian Federation
| | - Natalya A Doroschuk
- Laboratory of angiopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow, Russian Federation
| | - Vasily P Karagodin
- Laboratory of angiopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow, Russian Federation
| | - Alexander N Orekhov
- Laboratory of angiopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow, Russian Federation
| | - Igor A Sobenin
- Laboratory of angiopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow, 0
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19
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Shen X, Du A. The non-syndromic clinical spectrums of mtDNA 3243A>G mutation. NEUROSCIENCES (RIYADH, SAUDI ARABIA) 2021; 26:128-133. [PMID: 33814365 PMCID: PMC8024137 DOI: 10.17712/nsj.2021.2.20200145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/01/2021] [Indexed: 12/21/2022]
Abstract
The m.3243A >G mutation in the tRNA Leu (UUR) gene (MT-TL1) of the mitochondrial DNA is the most widely seen pathogenic mtDNA mutation which has major phenotypic variations. The clinical phenotype involves various organs such as the brain and nerves, skeletal muscles, heart, endocrine system, gastrointestinal tract, and skin. Some phenotypes conform to well established syndromes, while most of the symptoms appear individually or concomitant to other syndromes, making identification difficult. Furthermore, some progress has been made on cardiac manifestations as well as complications during pregnancy and perinatal period. This article provides a systematic review of the non-syndromic phenotypes and latest developments in m.3243A>G mutation.
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Affiliation(s)
- Xiya Shen
- From the Department of Neurology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ailian Du
- From the Department of Neurology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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20
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Macken WL, Vandrovcova J, Hanna MG, Pitceathly RDS. Applying genomic and transcriptomic advances to mitochondrial medicine. Nat Rev Neurol 2021; 17:215-230. [PMID: 33623159 DOI: 10.1038/s41582-021-00455-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 02/07/2023]
Abstract
Next-generation sequencing (NGS) has increased our understanding of the molecular basis of many primary mitochondrial diseases (PMDs). Despite this progress, many patients with suspected PMD remain without a genetic diagnosis, which restricts their access to in-depth genetic counselling, reproductive options and clinical trials, in addition to hampering efforts to understand the underlying disease mechanisms. Although they represent a considerable improvement over their predecessors, current methods for sequencing the mitochondrial and nuclear genomes have important limitations, and molecular diagnostic techniques are often manual and time consuming. However, recent advances in genomics and transcriptomics offer realistic solutions to these challenges. In this Review, we discuss the current genetic testing approach for PMDs and the opportunities that exist for increased use of whole-genome NGS of nuclear and mitochondrial DNA (mtDNA) in the clinical environment. We consider the possible role for long-read approaches in sequencing of mtDNA and in the identification of novel nuclear genomic causes of PMDs. We examine the expanding applications of RNA sequencing, including the detection of cryptic variants that affect splicing and gene expression and the interpretation of rare and novel mitochondrial transfer RNA variants.
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Affiliation(s)
- William L Macken
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - Jana Vandrovcova
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - Michael G Hanna
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - Robert D S Pitceathly
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK.
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21
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Ali AS, Ekinci EI, Pyrlis F. Maternally inherited diabetes and deafness (MIDD): An uncommon but important cause of diabetes. ENDOCRINE AND METABOLIC SCIENCE 2021. [DOI: 10.1016/j.endmts.2020.100074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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22
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Mitochondrial DNA A3243G variant-associated retinopathy: Current perspectives and clinical implications. Surv Ophthalmol 2021; 66:838-855. [PMID: 33610586 DOI: 10.1016/j.survophthal.2021.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/12/2022]
Abstract
Cellular function and survival are critically dependent on the proper functionality of the mitochondrion. Neurodegenerative cellular processes including cellular adenosine triphosphate production, intermediary metabolism control, and apoptosis regulation are all mitochondrially mediated. The A to G transition at position 3243 in the mitochondrial MTTL1 gene that encodes for the leucine transfer RNA (m.3243A>G) causes a variety of diseases, including maternally inherited loss of hearing and diabetes syndrome (MIDD), mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes syndrome (MELAS). Ophthalmological findings-including posterior sub-capsular cataract, ptosis, external ophthalmoplegia, and pigmentary retinopathy- have all been associated with the m.3243A>G variant. Pigmentary retinopathy is, however, the most common ocular finding, occurring in 38% to 86% of cases. To date, little is known about the pathogenesis, natural history, and heteroplasmic and phenotypic correlations of m.3243A>G-associated pigmentary retinopathy. We summarize the current understanding of mitochondrial genetics and pathogenesis of some associated diseases. We then review the pathophysiology, histology, clinical features, treatment, and important ocular and systemic phenotypic manifestations of m.3243A>G variant associated retinopathy. Mitochondrial diseases require a multidisciplinary team approach to ensure effective treatment, regular follow-up, and accurate genetic counseling.
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23
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Marco-Campmany A, Pacheco-Cervera J, Navarrete-Sanchis J, Tomás-Torrent JM, García-Canet S, Cuadrado-Gómez T. Intravitreal bevacizumab in cystoid macular edema associated to maternally inherited diabetes and deafness's macular dystrophy. Eur J Ophthalmol 2020; 32:1120672120969034. [PMID: 33124443 DOI: 10.1177/1120672120969034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Maternally inherited diabetes and deafness (MIDD) is a rare and infradiagnosed cause of diabetes which can, in a high number of cases, associate a macular dystrophy. CASE PRESENTATION We report the case of a 49- year-old man affected of this syndrome, with proven m3243G>A mitochondrial mutation, who developed macular cysts 20 years after the initial presentation of his macular dystrophy. The fluorescein angiography showed no leakage, ruling out a diabetic macular edema. A treatment with intravitreal bevacizumab led to cystic changes resolution and visual acuity recovery. CONCLUSION Intravitreal bevacizumab can be successfully employed for this complication of MIDD's macular dystrophy.
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Affiliation(s)
| | | | | | | | - Sara García-Canet
- Department of Ophthalmology, Hospital Universitario de La Ribera, Alzira, Spain
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24
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Structural Features Associated With the Development and Progression of RORA Secondary to Maternally Inherited Diabetes and Deafness. Am J Ophthalmol 2020; 218:136-147. [PMID: 32446735 DOI: 10.1016/j.ajo.2020.05.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the development and progression of retinal pigment epithelial and outer retinal atrophy (RORA) secondary to maternally inherited diabetes and deafness (MIDD). DESIGN Retrospective observational case series. METHODS Thirty-six eyes of 18 patients (age range, 22.4-71.6 years) with genetically proven MIDD and serial optical coherence tomography (OCT) images were included. As proposed reference standard to diagnose and stage atrophy, OCT images were longitudinally evaluated and analyzed for presence and precursors of RORA. RORA was defined as an area of (1) hypertransmission, (2) disruption of the retinal pigment epithelium, (3) photoreceptor degeneration, and (4) absence of other signs of a retinal pigment epithelial tear. RESULTS The majority of patients revealed areas of RORA in a circular area around the fovea of between 5° and 15° eccentricity. Over the observation time (range, 0.5-8.5 years), evidence for a consistent sequence of OCT features from earlier disease stages to the end stage of RORA could be found, starting with loss of ellipsoid zone and subretinal deposits, followed by loss of external limiting membrane and loss of retinal pigment epithelium with hypertransmission of OCT signal into the choroid, and leading to loss of the outer nuclear layer bordered by hyporeflective wedges. Outer retinal tabulations seemed to develop in regions of coalescent areas of RORA. CONCLUSIONS The development and progression of RORA could be tracked in MIDD patients using OCT images, allowing potential definition of novel surrogate markers. Similarities to OCT features in age-related macular degeneration, where mitochondrial dysfunction has been implicated in the pathogenesis, support wide-ranging benefits from proof-of-concept studies in MIDD.
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Roper T, Harber M, Jones G, Pitceathly RDS, Salama AD. Delayed diagnoses of mitochondrial cytopathies in patients presenting with end stage kidney disease: two case reports. BMC Nephrol 2020; 21:361. [PMID: 32838736 PMCID: PMC7446060 DOI: 10.1186/s12882-020-02002-5] [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] [Received: 07/07/2019] [Accepted: 08/03/2020] [Indexed: 11/10/2022] Open
Abstract
Background Up to one third of patients on renal replacement programmes have an unknown cause of kidney disease, and the diagnosis may only be established following renal transplantation when the disease recurs or if new extra-renal symptoms develop. Case presentation We present two patients who presented with progressive chronic kidney disease of unknown cause. Both patients underwent successful renal transplantation but subsequently developed multisystem abnormalities, and were ultimately diagnosed with mitochondrial cytopathy 10–15 years following transplantation. Conclusions Mitochondrial cytopathies are rare inborn errors of metabolism that should be considered in adults with renal impairment, especially in those with a family history of kidney or other multisystem disease. The widespread availability of genetic testing provides the potential for earlier diagnoses, thereby enhancing management decisions, anticipation of complications, avoidance of mitotoxic drugs, and informed prognosis prediction.
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Affiliation(s)
- Tayeba Roper
- Department of Renal Medicine, Guy's & St Thomas' NHS Foundation Trust, Great Maze Pond, London, UK.
| | - Mark Harber
- UCL Department of Renal Medicine, Royal Free Hospital, Pond Street, Hampstead, London, UK
| | - Gareth Jones
- UCL Department of Renal Medicine, Royal Free Hospital, Pond Street, Hampstead, London, UK
| | - Robert D S Pitceathly
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - Alan D Salama
- UCL Department of Renal Medicine, Royal Free Hospital, Pond Street, Hampstead, London, UK
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Müller PL, Treis T, Pfau M, Esposti SD, Alsaedi A, Maloca P, Balaskas K, Webster A, Egan C, Tufail A. Progression of Retinopathy Secondary to Maternally Inherited Diabetes and Deafness - Evaluation of Predicting Parameters. Am J Ophthalmol 2020; 213:134-144. [PMID: 31987901 DOI: 10.1016/j.ajo.2020.01.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/20/2019] [Accepted: 01/10/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE To investigate the prognostic value of demographic, functional, and imaging parameters on retinal pigment epithelium (RPE) atrophy progression secondary to maternally inherited diabetes and deafness (MIDD) and to evaluate the application of these factors in clinical trial design. DESIGN Retrospective observational case series. METHODS Thirty-five eyes of 20 patients (age range, 24.9-75.9 years) with genetically proven MIDD and demarcated RPE atrophy on serial fundus autofluorescence (AF) images were included. Lesion size and shape-descriptive parameters were longitudinally determined by 2 independent readers. A linear mixed-effect model was used to predict the lesion enlargement rate based on baseline variables. Sample size calculations were performed to model the power in a simulated interventional study. RESULTS The mean follow-up time was 4.27 years. The mean progression rate of RPE atrophy was 2.33 mm2/year, revealing a dependence on baseline lesion size (+0.04 [0.02-0.07] mm2/year/mm2, P < .001), which was absent after square root transformation. The fovea was preserved in the majority of patients during the observation time. In the case of foveal involvement, the loss of visual acuity lagged behind central RPE atrophy in AF images. Sex, age, and number of atrophic foci predicted future progression rates with a cross-validated mean absolute error of 0.13 mm/year and to reduce the required sample size for simulated interventional trials. CONCLUSIONS Progressive RPE atrophy could be traced in all eyes using AF imaging. Shape-descriptive factors and patients' baseline characteristics had significant prognostic value, guiding appropriate subject selection and sample size in future interventional trial design.
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Affiliation(s)
- Riley J. Lyons
- Medical student, Emory University School of Medicine, Atlanta, Georgia
| | - Nieraj Jain
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
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Showmaker KC, Cobb MB, Johnson AC, Yang W, Garrett MR. Whole genome sequencing and novel candidate genes for CAKUT and altered nephrogenesis in the HSRA rat. Physiol Genomics 2020; 52:56-70. [PMID: 31841396 PMCID: PMC6985787 DOI: 10.1152/physiolgenomics.00112.2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/09/2019] [Accepted: 12/09/2019] [Indexed: 12/30/2022] Open
Abstract
The HSRA rat is a model of congenital abnormalities of the kidney and urogenital tract (CAKUT). Our laboratory has used this model to investigate the role of nephron number (functional unit of the kidney) in susceptibility to develop kidney disease as 50-75% offspring are born with a single kidney (HSRA-S), while 25-50% are born with two kidneys (HSRA-C). HSRA-S rats develop increased kidney injury and hypertension with age compared with nephrectomized two-kidney animals (HSRA-UNX), suggesting that even slight differences in nephron number can be an important driver in decline in kidney function. The HSRA rat was selected and inbred from a family of outbred heterogeneous stock (NIH-HS) rats that exhibited a high incidence of CAKUT. The HS model was originally developed from eight inbred strains (ACI, BN, BUF, F344, M520, MR, WKY, and WN). The genetic make-up of the HSRA is therefore a mosaic of these eight inbred strains. Interestingly, the ACI progenitor of the HS model exhibits CAKUT in 10-15% of offspring with the genetic cause being attributed to the presence of a long-term repeat (LTR) within exon 1 of the c-Kit gene. Our hypothesis is that the HSRA and ACI share this common genetic cause, but other alleles in the HSRA genome contribute to the increased penetrance of CAKUT (75% HSRA vs. 15% in ACI). To facilitate genetic studies and better characterize the model, we sequenced the whole genome of the HSRA to a depth of ~50×. A genome-wide variant analysis of high-impact variants identified a number of novel genes that could be linked to CAKUT in the HSRA model. In summary, the identification of new genes/modifiers that lead to CAKUT/loss of one kidney in the HSRA model will provide greater insight into association between kidney development and susceptibility to develop cardiovascular disease later in life.
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Affiliation(s)
- Kurt C Showmaker
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Meredith B Cobb
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Ashley C Johnson
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Wenyu Yang
- College of Science, Huazhong Agricultural University, Wuhan, China
| | - Michael R Garrett
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
- Department of Medicine (Nephrology), University of Mississippi Medical Center, Jackson, Mississippi
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Mitochondrial DNA Variants and Common Diseases: A Mathematical Model for the Diversity of Age-Related mtDNA Mutations. Cells 2019; 8:cells8060608. [PMID: 31216686 PMCID: PMC6627076 DOI: 10.3390/cells8060608] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/30/2019] [Accepted: 06/14/2019] [Indexed: 12/18/2022] Open
Abstract
The mitochondrion is the only organelle in the human cell, besides the nucleus, with its own DNA (mtDNA). Since the mitochondrion is critical to the energy metabolism of the eukaryotic cell, it should be unsurprising, then, that a primary driver of cellular aging and related diseases is mtDNA instability over the life of an individual. The mutation rate of mammalian mtDNA is significantly higher than the mutation rate observed for nuclear DNA, due to the poor fidelity of DNA polymerase and the ROS-saturated environment present within the mitochondrion. In this review, we will discuss the current literature showing that mitochondrial dysfunction can contribute to age-related common diseases such as cancer, diabetes, and other commonly occurring diseases. We will then turn our attention to the likely role that mtDNA mutation plays in aging and senescence. Finally, we will use this context to develop a mathematical formula for estimating for the accumulation of somatic mtDNA mutations with age. This resulting model shows that almost 90% of non-proliferating cells would be expected to have at least 100 mutations per cell by the age of 70, and almost no cells would have fewer than 10 mutations, suggesting that mtDNA mutations may contribute significantly to many adult onset diseases.
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Hanif AM, Yan J, Jain N. Pattern Dystrophy: An Imprecise Diagnosis in the Age of Precision Medicine. Int Ophthalmol Clin 2019; 59:173-194. [PMID: 30585925 DOI: 10.1097/iio.0000000000000262] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Finsterer J, Zarrouk-Mahjoub S. MicroRNAs are inappropriate for characterising hearing impairment in mitochondrial disorders. Orphanet J Rare Dis 2018; 13:87. [PMID: 29855326 PMCID: PMC5984339 DOI: 10.1186/s13023-018-0831-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/23/2018] [Indexed: 11/10/2022] Open
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The Mitochondrial tRNA Gly T10003C Mutation may not be Associated with Diabetes Mellitus. Balkan J Med Genet 2018; 21:53-57. [PMID: 30425911 PMCID: PMC6231318 DOI: 10.2478/bjmg-2018-0006] [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] [Indexed: 11/20/2022] Open
Abstract
Mitochondrial DNA (mtDNA) mutations have long been proposed to play important roles in the pathogenesis of diabetes mellitus (DM). A large proportion of these mutations are localized at the mt-tRNA genes. Owing to its high mutation rate, a growing number of mt-tRNA mutations have been reported; however some of them are neutral genetic polymorphisms and will not result in the alteration of the mitochondrial function responsible for DM. In this study, we reassessed a recent reported "pathogenic" mutation, tRNAGly T10003C, in a clinical manifestation of DM. We first performed the conservation assessment of this mutation between different species. Moreover, the bioinformatics analysis was used to predict the secondary structure of mt-tRNAGly in wild type version and the mutant carrying the T10003C mutation. We also screened the presence of the T10003C mutation in 500 unrelated DM patients and 300 healthy controls. We noticed that the T10003C mutation was not very conserved and did not cause the secondary structure change of mt-tRNAGly. Moreover, this mutation was absent in the 500 unrelated DM patients and controls, suggesting that this mutation may be a rare event in the human population. In conclusion, the current study showed no association between the T10003C mutation and DM in humans.
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Ryzhkova AI, Sazonova MA, Sinyov VV, Galitsyna EV, Chicheva MM, Melnichenko AA, Grechko AV, Postnov AY, Orekhov AN, Shkurat TP. Mitochondrial diseases caused by mtDNA mutations: a mini-review. Ther Clin Risk Manag 2018; 14:1933-1942. [PMID: 30349272 PMCID: PMC6186303 DOI: 10.2147/tcrm.s154863] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
There are several types of mitochondrial cytopathies, which cause a set of disorders, arise as a result of mitochondria’s failure. Mitochondria’s functional disruption leads to development of physical, growing and cognitive disabilities and includes multiple organ pathologies, essentially disturbing the nervous and muscular systems. The origins of mitochondrial cytopathies are mutations in genes of nuclear DNA encoding mitochondrial proteins or in mitochondrial DNA. Nowadays, numerous mtDNA mutations significant to the appearance and progress of pathologies in humans are detected. In this mini-review, we accent on the mitochondrial cytopathies related to mutations of mtDNA. As well known, there are definite set of symptoms of mitochondrial cytopathies distinguishing or similar for different syndromes. The present article contains data about mutations linked with cytopathies that facilitate diagnosis of different syndromes by using genetic analysis methods. In addition, for every individual, more effective therapeutic approach could be developed after wide-range mutant background analysis of mitochondrial genome.
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Affiliation(s)
- Anastasia I Ryzhkova
- Laboratory of Medical Genetics, National Medical Research Center of Cardiology, Moscow, Russian Federation, .,Department of Virology, K.I. Skryabin Moscow State Academy of Veterinary Medicine and Biotechnology-MVA, Moscow, Russian Federation,
| | - Margarita A Sazonova
- Laboratory of Medical Genetics, National Medical Research Center of Cardiology, Moscow, Russian Federation, .,Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russian Federation
| | - Vasily V Sinyov
- Laboratory of Medical Genetics, National Medical Research Center of Cardiology, Moscow, Russian Federation,
| | - Elena V Galitsyna
- Department of Genetics, Southern Federal University, Rostov-on-Don, Russian Federation
| | - Mariya M Chicheva
- Department of Genetics, Southern Federal University, Rostov-on-Don, Russian Federation
| | | | - Andrey V Grechko
- Federal Research and Clinical Center of Reanimatology and Rehabilitology, Moscow, Russian Federation
| | - Anton Yu Postnov
- Laboratory of Medical Genetics, National Medical Research Center of Cardiology, Moscow, Russian Federation,
| | - Alexander N Orekhov
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russian Federation.,Institute for Atherosclerosis Research, Skolkovo Innovative Centre, Moscow Region, Russian Federation
| | - Tatiana P Shkurat
- Department of Genetics, Southern Federal University, Rostov-on-Don, Russian Federation
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Yee ML, Wong R, Datta M, Fazlo TN, Ebrahim MM, Mcnamara EC, De Jong G, Gilfillan C. Mitochondrial disease: an uncommon but important cause of diabetes mellitus. Endocrinol Diabetes Metab Case Rep 2018; 2018. [PMID: 30306776 PMCID: PMC6169542 DOI: 10.1530/edm-18-0091] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Mitochondrial diseases are rare, heterogeneous conditions affecting organs dependent on high aerobic metabolism.
Presenting symptoms and signs vary depending on the mutation and mutant protein load. Diabetes mellitus is the most
common endocrinopathy, and recognition of these patients is important due to its impact on management and screening
of family members. In particular, glycemic management differs in these patients: the use of metformin is avoided because
of the risk of lactic acidosis. We describe a patient who presented with gradual weight loss and an acute presentation of
hyperglycemia complicated by the superior mesenteric artery syndrome. His maternal history of diabetes and deafness
and a personal history of hearing impairment led to the diagnosis of a mitochondrial disorder.
Learning points:
•• The constellation of diabetes, multi-organ involvement and maternal inheritance should prompt consideration of
a mitochondrial disorder.
•• Mitochondrial encephalomyopathy, lactic acidosis, stroke-like episodes (MELAS) and maternally inherited diabetes
and deafness (MIDD) are the most common mitochondrial diabetes disorders caused by a mutation in m.3243A>G
in 80% of cases.
•• Metformin should be avoided due to the risk of lactic acidosis.
•• There is more rapid progression to insulin therapy and higher prevalence of diabetic complications compared to
type 2 diabetes.
•• Diagnosis of a mitochondrial disorder leads to family screening, education and surveillance for future
complications.
•• Superior mesenteric artery syndrome, an uncommon but important cause of intestinal pseudo-obstruction in cases
of significant weight loss, has been reported in MELAS patients.
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Affiliation(s)
- Ming Li Yee
- Department of Endocrinology, Eastern Health, Victoria, Australia,Eastern Health Clinical School, Monash University, Victoria, Australia
| | - Rosemary Wong
- Department of Endocrinology, Eastern Health, Victoria, Australia
| | - Mineesh Datta
- Eastern Health Clinical School, Monash University, Victoria, Australia,Medical Imaging, Eastern Health, Box Hill, Victoria, Australia
| | - Timothy Nicholas Fazlo
- Metabolic Diseases Unit, Royal Melbourne Hospital, Victoria, Australia,Department of Medicine and Radiology, University of Melbourne, Victoria, Australia
| | | | | | - Gerard De Jong
- Metabolic Diseases Unit, Royal Melbourne Hospital, Victoria, Australia
| | - Christopher Gilfillan
- Department of Endocrinology, Eastern Health, Victoria, Australia,Eastern Health Clinical School, Monash University, Victoria, Australia,Department of Medicine, Eastern Health, Box Hill, Victoria, Australia
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Mitochondrial tRNA genes are hotspots for mutations in a cohort of patients with exercise intolerance and mitochondrial myopathy. J Neurol Sci 2017; 379:137-143. [DOI: 10.1016/j.jns.2017.05.056] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 05/28/2017] [Accepted: 05/29/2017] [Indexed: 11/22/2022]
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Cherian KE, Kapoor N, Mathews SS, Paul TV. Endocrine Glands and Hearing: Auditory Manifestations of Various Endocrine and Metabolic Conditions. Indian J Endocrinol Metab 2017; 21:464-469. [PMID: 28553606 PMCID: PMC5434734 DOI: 10.4103/ijem.ijem_10_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The aetiology of hearing loss in humans is multifactorial. Besides genetic, environmental and infectious causes, several endocrine and metabolic abnormalities are associated with varying degrees of hearing impairment. The pattern of hearing loss may be conductive, sensori-neural or mixed. The neurophysiology of hearing as well as the anatomical structure of the auditory system may be influenced by changes in the hormonal and metabolic milieu. Optimal management of these conditions requires the integrated efforts of the otolaryngologist and the endocrinologist. The presence of hearing loss especially in the young age group should prompt the clinician to explore the possibility of an associated endocrine or metabolic disorder for timely referral and early initiation of treatment.
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Affiliation(s)
- Kripa Elizabeth Cherian
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suma Susan Mathews
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India
| | - Thomas Vizhalil Paul
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
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Godinho I, Gameiro J, Jorge S, Abreu F, Neves M, Lopes JA, Gomes da Costa A. Diabetes, deafness and renal disease. Clin Kidney J 2017; 10:487-489. [PMID: 28852486 PMCID: PMC5569948 DOI: 10.1093/ckj/sfx021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 02/14/2017] [Indexed: 11/12/2022] Open
Abstract
Deafness, kidney disease and diabetes are not a usual association, neither is a family history of these diseases. We present the case of a 47-year-old woman with non-nephrotic proteinuria, no haematuria, normal renal function, sensorineural hearing loss, recently diagnosed diabetes and maculopathy. There was a maternal family history of deafness, diabetes and renal disease. Renal biopsy revealed focal and segmental glomerulosclerosis (FSGS), leading to the pursuit of an m.3243A > G mitochondrial mutation and diagnosis of maternally inherited diabetes and deafness. The association of FSGS with mitochondrial diseases is not well known among nephrologists. Its timely diagnosis is important to avoid exposure to ineffective and unnecessary immunosuppression.
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Affiliation(s)
- Iolanda Godinho
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal
| | - Joana Gameiro
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal
| | - Sofia Jorge
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal
| | - Fernando Abreu
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal
| | - Marta Neves
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal
| | - José António Lopes
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal
| | - António Gomes da Costa
- Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal
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Maternally Inherited Diabetes and Deafness is Phenotypically and Genotypically Heterogeneous. J Neuroophthalmol 2016; 36:346-7. [DOI: 10.1097/wno.0000000000000387] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Morin TJ, Shropshire T, Liu X, Briggs K, Huynh C, Tabard-Cossa V, Wang H, Dunbar WB. Nanopore-Based Target Sequence Detection. PLoS One 2016; 11:e0154426. [PMID: 27149679 PMCID: PMC4858282 DOI: 10.1371/journal.pone.0154426] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 04/13/2016] [Indexed: 01/10/2023] Open
Abstract
The promise of portable diagnostic devices relies on three basic requirements: comparable sensitivity to established platforms, inexpensive manufacturing and cost of operations, and the ability to survive rugged field conditions. Solid state nanopores can meet all these requirements, but to achieve high manufacturing yields at low costs, assays must be tolerant to fabrication imperfections and to nanopore enlargement during operation. This paper presents a model for molecular engineering techniques that meets these goals with the aim of detecting target sequences within DNA. In contrast to methods that require precise geometries, we demonstrate detection using a range of pore geometries. As a result, our assay model tolerates any pore-forming method and in-situ pore enlargement. Using peptide nucleic acid (PNA) probes modified for conjugation with synthetic bulk-adding molecules, pores ranging 15-50 nm in diameter are shown to detect individual PNA-bound DNA. Detection of the CFTRΔF508 gene mutation, a codon deletion responsible for ∼66% of all cystic fibrosis chromosomes, is demonstrated with a 26-36 nm pore size range by using a size-enhanced PNA probe. A mathematical framework for assessing the statistical significance of detection is also presented.
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Affiliation(s)
- Trevor J. Morin
- Two Pore Guys Inc., Santa Cruz, CA, United States of America
| | | | - Xu Liu
- Two Pore Guys Inc., Santa Cruz, CA, United States of America
| | - Kyle Briggs
- Department of Physics, University of Ottawa, Ontario, Canada
| | - Cindy Huynh
- Two Pore Guys Inc., Santa Cruz, CA, United States of America
| | | | - Hongyun Wang
- Two Pore Guys Inc., Santa Cruz, CA, United States of America
- Baskin School of Engineering, University of California Santa Cruz, Santa Cruz, CA, United States of America
| | - William B. Dunbar
- Two Pore Guys Inc., Santa Cruz, CA, United States of America
- Baskin School of Engineering, University of California Santa Cruz, Santa Cruz, CA, United States of America
- * E-mail:
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Reinauer C, Meissner T, Roden M, Thon A, Holterhus PM, Haberland H, Binder E, Marg W, Bollow E, Holl R. Low prevalence of patients with mitochondrial disease in the German/Austrian DPV diabetes registry. Eur J Pediatr 2016; 175:613-22. [PMID: 26670026 DOI: 10.1007/s00431-015-2675-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/20/2015] [Accepted: 11/26/2015] [Indexed: 01/21/2023]
Abstract
UNLABELLED The aim of this study was to characterize the phenotype and treatment of young patients (manifestation <30 years) with diabetes of mitochondrial origin (DMO), based on the German/Austrian DPV (Diabetes Patienten Verlaufsdokumentation) registry. Only 13 (0.02 %) of all patients with diabetes in this cohort were identified with DMO, mainly due to the Kearns-Sayre (n = 5), Pearson (n = 3), or mitochondrial myopathy, encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome (n = 2). The onset of DMO (14.2, interquartile range (IQR) 7.1-16 years) was later than diabetes onset in individuals with T1D but earlier than in T2D. At manifestation, patients exhibited a mild elevation of blood glucose concentrations (251, IQR 178-299 mg/dl) without ketoacidosis. They had lower body mass index (BMI) values (-1.39 ± 0.28 kg/m(2)) than peers with T1D or T2D (p < 0.0001) and higher triglycerides (211, IQR 134-574 mg/dl) than in T1D (p = 0.04) while there was a high rate of dyslipidemia (86 %). Insulin requirements (0.58, IQR 0.37-0.90 U/kg/d) were between T1D and T2D while glucometabolic control (glycated hemoglobin A1c (HbA1c) 7.4 ± 0.52 %) in DMO was comparable to age-matched T2D and stable over a 5-year follow-up. CONCLUSION Primary mitochondrial disorders are a rare cause of juvenile diabetes and likely to be underdiagnosed. As there is clinical overlap with T1D and T2D, dyslipidemia and low body weight may help to identify further DMO cases. WHAT IS KNOWN • In adults diabetes of mitochondrial origin (DMO) is a rare cause of non-autoimmune diabetes, affecting about 0.8 % of diabetes cases. • Common features are a maternal family history of diabetes, hearing loss and neurological abnormalities. What is New: • In our juvenile cohort 0.02 % of diabetes patients (age < 30 years) were affected by DMO, while Kearns Sayre, MELAS and Pearson syndrome were the most frequent entities. • Juvenile DMO patients exhibited dyslipidemia, higher triglycerides and a lower BMI than peers with T1D or T2D, while some patients also showed retinal changes.
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Affiliation(s)
- Christina Reinauer
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany.
| | - Thomas Meissner
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany.,German Center for Diabetes Research (DZD e.V.), Partners Düsseldorf and Ulm, Düsseldorf, Germany
| | - Michael Roden
- German Center for Diabetes Research (DZD e.V.), Partners Düsseldorf and Ulm, Düsseldorf, Germany.,Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany.,Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University Düsseldorf, Leibniz Center for Diabetes Research, German Center for Diabetes Research (DZD), 40225, Düsseldorf, Germany
| | - Angelika Thon
- Department of Pediatric Pneumology, Allergology & Neonatology, Children's Hospital, Hannover Medical School, 30625, Hannover, Germany
| | - Paul-Martin Holterhus
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University Hospital Schleswig-Holstein, Christian-Albrechts University Kiel, 24118, Kiel, Germany
| | - Holger Haberland
- Hospital for Children and Adolescents, Sana Hospital Berlin Lichtenberg, 10365, Berlin, Germany
| | - Elisabeth Binder
- Department of Pediatrics, Medical University of Innsbruck, A 6020, Innsbruck, Austria
| | - Wolfgang Marg
- Center for Pediatrics and Adolescent Medicine, Bremen-Mitte Hospital, 28211, Bremen, Germany
| | - Esther Bollow
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, German Center for Diabetes Research (DZD), 89081, Ulm, Germany
| | - Reinhard Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, German Center for Diabetes Research (DZD), 89081, Ulm, Germany
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Ninomiya H, Hirata A, Kozawa J, Nakata S, Kimura T, Kitamura T, Yasuda T, Otsuki M, Imagawa A, Kaneto H, Funahashi T, Shimomura I. Treatment of Mitochondrial Diabetes with a Peroxisome Proliferator-activated Receptor (PPAR)-gamma Agonist. Intern Med 2016; 55:1143-7. [PMID: 27150869 DOI: 10.2169/internalmedicine.55.4418] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The 3243 A>G mutation in mitochondrial DNA is the most common cause of monogenic diabetes mellitus in Japan. A 45-year-old woman with mitochondrial diabetes and significant insulin resistance presented with hypoadiponectinemia despite a normal amount of visceral fat. Three months of treatment with pioglitazone (PIO) improved her blood glucose profile and response to the 75-g oral glucose tolerance test. These changes were accompanied by the amelioration of her insulin resistance and the impairment of early-phase insulin secretion. Her serum adiponectin levels increased to the normal range. In this case of mitochondrial diabetes, PIO was effective for glycemic control.
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Affiliation(s)
- Hiroyo Ninomiya
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan
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Zhou MC, Min R, Ji JJ, Zhang S, Tong AL, Xu JP, Li ZY, Zhang HB, Li YX. Analysis of association among clinical features and shorter leukocyte telomere length in mitochondrial diabetes with m.3243A>G mitochondrial DNA mutation. BMC MEDICAL GENETICS 2015; 16:92. [PMID: 26449496 PMCID: PMC4599722 DOI: 10.1186/s12881-015-0238-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 09/30/2015] [Indexed: 11/15/2022]
Abstract
Background Mitochondrial diabetes is a kind of rare diabetes caused by monogenic mutation in mitochondia. The study aimed to summarize the clinical phenotype profiles in mitochondrial diabetes withm.3243A>G mitochondrial DNA mutation and to investigate the mechanism in this kind of diabetes by analyzing the relationship among clinical phenotypes and peripheral leukocyte DNA telomere length. Methods Fifteen patients with maternally inherited diabetes in five families were confirmed as carrying the m.3243A>G mitochondrial DNA mutation. One hundred patients with type 2 diabetes and one hundred healthy control subjects were recruited to participate in the study. Sanger sequencing was used to detect the m.3243A>G mitochondrial DNA mutation. The peak height G/A ratio in the sequence diagram was calculated. Real-time polymerase chain reaction (PCR) was used to measure telomere length. Results The patients with mitochondrial diabetes all had definite maternally inherited history, normal BMI (19.5 ± 2.36 kg/m2), early onset of diabetes (35.0 ± 14.6 years) and deafness. The peak height G/A ratio correlated significantly and negatively with the age at onset of diabetes (≦25 years, 61.6 ± 20.17 %; 25–45 years, 16.59 ± 8.64 %; >45 years, 6.37 ± 0.59 %; p = 0.000). Telomere length was significantly shorter among patients with mitochondrial diabetes and type 2 diabetes than in the control group (1.28 ± 0.54 vs. 1.14 ± 0.43 vs. 1.63 ± 0.61; p = 0.000). However, there was no significant difference between patients with mitochondrial diabetes and those with type 2 diabetes. There was no correlation between telomere length and the peak height G/A ratio. Conclusion Deafness with definite maternal inheritance and normal BMI, associated with elevated blood lactic acid and encephalomyopathy, for the most part, suggest the diagnosis of mitochondrial diabetes . The peak height G/A ratio could reflect the spectrum of age at onset of the disease. Telomere length was shorter in patients with mitochondrial diabetes and those with type 2 diabetes, which suggests that the shorter telomere length is likely involved in the pathogenesis of diabetes but is not specific for this kind of diabetes.
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Affiliation(s)
- Mei-Cen Zhou
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Rui Min
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Jian-Jun Ji
- Hongshan Traditional Chinese Medicine Hospital, Chifeng City, Inner Mongolia, 024076, China
| | - Shi Zhang
- Metabolic Disease Hospital of Tianjin Medical University, Tianjin City, 300000, China
| | - An-Li Tong
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Jian-ping Xu
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Zeng-Yi Li
- Nanyang City Center Hospital, Nanyang City, Henan, 473003, China
| | - Hua-Bing Zhang
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Yu-Xiu Li
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Beijing, 100730, China.
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Karalliedde J, Gnudi L. Diabetes mellitus, a complex and heterogeneous disease, and the role of insulin resistance as a determinant of diabetic kidney disease. Nephrol Dial Transplant 2014; 31:206-13. [PMID: 25550448 DOI: 10.1093/ndt/gfu405] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/02/2014] [Indexed: 12/13/2022] Open
Abstract
Diabetes mellitus (DM) is increasingly recognized as a heterogeneous condition. The individualization of care and treatment necessitates an understanding of the individual patient's pathophysiology of DM that underpins their DM classification and clinical presentation. Classical type-2 diabetes mellitus is due to a combination of insulin resistance and an insulin secretory defect. Type-1 diabetes is characterized by a near-absolute deficiency of insulin secretion. More recently, advances in genetics and a better appreciation of the atypical features of DM has resulted in more categories of diabetes. In the context of kidney disease, patients with DM and microalbuminuria are more insulin resistant, and insulin resistance may be a pathway that results in accelerated progression of diabetic kidney disease. This review summarizes the updated classification of DM, including more rarer categories and their associated renal manifestations that need to be considered in patients who present with atypical features. The benefits and limitations of the tests utilized to make a diagnosis of DM are discussed. We also review the putative pathways and mechanisms by which insulin resistance drives the progression of diabetic kidney disease.
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Affiliation(s)
- Janaka Karalliedde
- Unit for Metabolic Medicine, Department of Diabetes and Endocrinology, Cardiovascular Division, School of Life Science & Medicine, King's College, London, UK
| | - Luigi Gnudi
- Unit for Metabolic Medicine, Department of Diabetes and Endocrinology, Cardiovascular Division, School of Life Science & Medicine, King's College, London, UK
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