1
|
Mahesan A, Choudhary PK, Kamila G, Rohil A, Meena AK, Kumar A, Jauhari P, Chakrabarty B, Gulati S. NDUFV1-Related Mitochondrial Complex-1 Disorders: A Retrospective Case Series and Literature Review. Pediatr Neurol 2024; 155:91-103. [PMID: 38626668 DOI: 10.1016/j.pediatrneurol.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/17/2024] [Accepted: 02/29/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Pathogenic variants in the NDUFV1 gene disrupt mitochondrial complex I, leading to neuroregression with leukoencephalopathy and basal ganglia involvement on neuroimaging. This study aims to provide a concise review on NDUFV1-related disorders while adding the largest cohort from a single center to the existing literature. METHODS We retrospectively collected genetically proven cases of NDUFV1 pathogenic variants from our center over the last decade and explored reported instances in existing literature. Magnetic resonance imaging (MRI) patterns observed in these patients were split into three types-Leigh (putamen, basal ganglia, thalamus, and brainstem involvement), mitochondrial leukodystrophy (ML) (cerebral white matter involvement with cystic cavitations), and mixed (both). RESULTS Analysis included 44 children (seven from our center and 37 from literature). The most prevalent comorbidities were hypertonia, ocular abnormalities, feeding issues, and hypotonia at onset. Children with the Leigh-type MRI pattern exhibited significantly higher rates of breathing difficulties, whereas those with a mixed phenotype had a higher prevalence of dystonia. The c.1156C>T variant in exon 8 of the NDUFV1 gene was the most common variant among individuals of Asian ethnicity and is predominantly associated with irritability and dystonia. Seizures and Leigh pattern of MRI of the brain was found to be less commonly associated with this variant. Higher rate of mortality was observed in children with Leigh-type pattern on brain MRI and those who did not receive mitochondrial cocktail. CONCLUSIONS MRI phenotyping might help predict outcome. Appropriate and timely treatment with mitochondrial cocktail may reduce the probability of death and may positively impact the long-term outcomes, regardless of the genetic variant or age of onset.
Collapse
Affiliation(s)
- Aakash Mahesan
- Child Neurology Division, Department of Pediatrics, Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Puneet Kumar Choudhary
- Child Neurology Division, Department of Pediatrics, Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Gautam Kamila
- Child Neurology Division, Department of Pediatrics, Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Aradhana Rohil
- Child Neurology Division, Department of Pediatrics, Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Ankit Kumar Meena
- Child Neurology Division, Department of Pediatrics, Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Atin Kumar
- Department of Radiodiagnosis and Interventional Radiology, AIIMS, New Delhi, India
| | - Prashant Jauhari
- Child Neurology Division, Department of Pediatrics, Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Biswaroop Chakrabarty
- Child Neurology Division, Department of Pediatrics, Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Sheffali Gulati
- Child Neurology Division, Department of Pediatrics, Centre of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, All India Institute of Medical Sciences, New Delhi, India.
| |
Collapse
|
2
|
Laliberté A, Berrahmoune S, Myers KA. Sulthiame use in children with pharmacoresistant epilepsies: A retrospective study. Epileptic Disord 2024. [PMID: 38818757 DOI: 10.1002/epd2.20250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE This retrospective study aimed to assess the efficacy and tolerability of sulthiame as an add-on treatment in children with pharmacoresistant epilepsies. METHODS All patients with epilepsy who received sulthiame at Montreal Children's Hospital over an 11-year period were included. Medical charts were reviewed, and extracted data included patient age and sex, seizure types, epilepsy syndrome, electroencephalography (EEG) reports, brain imaging reports, antiseizure treatments trialed, starting and final dose of sulthiame, duration of sulthiame treatment, adverse events attributed to sulthiame, and seizure frequency before and after sulthiame treatment. EEG studies were also analyzed and spike-wave index (SWI) in the first 10 min of sleep was calculated. RESULTS Sixteen patients were included, all of whom had pharmacoresistant epilepsies (mean of 9.9 trials of other antiseizure treatments). Six had genetic diagnoses, four had in utero/perinatal acquired brain injury, one had a suspected focal cortical dysplasia, and five were idiopathic. Ten patients had developmental and epileptic encephalopathy with spike-wave activation in sleep, three had Lennox-Gastaut syndrome, and one each had sleep-related hyperkinetic epilepsy, self-limited epilepsy with centrotemporal spikes, and mixed generalized and multifocal epilepsy. Of the 12 patients with uncontrolled seizures at the time of sulthiame initiation, 4 had improvement in seizure frequency, including 2 who became seizure free. Eight patients had EEG data available that allowed calculation of sleep SWI; from this group, SWI decreased from 81.1% +/- 17.6% to 45.1% +/- 36.5% (p = .007). The most common adverse events reported were somnolence/drowsiness, aggression, and increased seizure frequency. Of the patients with genetic etiologies, significant positive responses were seen in patients with pathogenic variants in NDUFS1 and SATB1. SIGNIFICANCE These data demonstrate the therapeutic potential of sulthiame, even in patients with highly pharmacoresistant epilepsy. Improvements may be seen in both seizure frequency and sleep SWI.
Collapse
Affiliation(s)
- Alexandra Laliberté
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Saoussen Berrahmoune
- Child Health and Human Development Program, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Kenneth A Myers
- Child Health and Human Development Program, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada
| |
Collapse
|
3
|
Dagostino R, Gottlieb A. Tissue-specific atlas of trans-models for gene regulation elucidates complex regulation patterns. BMC Genomics 2024; 25:377. [PMID: 38632500 PMCID: PMC11022497 DOI: 10.1186/s12864-024-10317-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 04/16/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Deciphering gene regulation is essential for understanding the underlying mechanisms of healthy and disease states. While the regulatory networks formed by transcription factors (TFs) and their target genes has been mostly studied with relation to cis effects such as in TF binding sites, we focused on trans effects of TFs on the expression of their transcribed genes and their potential mechanisms. RESULTS We provide a comprehensive tissue-specific atlas, spanning 49 tissues of TF variations affecting gene expression through computational models considering two potential mechanisms, including combinatorial regulation by the expression of the TFs, and by genetic variants within the TF. We demonstrate that similarity between tissues based on our discovered genes corresponds to other types of tissue similarity. The genes affected by complex TF regulation, and their modelled TFs, were highly enriched for pharmacogenomic functions, while the TFs themselves were also enriched in several cancer and metabolic pathways. Additionally, genes that appear in multiple clusters are enriched for regulation of immune system while tissue clusters include cluster-specific genes that are enriched for biological functions and diseases previously associated with the tissues forming the cluster. Finally, our atlas exposes multilevel regulation across multiple tissues, where TFs regulate other TFs through the two tested mechanisms. CONCLUSIONS Our tissue-specific atlas provides hierarchical tissue-specific trans genetic regulations that can be further studied for association with human phenotypes.
Collapse
Affiliation(s)
- Robert Dagostino
- McWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Assaf Gottlieb
- McWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, USA.
| |
Collapse
|
4
|
Granat L, Knorr DY, Ranson DC, Chakrabarty RP, Chandel NS, Bateman JM. A Drosophila model of mitochondrial disease phenotypic heterogeneity. Biol Open 2024; 13:bio060278. [PMID: 38304969 PMCID: PMC10924217 DOI: 10.1242/bio.060278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024] Open
Abstract
Mutations in genes that affect mitochondrial function cause primary mitochondrial diseases. Mitochondrial diseases are highly heterogeneous and even patients with the same mitochondrial disease can exhibit broad phenotypic heterogeneity, which is poorly understood. Mutations in subunits of mitochondrial respiratory complex I cause complex I deficiency, which can result in severe neurological symptoms and death in infancy. However, some complex I deficiency patients present with much milder symptoms. The most common nuclear gene mutated in complex I deficiency is the highly conserved core subunit NDUFS1. To model the phenotypic heterogeneity in complex I deficiency, we used RNAi lines targeting the Drosophila NDUFS1 homolog ND-75 with different efficiencies. Strong knockdown of ND-75 in Drosophila neurons resulted in severe behavioural phenotypes, reduced lifespan, altered mitochondrial morphology, reduced endoplasmic reticulum (ER)-mitochondria contacts and activation of the unfolded protein response (UPR). By contrast, weak ND-75 knockdown caused much milder behavioural phenotypes and changes in mitochondrial morphology. Moreover, weak ND-75 did not alter ER-mitochondria contacts or activate the UPR. Weak and strong ND-75 knockdown resulted in overlapping but distinct transcriptional responses in the brain, with weak knockdown specifically affecting proteosome activity and immune response genes. Metabolism was also differentially affected by weak and strong ND-75 knockdown including gamma-aminobutyric acid (GABA) levels, which may contribute to neuronal dysfunction in ND-75 knockdown flies. Several metabolic processes were only affected by strong ND-75 knockdown including the pentose phosphate pathway and the metabolite 2-hydroxyglutarate (2-HG), suggesting 2-HG as a candidate biomarker of severe neurological mitochondrial disease. Thus, our Drosophila model provides the means to dissect the mechanisms underlying phenotypic heterogeneity in mitochondrial disease.
Collapse
Affiliation(s)
- Lucy Granat
- Maurice Wohl Clinical Neuroscience Institute, King's College London, 5 Cutcombe Road, London SE5 9RX, UK
| | - Debbra Y. Knorr
- Maurice Wohl Clinical Neuroscience Institute, King's College London, 5 Cutcombe Road, London SE5 9RX, UK
| | - Daniel C. Ranson
- Maurice Wohl Clinical Neuroscience Institute, King's College London, 5 Cutcombe Road, London SE5 9RX, UK
| | - Ram Prosad Chakrabarty
- Department of Medicine, Biochemistry and Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Navdeep S. Chandel
- Department of Medicine, Biochemistry and Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Joseph M. Bateman
- Maurice Wohl Clinical Neuroscience Institute, King's College London, 5 Cutcombe Road, London SE5 9RX, UK
| |
Collapse
|
5
|
Dong L, Shang L, Liu C, Mao C, Huang X, Chu S, Peng B, Cui L, Gao J. Genotypic and phenotypic heterogeneity among Chinese pediatric genetic white matter disorders. Ital J Pediatr 2023; 49:155. [PMID: 37981684 PMCID: PMC10658925 DOI: 10.1186/s13052-023-01555-z] [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: 12/20/2022] [Accepted: 10/29/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND The pediatric genetic white matter disorders are characterized by a broad disease spectrum. Genetic testing is valuable in the diagnosis. However, there are few studies on the clinical and genetic spectrum of Chinese pediatric genetic white matter disorders. METHODS The participants were enrolled from the cohort of Peking Union Medical College Hospital. They all received history collection, brain MRI and gene sequencing. Their neurologic complaints which were related to white matter disorders occurred before 18. Brain MRI indicated periventricular and/or deep white matter lesions, fazekas grade 2-3. RESULTS Among the 13 subjects, there were 11 males and two females. The average age of onset was 10.0 ± 5.5 years old. The potential genetic variants were found in 84.6% (11/13) subjects. The ABCD1 showed the greatest mutation frequency (30.8%, 4/13). The EIF2B3 A151fs, EIF2B4 c.885 + 2T > G, EIF2B5 R129X and MPV17 Q142X were novel pathogenic/likely pathogenic variants. 100% (4/4) ABCD1 carriers were accompanied by visual impairment, whereas 100% (3/3) EIF2B carriers developed dysuria. 100% (4/4) ABCD1 carriers exhibited diffuse white matter hyperintensities mainly in the posterior cortical regions, while the EIF2B4 and EIF2B5 carriers were accompanied by cystic degeneration. CONCLUSION There is genotypic and phenotypic heterogeneity among Chinese subjects with pediatric genetic white matter disorders. The knowledge of these clinical and genetic characteristics facilitates an accurate diagnosis of these diseases.
Collapse
Affiliation(s)
- Liling Dong
- Neurology department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng district, Beijing, 100005, China
| | - Li Shang
- Neurology department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng district, Beijing, 100005, China
| | - Caiyan Liu
- Neurology department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng district, Beijing, 100005, China
| | - Chenhui Mao
- Neurology department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng district, Beijing, 100005, China
| | - Xinying Huang
- Neurology department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng district, Beijing, 100005, China
| | - Shanshan Chu
- Neurology department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng district, Beijing, 100005, China
| | - Bin Peng
- Neurology department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng district, Beijing, 100005, China
| | - Liying Cui
- Neurology department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng district, Beijing, 100005, China
| | - Jing Gao
- Neurology department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng district, Beijing, 100005, China.
| |
Collapse
|
6
|
Granat L, Knorr DY, Ranson DC, Hamer EL, Chakrabarty RP, Mattedi F, Fort-Aznar L, Hirth F, Sweeney ST, Vagnoni A, Chandel NS, Bateman JM. Yeast NDI1 reconfigures neuronal metabolism and prevents the unfolded protein response in mitochondrial complex I deficiency. PLoS Genet 2023; 19:e1010793. [PMID: 37399212 PMCID: PMC10348588 DOI: 10.1371/journal.pgen.1010793] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 07/14/2023] [Accepted: 05/22/2023] [Indexed: 07/05/2023] Open
Abstract
Mutations in subunits of the mitochondrial NADH dehydrogenase cause mitochondrial complex I deficiency, a group of severe neurological diseases that can result in death in infancy. The pathogenesis of complex I deficiency remain poorly understood, and as a result there are currently no available treatments. To better understand the underlying mechanisms, we modelled complex I deficiency in Drosophila using knockdown of the mitochondrial complex I subunit ND-75 (NDUFS1) specifically in neurons. Neuronal complex I deficiency causes locomotor defects, seizures and reduced lifespan. At the cellular level, complex I deficiency does not affect ATP levels but leads to mitochondrial morphology defects, reduced endoplasmic reticulum-mitochondria contacts and activation of the endoplasmic reticulum unfolded protein response (UPR) in neurons. Multi-omic analysis shows that complex I deficiency dramatically perturbs mitochondrial metabolism in the brain. We find that expression of the yeast non-proton translocating NADH dehydrogenase NDI1, which reinstates mitochondrial NADH oxidation but not ATP production, restores levels of several key metabolites in the brain in complex I deficiency. Remarkably, NDI1 expression also reinstates endoplasmic reticulum-mitochondria contacts, prevents UPR activation and rescues the behavioural and lifespan phenotypes caused by complex I deficiency. Together, these data show that metabolic disruption due to loss of neuronal NADH dehydrogenase activity cause UPR activation and drive pathogenesis in complex I deficiency.
Collapse
Affiliation(s)
- Lucy Granat
- Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
| | - Debbra Y. Knorr
- Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
| | - Daniel C. Ranson
- Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
| | - Emma L. Hamer
- Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
| | - Ram Prosad Chakrabarty
- Department of Medicine and Biochemistry & Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Francesca Mattedi
- Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
| | - Laura Fort-Aznar
- Department of Biology and York Biomedical Research Institute, University of York, Heslington, York, United Kingdom
- Alzheimer’s disease and other cognitive disorders Unit, Hospital Clínic de Barcelona IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Frank Hirth
- Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
| | - Sean T. Sweeney
- Department of Biology and York Biomedical Research Institute, University of York, Heslington, York, United Kingdom
| | - Alessio Vagnoni
- Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
| | - Navdeep S. Chandel
- Department of Medicine and Biochemistry & Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Joseph M. Bateman
- Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, United Kingdom
| |
Collapse
|
7
|
Distelmaier F, Klopstock T. Neuroimaging in mitochondrial disease. HANDBOOK OF CLINICAL NEUROLOGY 2023; 194:173-185. [PMID: 36813312 DOI: 10.1016/b978-0-12-821751-1.00016-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
The anatomic complexity of the brain in combination with its high energy demands makes this organ specifically vulnerable to defects of mitochondrial oxidative phosphorylation. Therefore, neurodegeneration is a hallmark of mitochondrial diseases. The nervous system of affected individuals typically shows selective regional vulnerability leading to distinct patterns of tissue damage. A classic example is Leigh syndrome, which causes symmetric alterations of basal ganglia and brain stem. Leigh syndrome can be caused by different genetic defects (>75 known disease genes) with variable disease onset ranging from infancy to adulthood. Other mitochondrial diseases are characterized by focal brain lesions, which is a core feature of MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes). Apart from gray matter, also white matter can be affected by mitochondrial dysfunction. White matter lesions vary depending on the underlying genetic defect and may progress into cystic cavities. In view of the recognizable patterns of brain damage in mitochondrial diseases, neuroimaging techniques play a key role in diagnostic work-up. In the clinical setting, magnetic resonance imaging (MRI) and MR spectroscopy (MRS) are the mainstay of diagnostic work-up. Apart from visualization of brain anatomy, MRS allows the detection of metabolites such as lactate, which is of specific interest in the context of mitochondrial dysfunction. However, it is important to note that findings like symmetric basal ganglia lesions on MRI or a lactate peak on MRS are not specific, and that there is a broad range of disorders that can mimic mitochondrial diseases on neuroimaging. In this chapter, we will review the spectrum of neuroimaging findings in mitochondrial diseases and discuss important differential diagnoses. Moreover, we will give an outlook on novel biomedical imaging tools that may provide interesting insights into mitochondrial disease pathophysiology.
Collapse
Affiliation(s)
- Felix Distelmaier
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
| | - Thomas Klopstock
- Department of Neurology, Friedrich-Baur-Institute, University Hospital, Ludwig-Maximilians-Universität (LMU) München, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; German Network for mitochondrial disorders (mitoNET), Munich, Germany
| |
Collapse
|
8
|
Alkhaldi HA, Vik SB. Analysis of compound heterozygous and homozygous mutations found in peripheral subunits of human respiratory Complex I, NDUFS1, NDUFS2, NDUFS8 and NDUFV1, by modeling in the E. coli enzyme. Mitochondrion 2023; 68:87-104. [PMID: 36462614 PMCID: PMC9805526 DOI: 10.1016/j.mito.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/14/2022] [Accepted: 11/26/2022] [Indexed: 12/05/2022]
Abstract
Respiratory Complex I (NADH:ubiquinone oxidoreductase) is composed of 45 subunits, seven mitochondrially-encoded and 38 imported. Mutations in the nuclearly-encoded subunits have been regularly discovered in humans in recent years, and many lead to cardiomyopathy, Leigh Syndrome, and early death. From the literature, we have identified mutations at 17 different sites and constructed 31 mutants in a bacterial model system. Many of these mutations, found in NDUFS1, NDUFS2, NDUFS8, and NDUFV1, map to subunit interfaces, and we hypothesized that they would disrupt assembly of Complex I. The mutations were constructed in the homologous E. coli genes, nuoG, nuoCD, nuoI and nuoF, respectively, and expressed from a plasmid containing all Complex I genes. Membrane vesicles were prepared and rates of deamino-NADH oxidase activity measured, which indicated a range of reduced activity. Some mutants were also analyzed using recently developed assays of assembly, time-delayed expression, and co-immunoprecipitation, which showed that assembly was disrupted. With compound heterozygotes, we determined which mutation was more deleterious. Construction of alanine mutations allowed us to distinguish between phenotypes that were caused by loss of the original amino acid or introduction of the mutant residue.
Collapse
Affiliation(s)
- Hind A Alkhaldi
- Department of Biological Sciences, Southern Methodist University, Dallas, TX 75275-0376, USA
| | - Steven B Vik
- Department of Biological Sciences, Southern Methodist University, Dallas, TX 75275-0376, USA.
| |
Collapse
|
9
|
Na JH, Lee YM. Heteroplasmic Mutant Load Differences in Mitochondrial DNA-Associated Leigh Syndrome. Pediatr Neurol 2023; 138:27-32. [PMID: 36335839 DOI: 10.1016/j.pediatrneurol.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/24/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Mitochondrial DNA (mtDNA)-associated Leigh syndrome is influenced by mutant pathogenicity and corresponding heteroplasmic loads; however, the manner in which heteroplasmic mutant load affects patient phenotypes and the relationship between mutant types and heteroplasmic mutant loads remain unknown. We aimed to investigate the distribution of the mutant load of different mtDNA mutations in a single-center cohort. METHODS We used next-generation sequencing to confirm mtDNA mutations in 31 patients with Leigh syndrome. Subsequently, we counted the number of mtDNA reads to quantitatively analyze the heteroplasmic mutant load and categorize the patients according to the mtDNA mutations they harbored. Confirmed cases of mtDNA-associated Leigh syndrome were classified according to the mutations observed in six genes and 10 nucleotides. RESULTS Of the 31 patients with Leigh syndrome, 27 harbored known pathogenic mutations. We discovered that MT-ATP6 was the most commonly mutated gene (n = 13 patients), followed by MT-ND3 (n = 7) and MT-ND5 (n = 4). MT-ATP6 had a significantly higher mutant load than MT-ND3 and MT-ND5 (P < 0.001, each). By contrast, MT-ND5 had a significantly lower mutant load than MT-ND3 (P = 0.007). Notably, the mutation loads varied significantly among patients carrying the MT-ATP6, MT-ND3, and MT-ND5 mutations. CONCLUSIONS Our study illustrated the heteroplasmic diversity and phenotypic expression threshold of mutated mitochondrial genes in mtDNA-associated Leigh syndrome. The results provide promising insights into the genotype-phenotype correlation in mtDNA-associated Leigh syndrome that are expected to guide the development of tailored treatments for Leigh syndrome.
Collapse
Affiliation(s)
- Ji-Hoon Na
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Young-Mock Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea; Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
| |
Collapse
|
10
|
Becker N, Sharma A, Gosse M, Kubat B, Conway KS. The neuropathologic findings in a case of progressive cavitating leukoencephalopathy due to NDUFV1 pathogenic variants. Acta Neuropathol Commun 2022; 10:142. [PMID: 36163075 PMCID: PMC9511743 DOI: 10.1186/s40478-022-01445-1] [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: 07/19/2022] [Accepted: 09/07/2022] [Indexed: 11/10/2022] Open
Abstract
Pathogenic variants in the NDUFV1 gene, which codes for complex I of the mitochondrial respiratory chain, have been associated with a variety of clinical phenotypes, including a progressive cavitating leukoencephalopathy. The neuropathology of NDUFV1-associated leukoencephalopathy is not well-described. We present a report of a 24-year-old female with two pathogenic variants in the NDUFV1 gene, together with antemortem skeletal muscle biopsy and postmortem neuropathologic examination. Autopsy neuropathology showed a cavitating leukoencephalopathy with extensive white matter involvement, regions of active demyelination, and sparing of the subcortical U-fibers. Muscle biopsy showed subtle but distinct histologic abnormalities by light microscopy, and ultrastructural analysis demonstrated mitochondrial abnormalities including abnormal subsarcolemmal mitochondrial accumulation, electron-dense inclusions, and enlarged mitochondria with abnormal cristae. Our report is the first comprehensive description of the neuropathology in a patient with compound heterozygous variants in the NDUFV1 gene and progressive cavitating leukoencephalopathy. This case is evidence of pathogenicity of one NDUFV1 variant (c.565 T > C, p.S189P), which has not been previously described as pathogenic. These findings, in combination with the ultrastructural abnormalities in the mitochondria by electron microscopy, support the mitochondrial nature of the pathology. Together, this case highlights the link between mitochondrial abnormalities and demyelinating processes in the central nervous system (CNS).
Collapse
Affiliation(s)
- Nicole Becker
- Department of Pathology, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Aditi Sharma
- Department of Neurology, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Matthew Gosse
- Department of Pathology, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Brooke Kubat
- Department of Neurology, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Kyle S Conway
- Department of Pathology, University of Michigan, 2800 Plymouth Rd., Building 35, Faculty Suite Room 36-1221-68, Ann Arbor, MI, 48109-2800, USA.
| |
Collapse
|
11
|
Men L, Feng J, Huang W, Xu M, Zhao X, Sun R, Xu J, Cao L. Lip cyanosis as the first symptom of Leigh syndrome associated with mitochondrial complex I deficiency due to a compound heterozygous NDUFS1 mutation: A case report. Medicine (Baltimore) 2022; 101:e30303. [PMID: 36042640 PMCID: PMC9410648 DOI: 10.1097/md.0000000000030303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Leigh syndrome (LS) is a rare, progressive, and fatal neurodegenerative disease that occurs mainly in infants and children. Neonatal LS has not yet been fully described. METHODS The study design was approved by the ethics review board of Shenzhen Children's Hospital. RESULTS A 24-day-old full-term male infant presented with a 2-day history of lip cyanosis when crying in September 2021. He was born to nonconsanguineous Asian parents. After birth, the patient was fed poorly. A recurrent decrease in peripheral oxygen saturation and difficulty in weaning from mechanical ventilation during hospitalization were observed. There were no abnormalities on brain magnetic resonance imaging (MRI) or blood and urine organic acid analyses on admission. His lactic acid level increased markedly, and repeat MRI showed symmetrical abnormal signal areas in the bilateral basal ganglia and brainstem with disease progression. Trio whole-exome sequencing revealed 2 heterozygous mutations (c.64C > T [p.R22X] and c.584T > C [p.L195S]) in NDUFS1. Based on these findings, mitochondrial respiratory chain complex I deficiency-related LS was diagnosed. The patient underwent tracheal intubation and mechanical ventilation for respiratory failure. His oxygen saturation levels were maintained at normal levels with partially assisted ventilation. He was administered broad-spectrum antibiotics, oral coenzyme Q10, multivitamins, and idebenone. During hospitalization, the patient developed progressive consciousness impairment and respiratory and circulatory failure. He died on day 30. CONCLUSION Lip cyanosis is an important initial symptom in LS. Mild upper respiratory tract infections can induce LS and aggravate the disease. No abnormal changes in the brain MRI were observed in the early LS stages in this patient. Multiple MRIs and blood lactic acid tests during disease progression and genetic testing are important for prompt and accurate diagnosis of LS.
Collapse
Affiliation(s)
- Lina Men
- Department of Neurology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Jinxing Feng
- Department of Neurology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Weimin Huang
- Department of Neurology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Mingguo Xu
- Department of Pediatric, the Third People’s Hospital of Longgang District, Shenzhen, China
| | - Xiaoli Zhao
- Department of Neurology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Ruixin Sun
- Department of Neurology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Jianfang Xu
- Department of Neurology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Liming Cao
- Department of Neurology, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
- * Correspondence: Liming Cao, MD, Department of Neurology, The First Affiliated Hospital of Shenzhen University, 3002 Sungang West Road, Futian District, Shenzhen City 518000, China. (e-mail: )
| |
Collapse
|
12
|
Maglioni S, Schiavi A, Melcher M, Brinkmann V, Luo Z, Laromaine A, Raimundo N, Meyer JN, Distelmaier F, Ventura N. Neuroligin-mediated neurodevelopmental defects are induced by mitochondrial dysfunction and prevented by lutein in C. elegans. Nat Commun 2022; 13:2620. [PMID: 35551180 PMCID: PMC9098500 DOI: 10.1038/s41467-022-29972-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 04/09/2022] [Indexed: 12/02/2022] Open
Abstract
Complex-I-deficiency represents the most frequent pathogenetic cause of human mitochondriopathies. Therapeutic options for these neurodevelopmental life-threating disorders do not exist, partly due to the scarcity of appropriate model systems to study them. Caenorhabditis elegans is a genetically tractable model organism widely used to investigate neuronal pathologies. Here, we generate C. elegans models for mitochondriopathies and show that depletion of complex I subunits recapitulates biochemical, cellular and neurodevelopmental aspects of the human diseases. We exploit two models, nuo-5/NDUFS1- and lpd-5/NDUFS4-depleted animals, for a suppressor screening that identifies lutein for its ability to rescue animals’ neurodevelopmental deficits. We uncover overexpression of synaptic neuroligin as an evolutionarily conserved consequence of mitochondrial dysfunction, which we find to mediate an early cholinergic defect in C. elegans. We show lutein exerts its beneficial effects by restoring neuroligin expression independently from its antioxidant activity, thus pointing to a possible novel pathogenetic target for the human disease. Mitochondrial deficiency causes rare incurable disorders. Here, the authors use C. elegans to study these diseases and find that the natural compound lutein prevents neurodevelopmental deficits, thus pointing to a possible therapeutic target for the human diseases.
Collapse
Affiliation(s)
- Silvia Maglioni
- IUF-Leibniz Research Institute for Environmental Medicine, 40225, Duesseldorf, Germany
| | - Alfonso Schiavi
- IUF-Leibniz Research Institute for Environmental Medicine, 40225, Duesseldorf, Germany.,Institute for Clinical Chemistry and Laboratory Diagnostic, Medical Faculty, Heinrich Heine University, 40225, Duesseldorf, Germany
| | - Marlen Melcher
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich Heine University, 40225, Duesseldorf, Germany
| | - Vanessa Brinkmann
- IUF-Leibniz Research Institute for Environmental Medicine, 40225, Duesseldorf, Germany
| | - Zhongrui Luo
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC. Campus UAB, 08193, Bellaterra, Barcelona, Spain
| | - Anna Laromaine
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC. Campus UAB, 08193, Bellaterra, Barcelona, Spain
| | - Nuno Raimundo
- Department of Cellular and Molecular Physiology, Penn State College of Medicine, 500 University Drive, Hershey, 17033, USA
| | - Joel N Meyer
- Nicholas School of the Environment, Duke University, Durham, NC, 27708-0328, USA
| | - Felix Distelmaier
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich Heine University, 40225, Duesseldorf, Germany
| | - Natascia Ventura
- IUF-Leibniz Research Institute for Environmental Medicine, 40225, Duesseldorf, Germany. .,Institute for Clinical Chemistry and Laboratory Diagnostic, Medical Faculty, Heinrich Heine University, 40225, Duesseldorf, Germany.
| |
Collapse
|
13
|
Gschwind M, Garcia Segarra N, Schaller A, Bolognini R, Nuoffer JM, Hourez R, Deprez M, Lhermitte B, Maeder P, Tran C, Kuntzer T. Early-onset leukoencephalomyelopathy due to a biallelic NDUFV1 variant in a mid-forties patient. Ann Clin Transl Neurol 2022; 9:888-892. [PMID: 35482023 PMCID: PMC9186134 DOI: 10.1002/acn3.51556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 03/11/2022] [Accepted: 03/26/2022] [Indexed: 11/09/2022] Open
Abstract
We present a patient who developed, after an early-onset, a stable course of spastic paraplegia and ataxia for 4 decades and eventually succumbed to two episodes of postinfectious lactic acidosis. Diagnostic workup including muscle biopsy and postmortem analysis, oxymetric analysis, spectrophotometric enzyme analysis, and MitoExome sequencing revealed a necrotizing leukoencephalomyelopathy due to the so far unreported biallelic variant of the NDUFV1 gene (p.(Pro122Leu)). This case extends our understanding of NDUFV1 variants with a 14-fold longer lifetime than so far reported cases, and will foster sensitivity toward respiratory chain disease also in adult patients with sudden deteriorating neurological deficits.
Collapse
Affiliation(s)
- Markus Gschwind
- Clinic of Neurology, Kantonsspital Aarau, Aarau, Switzerland.,Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland.,Department of Neurology, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - Nuria Garcia Segarra
- Center for Molecular Diseases, Division of Genetic Medicine, Lausanne University Hospital, University of Lausanne, Switzerland
| | - André Schaller
- Division of Human Genetics, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Ramona Bolognini
- Division of Human Genetics, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Jean-Marc Nuoffer
- University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Raphael Hourez
- Department of Neurology, Centre Hospitalier Universitaire Brugman, Brussels, Belgium
| | - Manuel Deprez
- Department of Pathology, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - Benoit Lhermitte
- Departement of Pathology, Hautepierre University Hospital, France
| | - Philippe Maeder
- Department of Neuroradiology, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - Christel Tran
- Center for Molecular Diseases, Division of Genetic Medicine, Lausanne University Hospital, University of Lausanne, Switzerland
| | - Thierry Kuntzer
- Department of Neurology, Lausanne University Hospital CHUV, Lausanne, Switzerland
| |
Collapse
|
14
|
Zanette V, Valle DD, Telles BA, Robinson AJ, Monteiro V, Santos MLSF, Souza RLR, Benincá C. NDUFV1 mutations in complex I deficiency: Case reports and review of symptoms. Genet Mol Biol 2021; 44:e20210149. [PMID: 34807224 PMCID: PMC8607527 DOI: 10.1590/1678-4685-gmb-2021-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/18/2021] [Indexed: 11/22/2022] Open
Abstract
Mitochondrial complex I (CI) deficiency is the most common oxidative phosphorylation disorder described. It shows a wide range of phenotypes with poor correlation within genotypes. Herein we expand the clinics and genetics of CI deficiency in the brazilian population by reporting three patients with pathogenic (c.640G>A, c.1268C>T, c.1207dupG) and likely pathogenic (c.766C>T) variants in the NDUFV1 gene. We show the mutation c.766C>T associated with a childhood onset phenotype of hypotonia, muscle weakness, psychomotor regression, lethargy, dysphagia, and strabismus. Additionally, this mutation was found to be associated with headaches and exercise intolerance in adulthood. We also review reported pathogenic variants in NDUFV1 highlighting the wide phenotypic heterogeneity in CI deficiency.
Collapse
Affiliation(s)
- Vanessa Zanette
- Universidade Federal do Paraná, Departamento de Genética, Laboratório de Polimorfismos e Ligação, Curitiba, PR, Brazil
| | - Daniel do Valle
- Hospital Pequeno Príncipe, Divisão de Neuropediatria, Curitiba, PR, Brazil
| | | | - Alan J Robinson
- University of Cambridge, Medical Research Council, Mitochondrial Biology Unit, Cambridge, United Kingdom
| | - Vaneisse Monteiro
- Hospital Pequeno Príncipe, Divisão de Neuropediatria, Curitiba, PR, Brazil
| | | | - Ricardo Lehtonen R Souza
- Universidade Federal do Paraná, Departamento de Genética, Laboratório de Polimorfismos e Ligação, Curitiba, PR, Brazil
| | - Cristiane Benincá
- Universidade Federal do Paraná, Departamento de Genética, Laboratório de Polimorfismos e Ligação, Curitiba, PR, Brazil.,University of Cambridge, Medical Research Council, Mitochondrial Biology Unit, Cambridge, United Kingdom
| |
Collapse
|
15
|
Zhang X, Dong W, Zhang J, Liu W, Yin J, Shi D, Ma W. A Novel Mitochondrial-Related Nuclear Gene Signature Predicts Overall Survival of Lung Adenocarcinoma Patients. Front Cell Dev Biol 2021; 9:740487. [PMID: 34760888 PMCID: PMC8573348 DOI: 10.3389/fcell.2021.740487] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/28/2021] [Indexed: 01/09/2023] Open
Abstract
Background: Lung cancer is the leading cause of cancer-related death worldwide, of which lung adenocarcinoma (LUAD) is one of the main histological subtypes. Mitochondria are vital for maintaining the physiological function, and their dysfunction has been found to be correlated with tumorigenesis and disease progression. Although, some mitochondrial-related genes have been found to correlate with the clinical outcomes of multiple tumors solely. The integrated relationship between nuclear mitochondrial genes (NMGs) and the prognosis of LUAD remains unclear. Methods: The list of NMGs, gene expression data, and related clinical information of LUAD were downloaded from public databases. Bioinformatics methods were used and obtained 18 prognostic related NMGs to construct a risk signature. Results: There were 18 NMGs (NDUFS2, ATP8A2, SCO1, COX14, COA6, RRM2B, TFAM, DARS2, GARS, YARS2, EFG1, GFM1, MRPL3, MRPL44, ISCU, CABC1, HSPD1, and ETHE1) identified by LASSO regression analysis. The mRNA expression of these 18 genes was positively correlated with their relative linear copy number alteration (CNA). Meanwhile, the established risk signature could effectively distinguish high- and low-risk patients, and its predictive capacity was validated in three independent gene expression omnibus (GEO) cohorts. Notably, a significantly lower prevalence of actionable EGFR alterations was presented in patients with high-risk NMGs signature but accompanied with a more inflame immune tumor microenvironment. Additionally, multicomponent Cox regression analysis showed that the model was stable when risk score, tumor stage, and lymph node stage were considered, and the 1-, 3-, and 5-year AUC were 0.74, 0.75, and 0.70, respectively. Conclusion: Together, this study established a signature based on NMGs that is a prognostic biomarker for LUAD patients and has the potential to be widely applied in future clinical settings.
Collapse
Affiliation(s)
- Xiangwei Zhang
- Department of General Thoracic, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Wei Dong
- Department of General Thoracic, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Jishuai Zhang
- Department of General Thoracic, Feicheng Hospital Affiliated to Shandong First Medical University, Feicheng, China
| | - Wenqiang Liu
- Department of General Thoracic, Shenxian County People's Hospital of Shandong Provincial Group, Liaocheng, China
| | - Jingjing Yin
- Department of General Thoracic, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Duozhi Shi
- Lifehealthcare Clinical Laboratories, Hangzhou, China
| | - Wei Ma
- Department of General Thoracic, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| |
Collapse
|
16
|
张 智, 袁 慧, 张 水. [A novel frameshift NDUFV1 mutation in a child with the phenotype of optic nerve atrophy]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:789-792. [PMID: 34134969 PMCID: PMC8214960 DOI: 10.12122/j.issn.1673-4254.2021.05.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the pathogenic gene in a child with optic atrophy and analyze the influence of this gene mutation on protein structure. OBJECTIVE We collected the clinical record of the 13-year-old girl and her relatives. The child received examinations of the visual acuity, visual field, fundus, OCT, visual-evoked potential (VEP) and the nerve system, underwent brain MRI and was followed up for 1 year. Genomic DNA was extracted from the peripheral blood of the child and her parents for next-generation sequencing of the whole exon. The pathogenic gene mutation was identified and the resultant changes in the protein structure was analyzed. OBJECTIVE The patient presented with impaired vision and optic nerve atrophy in both eyes with low amplitude of VEP, but did not show dystonia or pyramidal tract symptom. Brain MRI detected no leukodystrophy. Genetic analysis suggested a heterozygous c.53_54delTG mutation in exon 1 in the NDUFV1 gene of complex I, which caused a frameshift starting with the codon valine 18, thus changing the amino acid to an Alanine residue and creating a premature stop codon at position 20 of the new reading frame (p.Val18AlafsX20). A heterozygous for c.1162+4A>C: IVS8 + 4A>C in intron 8 was also found. Protein structure analysis showed the missing of important structure of NDUFV1 subunit in complex I. OBJECTIVE We identified a novel NDUFV1 mutation in a child with optic nerve atrophy. This finding may provide further insight into the genotype-phenotype correlations for NDUFV1 gene.
Collapse
Affiliation(s)
- 智科 张
- 中日友好医院,北京 100029Department of Ophthalmology, China-Japan Friendship Hospital, Beijing 100029, China
| | - 慧君 袁
- Bascom Palmer眼科中心,美国 33136Bascom Palmer Eye Institute, USA, 33136
| | - 水馨 张
- 北京市海淀区中医医院,北京 100080Beijing Haidian District Traditional Chinese Medicine Hospital, Beijing 100080, China
| |
Collapse
|
17
|
Liu Z, Zhang L, Ren C, Xu M, Li S, Ban R, Wu Y, Chen L, Sun S, Elstner M, Shimura M, Ogawa-Tominaga M, Murayama K, Shi T, Prokisch H, Fang F. Whole genome and exome sequencing identify NDUFV2 mutations as a new cause of progressive cavitating leukoencephalopathy. J Med Genet 2021; 59:351-357. [PMID: 33811136 PMCID: PMC8961761 DOI: 10.1136/jmedgenet-2020-107383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 12/21/2020] [Accepted: 01/10/2021] [Indexed: 11/18/2022]
Abstract
Background Progressive cavitating leukoencephalopathy (PCL) is thought to result from mutations in nuclear genes affecting mitochondrial function and energy metabolism. To date, mutations in two subunits of complex I, NDUFS1 and NDUFV1, have been reported to be related to PCL. Methods Patients underwent clinical examinations, brain MRI, skin biopsy and muscle biopsy. Whole-genome or whole-exome sequencing was performed on the index patients from two unrelated families with PCL. The effects of the mutations were examined through complementation of the NDUFV2 mutation by cDNA expression. Results The common clinical features of the patients in this study were recurring episodes of acute or subacute developmental regression that appeared in the first years of life, followed by gradual remissions and prolonged periods of stability. MRI showed leukoencephalopathy with multiple cavities. Three novel NDUFV2 missense mutations were identified in these families. Complex I deficiency was confirmed in affected individuals’ fibroblasts and a muscle biopsy. Functional and structural analyses revealed that these mutations affect the structural stability and function of the NDUFV2 protein, indicating that defective NDUFV2 function is responsible for the phenotypes in these individuals. Conclusions Here, we report the clinical presentations, neuroimaging and molecular and functional analyses of novel mutations in NDUFV2 in two sibling pairs of two Chinese families presenting with PCL. We hereby expand the knowledge on the clinical phenotypes associated with mutations in NDUFV2 and the genotypes causative for PCL.
Collapse
Affiliation(s)
- Zhimei Liu
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Li Zhang
- Center for Bioinformatics and Computational Biology, Institute of Biomedical Sciences, School of Life Sciences, East China Normal University, Shanghai, China.,Key Laboratory of Advanced Theory and Application in Statistics and Data Science - MOE, School of Statistics, East China Normal University, Shanghai, China
| | - Changhong Ren
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Manting Xu
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Shufang Li
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Rui Ban
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ye Wu
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Ling Chen
- Department of Neurology, Children's Hospital of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Suzhen Sun
- Department of Neurology, Children's Hospital of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Matthias Elstner
- Department of Neurology, Technical University Munich, Munich, Germany
| | - Masaru Shimura
- Center for Medical Genetics, Department of Metabolism, Chiba Children's Hospital, Chiba, Japan
| | - Minako Ogawa-Tominaga
- Center for Medical Genetics, Department of Metabolism, Chiba Children's Hospital, Chiba, Japan
| | - Kei Murayama
- Center for Medical Genetics, Department of Metabolism, Chiba Children's Hospital, Chiba, Japan
| | - Tieliu Shi
- Center for Bioinformatics and Computational Biology, Institute of Biomedical Sciences, School of Life Sciences, East China Normal University, Shanghai, China .,Key Laboratory of Advanced Theory and Application in Statistics and Data Science - MOE, School of Statistics, East China Normal University, Shanghai, China
| | - Holger Prokisch
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China .,Institute of Human Genetics, Technical University Munich, Munich, Germany.,Institute of Neurogenomics, Helmholtz Zentrum Munich, Neuherberg, Germany
| | - Fang Fang
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| |
Collapse
|
18
|
Mitochondrial proteomics alterations in rat hearts following ischemia/reperfusion and diazoxide post‑conditioning. Mol Med Rep 2020; 23:161. [PMID: 33355377 PMCID: PMC7789131 DOI: 10.3892/mmr.2020.11800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 08/07/2020] [Indexed: 02/07/2023] Open
Abstract
Diazoxide post-conditioning (D-Post) has been shown to be effective in alleviating myocardial ischemia/reperfusion (I/R) injury; however, the specific mechanisms are not fully understood. In the present study, isolated rat hearts were subjected to I/R injury and D-Post. The mitochondria were extracted, and mitochondrial protein expression was detected in normal, I/R and D-Post hearts using two-dimensional electrophoresis and matrix-assisted laser desorption ionization-time of flight mass spectrometry. Differentially expressed proteins were then identified using comparative proteomics. In total, five differentially expressed proteins were identified between the I/R and D-Post hearts. Compared with the I/R hearts, the expression of NADH dehydrogenase (ubiquinone) flavoprotein 1 (NDUFV1), NADH-ubiquinone oxidoreductase 75 kDa subunit (NDUFS1), 2-oxoglutarate dehydrogenase (OGDH) and ATP synthase α subunit (isoform CRA_b, gi|149029482) was increased in D-Post hearts. In addition, the expression of another isoform of ATP synthase α subunit (isoform CRA_c, gi|149029480) was decreased in the D-Post group compared with the I/R group. The expression profiles of NDUFV1, NDUFS1 and OGDH in the two groups were further validated via western blotting. The five differentially expressed proteins may be protective effectors in D-Post, as well as potential targets for the treatment of cardiac I/R injury.
Collapse
|
19
|
Novel NDUFA13 Mutations Associated with OXPHOS Deficiency and Leigh Syndrome: A Second Family Report. Genes (Basel) 2020; 11:genes11080855. [PMID: 32722639 PMCID: PMC7465247 DOI: 10.3390/genes11080855] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/10/2020] [Accepted: 07/24/2020] [Indexed: 01/23/2023] Open
Abstract
Leigh syndrome (LS) usually presents as an early onset mitochondrial encephalopathy characterized by bilateral symmetric lesions in the basal ganglia and cerebral stem. More than 75 genes have been associated with this condition, including genes involved in the biogenesis of mitochondrial complex I (CI). In this study, we used a next-generation sequencing (NGS) panel to identify two novel biallelic variants in the NADH:ubiquinone oxidoreductase subunit A13 (NDUFA13) gene in a patient with isolated CI deficiency in skeletal muscle. Our patient, who represents the second family report with mutations in the CI NDUFA13 subunit, presented with LS lesions in brain magnetic resonance imaging, mild hypertrophic cardiomyopathy, and progressive spastic tetraparesis. This phenotype manifestation is different from that previously described in the first NDUFA13 family, which was predominantly characterized by neurosensorial symptoms. Both in silico pathogenicity predictions and oxidative phosphorylation (OXPHOS) functional findings in patient’s skin fibroblasts (delayed cell growth, isolated CI enzyme defect, decreased basal and maximal oxygen consumption and as well as ATP production, together with markedly diminished levels of the NDUFA13 protein, CI, and respirasomes) suggest that these novel variants in the NDUFA13 gene are the underlying cause of the CI defect, expanding the genetic heterogeneity of LS.
Collapse
|
20
|
Zhang J, Liu M, Zhang Z, Zhou L, Kong W, Jiang Y, Wang J, Xiao J, Wu Y. Genotypic Spectrum and Natural History of Cavitating Leukoencephalopathies in Childhood. Pediatr Neurol 2019; 94:38-47. [PMID: 30770271 DOI: 10.1016/j.pediatrneurol.2019.01.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 12/26/2018] [Accepted: 01/01/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND We aimed to delineate the pattern of natural course, neuroimaging features, and the genotypic spectrum of cavitating leukoencephalopathies. METHODS Children (age of onset ≤16 years) who met the criteria for cavitating leukoencephalopathies from January 2009 to October 2018 were identified. Whole-exome sequencing and prospective follow-up study of the natural history and brain magnetic resonance imaging (MRI) were performed. RESULTS Thirty-seven children were clinically diagnosed with cavitating leukoencephalopathies. Pathogenic or likely pathogenic mutations in eight genes were identified in 31 individuals (83.78%): IBA57 (17/37), NDUFS1 (5/37), NDUFV1 (2/37), NDUFV2 (3/37), NDUFAF5 (1/37), LYRM7 (1/37), NDUFB8 (1/37), and GLRX5 (1/37). All genes were engaged in mitochondrial function. IBA57 was identified in half of children. Mutations in NDUFV2, NDUFAF5, NDUFB8, or GLRX5 were first found to be related to cavitating leukoencephalopathies. Follow-up with a median of 23.5 months (four to 107 months) was available. The median age at disease onset was 11 months. All cases presented acute or subacute onset, and the initial presentation was rapid motor regression in 35 cases. Thirty-five children (35/37) exhibited a stabilized or improved pattern. Cavities and high-intensity diffusion-weighted imaging signals were the common MRI features during the acute stage. Although clinically stable, 21 children had reserved high diffusion-weighted imaging signals for a long time. Patients with different gene mutations show different MRI patterns. CONCLUSIONS The study expands the number of genes involved in cavitating leukoencephalopathies to 22. IBA57 is the most common candidate gene. Most cases showed a stabilized or improved pattern after an acute or subacute onset, which is different from most other inherited metabolic diseases or leukodystrophies. More cases and a longer follow-up period are needed.
Collapse
Affiliation(s)
- Jie Zhang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Ming Liu
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Zhongbin Zhang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Ling Zhou
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Weijing Kong
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yuwu Jiang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Jingmin Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Jiangxi Xiao
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Ye Wu
- Department of Pediatrics, Peking University First Hospital, Beijing, China.
| |
Collapse
|
21
|
Djouadi F, Bastin J. Mitochondrial Genetic Disorders: Cell Signaling and Pharmacological Therapies. Cells 2019; 8:cells8040289. [PMID: 30925787 PMCID: PMC6523966 DOI: 10.3390/cells8040289] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 03/19/2019] [Accepted: 03/23/2019] [Indexed: 12/19/2022] Open
Abstract
Mitochondrial fatty acid oxidation (FAO) and respiratory chain (RC) defects form a large group of inherited monogenic disorders sharing many common clinical and pathophysiological features, including disruption of mitochondrial bioenergetics, but also, for example, oxidative stress and accumulation of noxious metabolites. Interestingly, several transcription factors or co-activators exert transcriptional control on both FAO and RC genes, and can be activated by small molecules, opening to possibly common therapeutic approaches for FAO and RC deficiencies. Here, we review recent data on the potential of various drugs or small molecules targeting pivotal metabolic regulators: peroxisome proliferator activated receptors (PPARs), sirtuin 1 (SIRT1), AMP-activated protein kinase (AMPK), and protein kinase A (PKA)) or interacting with reactive oxygen species (ROS) signaling, to alleviate or to correct inborn FAO or RC deficiencies in cellular or animal models. The possible molecular mechanisms involved, in particular the contribution of mitochondrial biogenesis, are discussed. Applications of these pharmacological approaches as a function of genotype/phenotype are also addressed, which clearly orient toward personalized therapy. Finally, we propose that beyond the identification of individual candidate drugs/molecules, future pharmacological approaches should consider their combination, which could produce additive or synergistic effects that may further enhance their therapeutic potential.
Collapse
Affiliation(s)
- Fatima Djouadi
- Centre de Recherche des Cordeliers, INSERM U1138, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, F-75006 Paris, France.
| | - Jean Bastin
- Centre de Recherche des Cordeliers, INSERM U1138, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, F-75006 Paris, France.
| |
Collapse
|
22
|
Wadhwa Y, Rohilla S, Kaushik JS. Cystic Leucoencephalopathy in NDUFV1 Mutation. Indian J Pediatr 2018; 85:1128-1131. [PMID: 29948731 DOI: 10.1007/s12098-018-2721-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/25/2018] [Indexed: 11/28/2022]
Abstract
Complex I deficiency is one of the most common mitochondrial respiratory chain defect. This deficiency of oxidative phosphorylation results from mutation in nuclear and mitochondrial DNA. Mutations in NDUFV1 (Flavin binding subunit of Respiratory complex 1) results in neurological manifestations including Leigh syndrome and leucoencephalopathy. The authors report a one-year-old boy with history of regression of motor milestones following a trivial fall from the bed. His magnetic resonance imaging revealed diffuse, cystic leucoencephalopathy involving corpus callosum and periventricular white matter. Clinical features and radiological findings may resemble those of vanishing white matter disease. Next generation sequencing revealed likely compound heterozygous missense pathogenic variant in exon 8 of NDUFV1 gene [c.1156C > C/T (p.Arg386Cys)] and possibly novel splice site variation in intron 2 of NDUFV1 gene (c.155 + 1G > G/A). NDUFV1 related leucoencephalopathy must be considered among those presenting with sudden onset of motor regression with neuroimaging correlate of diffuse cystic leucodystrophy.
Collapse
Affiliation(s)
- Yamini Wadhwa
- Department of Radiodiagnosis, Pt B D Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Seema Rohilla
- Department of Radiodiagnosis, Pt B D Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Jaya Shankar Kaushik
- Pediatric Neurology Services, Department of Pediatrics, Pt B D Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, 124001, India.
| |
Collapse
|
23
|
Liu M, Zhang J, Zhang Z, Zhou L, Jiang Y, Wang J, Xiao J, Wu Y. Phenotypic spectrum of mutations in IBA57
, a candidate gene for cavitating leukoencephalopathy. Clin Genet 2017; 93:235-241. [PMID: 28671726 DOI: 10.1111/cge.13090] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 06/25/2017] [Accepted: 06/27/2017] [Indexed: 01/17/2023]
Affiliation(s)
- M. Liu
- Department of Paediatrics; Peking University First Hospital; Beijing China
| | - J. Zhang
- Department of Paediatrics; Peking University First Hospital; Beijing China
| | - Z. Zhang
- Department of Paediatrics; Peking University First Hospital; Beijing China
| | - L. Zhou
- Department of Paediatrics; Peking University First Hospital; Beijing China
| | - Y. Jiang
- Department of Paediatrics; Peking University First Hospital; Beijing China
| | - J. Wang
- Department of Paediatrics; Peking University First Hospital; Beijing China
| | - J. Xiao
- Department of radiology; Peking University First Hospital; Beijing China
| | - Y. Wu
- Department of Paediatrics; Peking University First Hospital; Beijing China
| |
Collapse
|
24
|
Sofou K, de Coo IFM, Ostergaard E, Isohanni P, Naess K, De Meirleir L, Tzoulis C, Uusimaa J, Lönnqvist T, Bindoff LA, Tulinius M, Darin N. Phenotype-genotype correlations in Leigh syndrome: new insights from a multicentre study of 96 patients. J Med Genet 2017; 55:21-27. [PMID: 29101127 DOI: 10.1136/jmedgenet-2017-104891] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/21/2017] [Accepted: 10/04/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND Leigh syndrome is a phenotypically and genetically heterogeneous mitochondrial disorder. While some genetic defects are associated with well-described phenotypes, phenotype-genotype correlations in Leigh syndrome are not fully explored. OBJECTIVE We aimed to identify phenotype-genotype correlations in Leigh syndrome in a large cohort of systematically evaluated patients. METHODS We studied 96 patients with genetically confirmed Leigh syndrome diagnosed and followed in eight European centres specialising in mitochondrial diseases. RESULTS We found that ataxia, ophthalmoplegia and cardiomyopathy were more prevalent among patients with mitochondrial DNA defects. Patients with mutations in MT-ND and NDUF genes with complex I deficiency shared common phenotypic features, such as early development of central nervous system disease, followed by high occurrence of cardiac and ocular manifestations. The cerebral cortex was affected in patients with NDUF mutations significantly more often than the rest of the cohort. Patients with the m.8993T>G mutation in MT-ATP6 gene had more severe clinical and radiological manifestations and poorer disease outcome compared with patients with the m.8993T>C mutation. CONCLUSION Our study provides new insights into phenotype-genotype correlations in Leigh syndrome and particularly in patients with complex I deficiency and with defects in the mitochondrial ATP synthase.
Collapse
Affiliation(s)
- Kalliopi Sofou
- Department of Pediatrics, The Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Irenaeus F M de Coo
- Department of Neurology, The Erasmus University Medical Center, Rotterdam, Netherlands
| | - Elsebet Ostergaard
- Department of Clinical Genetics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Pirjo Isohanni
- Department of Paediatric Neurology, Children's Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.,Research Programs Unit, Molecular Neurology, Biomedicum, University of Helsinki, Helsinki, Finland
| | - Karin Naess
- Centre for Inherited Metabolic Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Linda De Meirleir
- Department of Paediatric Neurology, University Hospital Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Charalampos Tzoulis
- Department of Neurology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Johanna Uusimaa
- Department of Paediatrics, Institute of Clinical Medicine, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Tuula Lönnqvist
- Department of Paediatric Neurology, Children's Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Laurence Albert Bindoff
- Department of Neurology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Már Tulinius
- Department of Pediatrics, The Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Niklas Darin
- Department of Pediatrics, The Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
25
|
Helman G, Caldovic L, Whitehead MT, Simons C, Brockmann K, Edvardson S, Bai R, Moroni I, Taylor JM, Van Haren K, Taft RJ, Vanderver A, van der Knaap MS. Magnetic resonance imaging spectrum of succinate dehydrogenase-related infantile leukoencephalopathy. Ann Neurol 2016; 79:379-86. [PMID: 26642834 PMCID: PMC5712845 DOI: 10.1002/ana.24572] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 11/21/2015] [Accepted: 11/24/2015] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Succinate dehydrogenase-deficient leukoencephalopathy is a complex II-related mitochondrial disorder for which the clinical phenotype, neuroimaging pattern, and genetic findings have not been comprehensively reviewed. METHODS Nineteen individuals with succinate dehydrogenase deficiency-related leukoencephalopathy were reviewed for neuroradiological, clinical, and genetic findings as part of institutional review board-approved studies at Children's National Health System (Washington, DC) and VU University Medical Center (Amsterdam, the Netherlands). RESULTS All individuals had signal abnormalities in the central corticospinal tracts and spinal cord where imaging was available. Other typical findings were involvement of the cerebral hemispheric white matter with sparing of the U fibers, the corpus callosum with sparing of the outer blades, the basis pontis, middle cerebellar peduncles, and cerebellar white matter, and elevated succinate on magnetic resonance spectroscopy (MRS). The thalamus was involved in most studies, with a predilection for the anterior nucleus, pulvinar, and geniculate bodies. Clinically, infantile onset neurological regression with partial recovery and subsequent stabilization was typical. All individuals had mutations in SDHA, SDHB, or SDHAF1, or proven biochemical defect. INTERPRETATION Succinate dehydrogenase deficiency is a rare leukoencephalopathy, for which improved recognition by magnetic resonance imaging (MRI) in combination with advanced sequencing technologies allows noninvasive diagnostic confirmation. The MRI pattern is characterized by cerebral hemispheric white matter abnormalities with sparing of the U fibers, corpus callosum involvement with sparing of the outer blades, and involvement of corticospinal tracts, thalami, and spinal cord. In individuals with infantile regression and this pattern of MRI abnormalities, the differential diagnosis should include succinate dehydrogenase deficiency, in particular if MRS shows elevated succinate.
Collapse
Affiliation(s)
- Guy Helman
- Department of Neurology, Children's National Health System, Washington, DC, USA
- Center for Genetic Medicine Research, Children's National Health System, Washington, DC, USA
| | - Ljubica Caldovic
- Center for Genetic Medicine Research, Children's National Health System, Washington, DC, USA
| | - Matthew T. Whitehead
- Department of Neuroradiology, Children's National Health System, Washington, DC, USA
| | - Cas Simons
- Institute for Molecular Bioscience, University of Queensland, St. Lucia, Queensland, Australia
| | - Knut Brockmann
- Department of Pediatrics and Pediatric Neurology, Georg-August University, Gottingen, Germany
| | - Simon Edvardson
- Neuropediatric Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - Isabella Moroni
- Child Neurology Unit, The Foundation “Carlo Besta” Institute of Neurology-IRCCS, Milan, ItalyDivision of Neurology, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - J. Michael Taylor
- Department of Neurology, Lucile Packard Children's Hospital and Stanford University School of Medicine, Stanford, CA, USA
| | | | | | - Ryan J. Taft
- Institute for Molecular Bioscience, University of Queensland, St. Lucia, Queensland, Australia
- School of Medicine & Health Sciences, George Washington University, Washington, DC USA
- Department of Child Neurology, VU University Medical Center, Amsterdam, NL
| | - Adeline Vanderver
- Department of Neurology, Children's National Health System, Washington, DC, USA
- Center for Genetic Medicine Research, Children's National Health System, Washington, DC, USA
- Department of Child Neurology, VU University Medical Center, Amsterdam, NL
| | - Marjo S. van der Knaap
- Department of Functional Genomics, Neuroscience Campus Amsterdam, Amsterdam, NL
- Department of Functional Genomics, Neuroscience Campus Amsterdam, Amsterdam, NL
| |
Collapse
|