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Garone C, Garcia-Diaz B, Emmanuele V, Lopez LC, Tadesse S, Akman HO, Tanji K, Quinzii CM, Hirano M. Deoxypyrimidine monophosphate bypass therapy for thymidine kinase 2 deficiency. EMBO Mol Med 2015; 6:1016-27. [PMID: 24968719 PMCID: PMC4154130 DOI: 10.15252/emmm.201404092] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Autosomal recessive mutations in the thymidine kinase 2 gene (TK2) cause mitochondrial DNA depletion, multiple deletions, or both due to loss of TK2 enzyme activity and ensuing unbalanced deoxynucleotide triphosphate (dNTP) pools. To bypass Tk2 deficiency, we administered deoxycytidine and deoxythymidine monophosphates (dCMP+dTMP) to the Tk2 H126N (Tk2(-/-)) knock-in mouse model from postnatal day 4, when mutant mice are phenotypically normal, but biochemically affected. Assessment of 13-day-old Tk2(-/-) mice treated with dCMP+dTMP 200 mg/kg/day each (Tk2(-/-200dCMP/) (dTMP)) demonstrated that in mutant animals, the compounds raise dTTP concentrations, increase levels of mtDNA, ameliorate defects of mitochondrial respiratory chain enzymes, and significantly prolong their lifespan (34 days with treatment versus 13 days untreated). A second trial of dCMP+dTMP each at 400 mg/kg/day showed even greater phenotypic and biochemical improvements. In conclusion, dCMP/dTMP supplementation is the first effective pharmacologic treatment for Tk2 deficiency.
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Affiliation(s)
- Caterina Garone
- Department of Neurology, Columbia University Medical Center, New York, NY, USA Human Genetics Joint PhD Program, University of Bologna and Turin, Turin, Italy
| | - Beatriz Garcia-Diaz
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Valentina Emmanuele
- Department of Neurology, Columbia University Medical Center, New York, NY, USA Pediatric Clinic University of Genoa IRCCS G. Gaslini Institute, Genoa, Italy
| | - Luis C Lopez
- Instituto de Biotecnología, Centro de Investigación Biomédica, Universidad de Granada Parque Tecnológico de Ciencias de la Salud, Armilla, Spain
| | - Saba Tadesse
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Hasan O Akman
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Kurenai Tanji
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Catarina M Quinzii
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Michio Hirano
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
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