mitochondrial myopathies Flashcards

1
Q

what is mitochondrial DNA like

A

Closed circular double stranded molecule
Human mt genome 16.5 kb
5-10 copies of genome in each mitochondrion (a cell has 2-2000 mitochondria)
>900 different mt proteins encoded by nDNA, translated on cytosolic ribosomes, important and then assembled in mt

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2
Q

what are the origins of mitochondria

A
Endosymbiotic origin 
Many features (circular DNA/70S ribosomes) of mt genetic system resemble prokaryotes
Strengthened theory mt are evolutionary descendants of prokaryote
Result of endosymbiotic relationship with ancestral eukaryotic cells early in history of life on earth
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3
Q

how are mitochondria inherited

A

embryo derives all mt from egg, most sperm mt in tail so not absorbed or destroyed if they do enter
maternally

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4
Q

what is the mitochondrial genome

A

Many of the genes needed for mt function have moved from mt into nuclear genome
Mt genome codes for
13 of resp chain proteins, 2 rRNA, 22 tRNA
Another difference – tRNA structures different from nuclear tRNA

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5
Q

how are mitochondria effected by ageing

A

Efficiency declines with age, partly as a result of accumulation of damage and mutations to mtDNA caused by ROS
Defects in OXPHOS are strongly implicated in Alz/Park and T2D
Defects in OXPHOS – involves tissues most reliant on it, occurs later in life, progressive with age, progressive enrichment in mutated mtDNAs

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6
Q

what is REDOX used for

A

REDOX reactions essential for cell metabolism
OIL RIG important for e- carriers NAD+, NADP+, FAD+
Reduction of oxygen O2 +4e->H20
O2 O2- H2O2 OH and OH- H2O (add 1 e-)

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7
Q

what are reactive oxygen species (ROS)

A
Superoxide anion O2-
Hydroxyl radical HO
Peroxide ion O2 2-
Hydrogen peroxide H2O2
Hypochlorous acid (HOCl)
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8
Q

How are ROS generated in the mitochondria

A

by complexes I, III and IV

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9
Q

how is the efficiency of OXPHOS affected by ageing

A

ETC is major producer of ROS
Mt genome suffers greatest exposure to and damage by ROS
Mt DNA less effective at correcting mistakes and damage of DNA

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10
Q

how do mitochondrial diseases occur

A

Arise from defects in mt enzymes and systems eg TCA cycle and OXPHOS rare
Major defects incompatible with life and affected embryos rarely survive
Over 150 different diseases, some linked to mtDNA
Often involve CNS and musculoskeletal system (aka mt myopathies)

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11
Q

how are mitochondrial diseases classified biochemically

A

1 defects of mt transport systems (carnitine palmitoyltransferase CPTI and II) deficiencies
2 defects of substrate utlisation (pyruvate dehydrogenase complex (PDC) deficiency and fatty acid oxidation defects)
3 defects of TCA cycle (fumarase deficiency or a0ketoglutarate dehydrogenase deficiency)
4 defects of OXPHOS coupling (Luft’s syndrome)
5 defects of oxidative phosphorylation (complex I/II/III/IV/V deficiencies – defects of ETC components)

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12
Q

what are mitochondrial myopathies

A

A number of human diseases are attributed to mutations in mt genes in mtDNA that reduce capacity of cells to produce ATP
Group of neuromuscular diseases, most occur before 20, often as exercise intolerance or muscle weakness, other symptoms include HF, heart rhythm disturbances, dementia, deafness, blindness and seizures

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13
Q

how are cells affected by mitochondrial myopathies

A

Some tissues eg neurons, myocytes, skeletal muscle cells and B cells of pancreas are less able to tolerate lowered ATP production

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14
Q

how is inheritance of mitochondrial diseases determined

A

Onset of clinical symptoms, phenotypic variability and variable penetrance of mt disease governed by
Homoplasmy and heteroplasmy of mt – threshold effect
Genetic bottleneck

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15
Q

what is the threshold effect

A

progenitor cell with heterogeneous mt divide, distribute mt unevenly
varying amount of mutant mt, certain percentage will meet threshold and classify as disease

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16
Q

what is a genetic bottleneck

A

small numbers of mother’s mt deleted randomly to go into each egg cell
division in every cell, high level of mutation

17
Q

Mt myopathies caused by mutations in mtDNA

A

LHON – lebers hereditary optic neuropathy
MEREF – myoclonus epilepsy with ragged red fibre
MELAS – mitochondrial encephalomyopathy lactic acidosis and stroke-like episodes
KSS- Kearns-Sayre syndrome

18
Q

what causes LHON syndrome

A

Single base change in mt gene ND4 (arg to his) in a polypeptide of complex 1
Mt partially defective in e- transport from NADH to ubiquinone
Some ATP produced by e transport from succinate but not enough to support very active metabolism of neurons
Single base change in mt gene for cyt b in complex II also produces LHON

19
Q

what results from LHON syndrome

A

Results in damage to optic nerve and blindness

20
Q

what causes MERF syndrome

A

Caused by point mutation in mt gene encoding a tRNA specific for lysine
Disrupts synthesis of many proteins essential for oxidative phosphorylation (ATP synthesis)
Mutation at position 8344 in mt genome in over 80% cases
Many other genes involved and include
Mt-TK/TL1/TH/TF

21
Q

what results from MERF syndrome

A

Skeletal muscle fibres of MERF patients have abnormally shaped mt
Ragged red fibres
Clumps of defective mt accumulation in aerobic skeletal muscle fibres (appear red after staining)

22
Q

what causes MELAS syndrome

A

Gene dysfunction involves mt ND5 (complex I) and mt-TH/TL1/TV (all involved in tRNA)

23
Q

what results from MELAS syndrome

A

Affects primarily brain and skeletal muscle
Symptoms appear in childhood and include build up of lactic acid, stroke like episodes with muscle weakness, seizures leading to vision loss, movement difficulties (including invol muscle spasms (myoclonus) and dementia

24
Q

what causes KSS

A

Results from 5kb deletion of mt genome

25
Q

what results from KSS

A

Onset before 20
Short stature, multiple endocrinopathies incl diabetes
Other symptoms – lactic acidosis, heart conduction defects, raised cerebrospinal fluid protein count

26
Q

how are mt myopathies treated

A

Occupational/physical therapy – range of muscle movement extended, vitamin therapies (eg riboflavin creatine, CoQ, C, K and carnitine may improve function)
No specific treatment – develop genetic strategies for manipulating mt genome

27
Q

how are mt myopathies diagnosed

A

Diagnosis – combination of biochemical tests, histology and genetic testing
Prognosis – variable and dependant on disease type and metabolism

28
Q

how are mt myopathies prevented

A

IVF strategies designed to replace mitochondria inherited
Malfunc mt replaced by donor healthy ones
Merging DNA from mother and healthy mt one
eg mt gene replacement (pronuclear stage) or maternal spindle transfer
latter requires an unfertilised donor egg as opposed to a fertilised one