Peculiar combinations of individually non-pathogenic missense mitochondrial DNA variants cause low penetrance Leber's hereditary optic neuropathy.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101239074 Publication Model: eCollection Cited Medium: Internet ISSN: 1553-7404 (Electronic) Linking ISSN: 15537390 NLM ISO Abbreviation: PLoS Genet Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science, c2005-

Multifactorial Inheritance* ; Mutation, Missense* ; Penetrance*; DNA, Mitochondrial/*genetics ; Optic Atrophy, Hereditary, Leber/*genetics; Adult ; Amino Acid Sequence ; Electron Transport Complex I/chemistry ; Electron Transport Complex I/genetics ; Epistasis, Genetic ; Family ; Female ; Genes, Mitochondrial ; Humans ; Male ; Models, Molecular ; NADH Dehydrogenase/chemistry ; NADH Dehydrogenase/genetics ; Pedigree ; Young Adult

We here report on the existence of Leber's hereditary optic neuropathy (LHON) associated with peculiar combinations of individually non-pathogenic missense mitochondrial DNA (mtDNA) variants, affecting the MT-ND4, MT-ND4L and MT-ND6 subunit genes of Complex I. The pathogenic potential of these mtDNA haplotypes is supported by multiple evidences: first, the LHON phenotype is strictly inherited along the maternal line in one very large family; second, the combinations of mtDNA variants are unique to the two maternal lineages that are characterized by recurrence of LHON; third, the Complex I-dependent respiratory and oxidative phosphorylation defect is co-transferred from the proband's fibroblasts into the cybrid cell model. Finally, all but one of these missense mtDNA variants cluster along the same predicted fourth E-channel deputed to proton translocation within the transmembrane domain of Complex I, involving the ND1, ND4L and ND6 subunits. Hence, the definition of the pathogenic role of a specific mtDNA mutation becomes blurrier than ever and only an accurate evaluation of mitogenome sequence variation data from the general population, combined with functional analyses using the cybrid cell model, may lead to final validation. Our study conclusively shows that even in the absence of a clearly established LHON primary mutation, unprecedented combinations of missense mtDNA variants, individually known as polymorphisms, may lead to reduced OXPHOS efficiency sufficient to trigger LHON. In this context, we introduce a new diagnostic perspective that implies the complete sequence analysis of mitogenomes in LHON as mandatory gold standard diagnostic approach.

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0 (DNA, Mitochondrial)
0 (NADH dehydrogenase subunit 4)
EC 1.6.99.3 (MT-ND6 protein, human)
EC 1.6.99.3 (NADH Dehydrogenase)
EC 1.6.99.3 (NADH dehydrogenase subunit 1, human)
EC 7.1.1.2 (Electron Transport Complex I)

Date Created: 20180215 Date Completed: 20180718 Latest Revision: 20191210

20231215

PMC5828459

10.1371/journal.pgen.1007210

29444077