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Recurrent De Novo Dominant Mutations in SLC2SA4 Cause Severe Early-Onset Mitochondrial Disease and Loss of Mitochondrial DNA Copy Number

Lookup NU author(s): Dr Kyle Thompson, Dr Charlotte Alston, Dr Langping He, Professor Bobby McFarlandORCiD, Professor Robert Taylor

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Mutations in SLC25A4 encoding the mitochondrial ADP/ATP carrier AAC1 are well-recognized causes of mitochondrial disease. Several heterozygous SLC25A4 mutations cause adult-onset autosomal-dominant progressive external ophthalmoplegia associated with multiple mitochondrial DNA deletions, whereas recessive SLC25A4 mutations cause childhood-onset mitochondrial myopathy and cardiomyopathy. Here, we describe the identification by whole-exome sequencing of seven probands harboring dominant, de novo SLC25A4 mutations. All affected individuals presented at birth, were ventilator dependent and, where tested, revealed severe combined mitochondria' respiratory chain deficiencies associated with a marked loss of mitochondria' DNA copy number in skeletal muscle. Strikingly, an identical c.239G>A (p.Arg80His) mutation was present in four of the seven subjects, and the other three case subjects harbored the same c.703C>G (p.Arg235Gly) mutation. Analysis of skeletal muscle revealed a marked decrease of AAC1 protein levels and loss of respiratory chain complexes containing mitochondria' DNA-encoded subunits. We show that both recombinant AAC1 mutant proteins are severely impaired in ADP/ATP transport, affecting most likely the substrate binding and mechanics of the carrier, respectively. This highly reduced capacity for transport probably affects mitochondria' DNA maintenance and in turn respiration, causing a severe energy crisis. The confirmation of the pathogenicity of these de novo SLC25A4 mutations highlights a third distinct clinical phenotype associated with mutation of this gene and demonstrates that early-onset mitochondria' disease can be caused by recurrent de novo mutations, which has significant implications for the application and analysis of whole-exome sequencing data in mitochondrial disease.


Publication metadata

Author(s): Thompson K, Majd H, Dallabona C, Reinson K, King MS, Alston CL, He LP, Lodi T, Jones SA, Fattal-Valevski A, Fraenkel ND, Saada A, Haham A, Isohanni P, Vara R, Barbosa IA, Simpson MA, Deshpande C, Puusepp S, Bonnen PE, Rodenburg RJ, Suomalainen A, Õunap K, Elpeleg O, Ferrero I, McFarland R, Kunji ERS, Taylor RW

Publication type: Article

Publication status: Published

Journal: American Journal of Human Genetics

Year: 2016

Volume: 99

Issue: 4

Pages: 860-876

Print publication date: 06/10/2016

Online publication date: 29/09/2016

Acceptance date: 18/08/2016

Date deposited: 08/12/2016

ISSN (print): 0002-9297

ISSN (electronic): 1537-6605

Publisher: Cell Press

URL: http://dx.doi.org/10.1016/j.ajhg.2016.08.014

DOI: 10.1016/j.ajhg.2016.08.014


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Funding

Funder referenceFunder name
Academy of Finland
Department of Health via the NIHR comprehensive Biomedical Research Centre award to Guy's and St. Thomas' NHS Foundation Trust in partnership with the King's College London
Helsinki University Hospital Funds
UK NHS Highly Specialised "Rare Mitochondrial Disorders of Adults and Children" Service in Newcastle upon Tyne
Jane and Aatos Erkko Foundation
Lily Foundation
Sigrid Juselius Foundation
096919/Z/11/ZWellcome Trust
8175Estonian Science Foundation
G0601943MRC Centre for Neuromuscular Diseases
GGP15041Fondazione Telethon (Italy)
NIHR-HCS-D12-03-04NIHR/CSO Healthcare Science Research Fellowship from the National Institute for Health Research
MC_U105663139Medical Research Council UK
R01NS083726National Institute of Neurological Disorders and Stroke of the National Institutes of Health
PUT355Estonian Science Foundation

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