Mitochondrial Myopathies Flashcards

1
Q

Origins of the mitochondrion:

A
  • Endosymbiotic origin
  • circular DNA/70s ribosomes in
    mitochondria are also found in prokaryotes
  • evolutionary descendants
  • result of an endosymbiotic relationship
    with ancestral eukaryotic cells
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2
Q

Mitochondrial Inheritance:

A
  • the embryo derives all its mitochondria
    from the egg
  • most sperm mitochondria are located in
    the tail and hence not absorbed upon
    fertilisation
  • any paternal mitochondria that do enter
    the egg are destroyed
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3
Q

How many different mitochondrial proteins are encoded by nuclear DNA on cytosolic ribsomes, imported and then assembled in the mitochondrion?

A

Over 900

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4
Q

How many copies of the genome are there in each mitochondrion?

A

5 - 10 copies

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5
Q

Mitochondrial Genome

A
  • many genes needed for mitochondrial
    function have moved from mitochondrion
    into nuclear genome
  • mt genome codes for:
    • 13 respiratory chain proteins
    • 2 rRNA
    • 22 tRNA
  • mt genetic code differs from the normal
    universal genetic code
  • tRNA structure differs from nuclear
    encoded tRNA
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6
Q

Mitochondria and ageing:
- respiratory chain is a major producer what
damaging substances
- elaborate on effect

A
  • respiratory chain is the major producer of
    reactive oxygen species (ROS)
  • mt genome suffers the greatest exposure
    to and damage by ROS
  • mt genome is less effective at correcting
    mistakes and repairing mt DNA damage
  • consequently defects in mtDNA
    accumulate with age and mt DNA mutates
    more rapidly (10 x ***) than nuclear DNA
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7
Q

Efficiency of oxidative phosphorylation (3):

A
  • declines with age
  • ***partly as a result of the accumulation of
    mutations to mtDNA caused by ROS
  • oxidative phosphorylation enzyme defects
    are strongly implicated in Alzheimer’s,
    Parkinsons and type II diabetes
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8
Q

Defects in oxidative phosphorylation:

A
  • involves tissues most reliant on oxidative
    phosphorylation eg muscle, brain, neurons
  • occurs later in life and progressive with age
    -> enrichment in mutated mtDN
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9
Q

Mitochondrial Diseases:
- are
- mostly involve

A
  • defects in mt enzmes and systems eg TCA
    cycle and oxidative phosphorylation are
    rare (most die in fetus)
  • most involve central nervous system and
    musculoskeletal system
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10
Q

Mitochondrial myopathies:

A
  • some tissuess/cells like beta cells of
    pancreas and neurons are less able to
    tolerate lowered ATP production

mt myopathies: group of neuromuscular diseases:
- most occur before the age of 20, with
exercise intolerance or muscle weakness
- other symptoms include heart
failure/arryhtmias/ demantia/
deafness/blindness/seizures

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11
Q

Heterogeneity of mitochondrial diseases:
- onset of clinical symptoms, phenotypic
variability and variable penetrance of mt
diseases are governed by (2):

A
  • homoplasmy and heteroplasmy of mt =
    threshold effect
  • Mt genetic bottleneck
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12
Q

Threshold effect for mitochondrial myopathies:

A
  • 70% mutant will express dysfunction
    (generally)
  • at cell division, mitochondria are
    distributed unequally and do not
    necessarily reflect the ratio of normal:
    abnormal mitochondria found in the
    progenitor cell
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13
Q

Heteroplasmic cell

A

both normal and mutant mt DNA present

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14
Q

Mt genetic bottleneck:

A
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15
Q

Biochemical classification of mt myopathies (5):

A

1) Defects of the mitochondrial transport
systems
2) Defects of substrate utilisation
3) Defects of the TCA Cycle
4) Defects of oxidative phosphorylation
coupling
5) Defects of oxidative phsophorylation

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16
Q

1) Defects of mitochondrial transport systems:

A
  • Carnitine palmitoyl transferase deficiencies
17
Q

2) Defects of substrate utilisation:

A
  • pyruvate dehydrogenase complex
  • fatty acid oxidation defects
18
Q

3) Defects of the TCA Cycle:

A
  • fumurase deficiency
  • alpha ketoglutarate dehydrogenase
    deficiency
19
Q

4) Defects of oxidative phosphorylation
coupling:

A
  • Luft’s syndrome
20
Q

5) Defects of oxidative phosphorylation:

A
  • Complexes 1,2,3,4,5 deficiences combined
    defects of the respiratory chain
    components
21
Q

LHON stands for

A
  • Lebers hereditary optic neuropathy
  • mitochondrial myopathy
22
Q

MERFF stands for

A
  • myoclonus epilepsy with ragged red fibre
  • mitochondrial myopathy
23
Q

LHON Syndrome: Leber’s hereditary optic neuropathy:

A
  • single base change in mt gene ND4 in
    polypeptide of Complex 1**
  • **mt partially defective in e- transport
    from NADH to Ubiquinone
  • some ATP produced by e- transport from
    succinagte but not enough to support the
    very active metabolism of neurons
  • **results in damage to optic nerve;
    blindness
  • ** single base change in cyt b in complex III
    also
24
Q

MERRF Syndrome: Myoclonus epilepsy with ragged red fibre:

A
  • caused by a point mutation in gene coding
    ***for tRNA lysine
  • disrupts synthesis of proteins essential for
    oxidative phosphorylation (APT synthesis)
  • 80% mutation at position 8344
  • skeletal fibres of MERRF pts have
    **abnormally shaped mitochondria
25
Q

Ragged red fibres

A
  • ***clumps of defective mitochondria
    accumulate in aerobic skelatal muscle
    fibres and appear red after staining
26
Q

Diagnosis of mitochondrial myopathies:

A
  • combination of biochem tests, histology,
    genetic testing
  • initial blood/urine metabolite analysis
    (lactate)
  • muscle biopsy: activation of mt enzymes,
    rates of oxidative phosphorylation,
    substrate utilisation, ATP synthesis
  • genetic screening to identify mutations
27
Q

Prognosis of mt myopthies:

A
  • variable and dependent on types of
    disease and pts metabolism
28
Q

Treatment of mt myopthies:

A
  • occupational therapy may extend range of
    muscle movement
  • vitamin therapies: riboflavin, carnitine etc
    may help some
  • no specific treatments; GENETIC STRATEGY
    development
29
Q

Prevention of mitochondrial myopathies:

A
  • IVF strategy designed to replace defective
    mt inherited from a mother
  • strategy involves merging DNA from two
    eggs; one from mother with defect and
    another from healthy donor
  • malfunction mt replaced by the donor
    healthy ones
  • approved in 2015, 2017 first license
30
Q

Mitochondrial Gene Replacement: Pronuclear Stage:

A
  • fertilised egg with abnormal mitochondria
  • pronuclei removed from abnoral zygote
    and transferred to a normal donor egg
    which is enucleated
  • zygote reconstructed with normal
    mitochondria
31
Q

Mitochondrial Gene Replacement: Maternal Spindle Transfer:

A
  • unfertilised abnormal egg
  • spindle and chromosomes removed
  • fused into an enuclleated donor egg
  • then fertilisation