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de Muijnck C, van Schooneveld MJ, Plomp AS, Rodenburg RJ, van Genderen MM, Boon CJ. Leber's hereditary optic neuropathy like disease in MT-ATP6 variant m.8969G>A. Am J Ophthalmol Case Rep 2024; 34:102070. [PMID: 38756953 PMCID: PMC11096717 DOI: 10.1016/j.ajoc.2024.102070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/15/2024] [Accepted: 04/19/2024] [Indexed: 05/18/2024] Open
Abstract
Purpose To describe a case with Leber's hereditary optic neuropathy (LHON) like optic atrophy in the presence of MT-ATP6 gene variant m.8969G > A. Observations A 20-year-old patient with a history of mild developmental delay, mild cognitive impairment, and positional tremor presented with subacute painless visual loss over a few weeks. Mitochondrial genome sequencing revealed a variant in MT-ATP6, m.8969G > A (p.Ser148Asn). This variant was previously reported in association with mitochondrial myopathy, lactic acidosis, and sideroblastic anemia (MLASA) and with nephropathy, followed by brain atrophy, muscle weakness and arrhythmias, but not with optic atrophy. Conclusions and importance Rare variants in MT-ATP6 can also cause LHON like optic atrophy. It is important to perform further genetic analysis of mitochondrial DNA in genetically unsolved cases suspected of Leber's hereditary optic neuropathy to confirm the clinical diagnosis.
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Affiliation(s)
- Cansu de Muijnck
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands
- Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Mary J. van Schooneveld
- Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Astrid S. Plomp
- Department of Human Genetics, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - Richard J. Rodenburg
- Radboud Center for Mitochondrial Medicine, Departments of Pediatrics and Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Maria M. van Genderen
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands
- Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, the Netherlands
| | - Camiel J.F. Boon
- Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
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Giannoccaro MP, Morelli L, Ricciardiello F, Donadio V, Bartiromo F, Tonon C, Carbonelli M, Amore G, Carelli V, Liguori R, La Morgia C. Co-occurrence of glial fibrillary acidic protein astrocytopathy in a patient with Leber's hereditary optic neuropathy due to DNAJC30 mutations. Eur J Neurol 2024:e16344. [PMID: 38757769 DOI: 10.1111/ene.16344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/29/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024]
Abstract
Leber's hereditary optic neuropathy (LHON) is a mitochondrial disease characterized by visual loss, and rarely associated with extraocular manifestations including multiple sclerosis-like lesions. The association of LHON and neuromyelitis optica spectrum disorders has rarely been reported. Here is reported a case of glial fibrillary acidic protein astrocytopathy presenting with area postrema syndrome in a patient with previously diagnosed recessive LHON due to mutations in the nuclear gene DNAJC30. This case emphasizes the necessity of extensive investigations for other treatable conditions in patients with LHON and otherwise unexplained extraocular involvement and the possibility that also visual symptoms can respond to immune therapy.
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Affiliation(s)
- Maria Pia Giannoccaro
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Luana Morelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Vincenzo Donadio
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Fiorina Bartiromo
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Caterina Tonon
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Michele Carbonelli
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Giulia Amore
- Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Valerio Carelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Rocco Liguori
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Chiara La Morgia
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
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Mauring L, Puusepp S, Parik M, Roomets E, Teek R, Reimand T, Pajusalu S, Kaljurand K, Õunap K. Autosomal recessive Leber's hereditary optic neuropathy caused by a homozygous variant in DNAJC30 gene. Eur J Med Genet 2023; 66:104821. [PMID: 37579815 DOI: 10.1016/j.ejmg.2023.104821] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/18/2023] [Accepted: 08/10/2023] [Indexed: 08/16/2023]
Abstract
Recently, Stenton et al. (2021) described a new, autosomal recessive inheritance pattern of Leber's hereditary optic neuropathy (LHON) caused by missense variants in the DNAJC30 gene. The DNAJC30 c.152A > G, p.(Tyr51Cys) variant was by far the most common variant reported in patients originating from Eastern Europe, therefore, it is believed to be a founder variant in these populations. We report the first two cases of DNAJC30-linked autosomal recessive LHON in a young male and a female originating from Estonia. The patients presented severe loss of central vision and clinical features indistinguishable from mitochondrial LHON. The whole exome sequencing carried out in the male patient and the next-generation sequencing panel in the young female patient identified the same homozygous missense variant in the DNAJC30 gene. Our cases further reinforce the pathogenicity of c.152A > G, p.(Tyr51Cys) DNAJC30 variant causing autosomal recessive LHON. According to the gnomAD database, the allele frequency of this variant in the Estonian population is 0.8%, translating into a prevalence of carriers of 1:60. It is the highest among different gnomAD populations. Applying the Hardy-Weinberg equation, an estimated 92 persons in the Estonian population carry the homozygous variant c.152A > G, p.(Tyr51Cys) in DNAJC30. In patients with LHON, we advise sequencing both the DNAJC30 gene and mitochondrial DNA simultaneously.
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Affiliation(s)
- L Mauring
- Genetics and Personalized Medicine Clinic, Tartu University Hospital, Tartu, Estonia; Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia; Eye Clinic, Tartu University Hospital, Tartu, Estonia.
| | - S Puusepp
- Genetics and Personalized Medicine Clinic, Tartu University Hospital, Tartu, Estonia; Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - M Parik
- Eye Clinic, Tartu University Hospital, Tartu, Estonia
| | - E Roomets
- Tallinn's Children's Hospital, Tallinn, Estonia
| | - R Teek
- Genetics and Personalized Medicine Clinic, Tartu University Hospital, Tartu, Estonia
| | - T Reimand
- Genetics and Personalized Medicine Clinic, Tartu University Hospital, Tartu, Estonia; Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - S Pajusalu
- Genetics and Personalized Medicine Clinic, Tartu University Hospital, Tartu, Estonia; Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - K Kaljurand
- Eye Clinic, Tartu University Hospital, Tartu, Estonia; Department of Eye Clinic, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - K Õunap
- Genetics and Personalized Medicine Clinic, Tartu University Hospital, Tartu, Estonia; Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
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Miao Q, Cheng Y, Zheng H, Yuan J, Chen C. PhNR and Peripapillary RNFL Changes in Leber Hereditary Optic Neuropathy With m.G11778A Mutation. Mitochondrion 2023; 70:111-117. [PMID: 37127073 DOI: 10.1016/j.mito.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/08/2023] [Accepted: 04/23/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE To analyze the functional and structural changes in retinal ganglion cells (RGCs) and their axons that occur during Leber's hereditary optic neuropathy (LHON) using photopic negative response (PhNR) and spectral domain optical coherence tomography (SD-OCT). METHODS Individuals diagnosed with LHON and their family members were invited to participate in this cross-sectional study. PhNR and OCT were used. The PhNR amplitude and peripapillary retinal nerve fiber layer (pRNFL) thicknesses were compared among the three groups. In addition, affected individuals were divided into subacute, dynamic and chronic phases based on disease duration in order to evaluate the decay in RGCs function and structure. RESULTS 73 affected and 30 carriers with a m.11778G>A mutation were included. PhNR amplitude and the thickness of pRNFL significantly decreased in affected individuals and carriers compared to that of the controls (P<0.001). However, there was no difference between the carriers and the controls (P>0.05). There was no difference in the PhNR amplitude of different phases (P=0.464). In the subacute phase, only temporal pRNFL thickness decreased significantly (P<0.001). PRNFL thickness decreased significantly in dynamic phase (P<0.001). Temporal pRNFL thickness continued to decrease in the chronic phase (P=0.042). CONCLUSION In the subacute phase, the function of RGCs was severely impaired. Thickness of pRNFL decreased significantly in four quadrants during disease progression. In the chronic phase, pRNFL thickness decreased slightly. Carriers have shown RGCs dysfunction before pathological changes occur, suggesting subclinical abnormalities.
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Affiliation(s)
- Qingmei Miao
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yufang Cheng
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Hongmei Zheng
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Jiajia Yuan
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Changzheng Chen
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China.
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Affiliation(s)
- Mayur R Moreker
- Department of Ophthalmology, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Tanuj R Sharma
- Department of Ophthalmology, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
| | - Satish V Khadilkar
- Department of Neurology, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
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Rotsos T, Papakonstantinou E, Symeonidis C, Krassas A, Kamakari S. Wolfram Syndrome: A case report of two sisters Wolfram Syndrome: Case report of two sisters. Am J Ophthalmol Case Rep 2022; 26:101452. [PMID: 35252627 PMCID: PMC8892096 DOI: 10.1016/j.ajoc.2022.101452] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To present a case of two siblings with optic atrophy associated with Wolfram Syndrome. OBSERVATIONS Two young adult siblings presented with serious bilateral loss of vision and dyschromatopsia established in early adolescence. They were referred with a presumed diagnosis of Leber's Hereditary Optic Neuropathy. At baseline, visual acuity was 20/400 in the right eye and 20/200 in the left eye in patient A and 20/200 in both eyes in patient B, color perception tested with pseudo-isochromatic plates was 0/17 in each eye, optic discs were pale, visual field testing revealed diffuse scotomas bilaterally while electrophysiology showed delayed prominent positive deflection (P100) values in both patients. Personal history revealed Type 1 diabetes mellitus since early childhood. Patients were lost to follow-up and presented 4 years later with significant VA decrease (<20/400) and suspected hearing loss. At that point, genetic testing revealed a pathogenic variation in the WFS1 gene thus confirming the diagnosis of Wolfram syndrome. Treatment with idebenone was proposed, to which only one of the siblings agreed. The other patient remained under observation, as no known treatment for optic atrophy in Wolfram syndrome exists to date. CONCLUSIONS AND IMPORTANCE Wolfram syndrome is a rare neurodegenerative genetic disease associated with diabetes mellitus, optic atrophy and deafness. Careful and detailed medical and family history led to appropriate testing that confirmed the diagnosis of Wolfram syndrome. To this day, there is no definite treatment for this disease, but the experimental use of idebenone has been suggested to improve visual function. Genetic testing of family members and offspring of patients is strongly recommended.
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Affiliation(s)
- Tryfon Rotsos
- 1st Department of Ophthalmology, University of Athens, G. Gennimatas General Hospital, 154 Mesogion Av., 115 27, Athens, Greece
| | - Evangelia Papakonstantinou
- 1st Department of Ophthalmology, University of Athens, G. Gennimatas General Hospital, 154 Mesogion Av., 115 27, Athens, Greece
| | - Chrysanthos Symeonidis
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki Ring Road, 546 03, Thessaloniki, Greece
- Corresponding author. 44 Tsimiski str., 546 23, Thessaloniki, Greece.
| | - Augoustinos Krassas
- 1st Department of Ophthalmology, University of Athens, G. Gennimatas General Hospital, 154 Mesogion Av., 115 27, Athens, Greece
| | - Smaragda Kamakari
- Ophthalmic Genetics Unit, OMMA Institute, 74 Katechaki Str., 115 25, Athens, Greece
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Jiang J, Sun G, Miao Q, Li B, Wang D, Yuan J, Chen C. Observation of Peripapillary Choroidal Vascularity in Natural Disease Course and After Gene Therapy for Leber's Hereditary Optic Neuropathy. Front Med (Lausanne) 2021; 8:770069. [PMID: 34950684 PMCID: PMC8691380 DOI: 10.3389/fmed.2021.770069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/18/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose: To compare peripapillary choroidal vascularity among Leber's Hereditary Optic Neuropathy (LHON) patients at different stages of natural course and healthy controls using optical coherence tomography (OCT), and to evaluate peripapillary choroidal vascularity changes in LHON patients before and after gene therapy. Methods: 57 LHON patients and 15 healthy controls were enrolled in this prospective clinical study. LHON patients were divided into three duration groups based on stage of disease progression. Both patients and healthy controls underwent OCT scans focused on the optic disc at baseline with Heidelberg Spectralis, and patients underwent OCT at 1, 3, and 6 months after gene therapy. OCT images were converted and binarized using ImageJ software. Choroidal thickness (CT), total choroidal area (TCA), and choroidal vascularity index (CVI) in each quadrant of OCT images were measured to evaluate peripapillary choroidal vascularity. Results: At baseline, the average CT was not significantly different between LHON patients at different stages and between healthy controls (P = 0.468). Although average TCA and average CVI were slightly higher in LHON patients at different stages than in healthy controls, the difference was not statistically significant (P = 0.282 and 0.812, respectively). After gene therapy, The average TCA at 1 month after gene therapy was significantly higher than that before gene therapy (P = 0.003), while no significant differences were found in the average CT or average CVI in LHON patients before and 1,3 and 6 months after gene therapy using pairwise comparisons (all P > 0.05). Conclusions: No significant difference was found in choroidal vascularity of LHON patients at different stages and healthy controls. Choroidal vascularity seems to stay stable after gene therapy.
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Affiliation(s)
- Jingwen Jiang
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Gongpeng Sun
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qingmei Miao
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Bin Li
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Neurophth Biotechnology Co., Ltd. Wuhan, China
| | - Dan Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiajia Yuan
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Changzheng Chen
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, China
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Wang Y, Hu LF, Cui PF, Qi LY, Xing L, Jiang HL. Pathologically Responsive Mitochondrial Gene Therapy in an Allotopic Expression-Independent Manner Cures Leber's Hereditary Optic Neuropathy. Adv Mater 2021; 33:e2103307. [PMID: 34431574 DOI: 10.1002/adma.202103307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/20/2021] [Indexed: 06/13/2023]
Abstract
Leber's hereditary optic neuropathy (LHON) is a rare inherited blindness caused by mutations in the mitochondrial DNA (mtDNA). The disorder is untreatable and tricky, as the existing chemotherapeutic agent Idebenone alleviates symptoms rather than overcoming the underlying cause. Although some studies have made progress on allotopic expression for LHON, in situ mitochondrial gene therapy remains challenging, which may simplify delivery procedures to be a promising therapeutic for LHON. LHON becomes more difficult to manage in the changed mitochondrial microenvironment, including increasing reactive oxygen species (ROS) and decreasing mitochondrial membrane potential (MMP). Herein, a pathologically responsive mitochondrial gene delivery vector named [triphenylphosphine-terminated poly(sulfur-containing thioketal undecafluorohexylamine histamine) and Ide-terminated poly(sulfur-containing thioketal undecafluorohexylamine histamine)] (TISUH) is reported to facilitate commendable in situ mitochondrial gene therapy for LHON. TISUH directly targets diseased mitochondria via triphenylphosphine and fluorination addressing the decreasing MMP. In addition, TISUH can be disassembled by high mitochondrial ROS levels to release functional genes for enhancing gene transfection efficiency and fundamentally correcting genetic abnormalities. In both traditional and gene-mutation-induced LHON mouse models, TISUH-mediated gene therapy shows satisfactory curative effect through the sustained therapeutic protein expression in vivo. This work proposes a novel pathologically responsive in situ mitochondrial delivery platform and provides a promising approach for refractory LHON as well as other mtDNA mutated diseases treatments.
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Affiliation(s)
- Yi Wang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Li-Fan Hu
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Peng-Fei Cui
- School of Pharmacy, Changzhou University, Changzhou, 213164, China
| | - Lian-Yu Qi
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Lei Xing
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
- Jiangsu Key Laboratory of Druggability of Biopharmaceuticals, China Pharmaceutical University, Nanjing, 210009, China
- Jiangsu Key Laboratory of Drug Discovery for Metabolic Diseases, China Pharmaceutical University, Nanjing, 210009, China
| | - Hu-Lin Jiang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
- Jiangsu Key Laboratory of Druggability of Biopharmaceuticals, China Pharmaceutical University, Nanjing, 210009, China
- Jiangsu Key Laboratory of Drug Discovery for Metabolic Diseases, China Pharmaceutical University, Nanjing, 210009, China
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Beckmann Y, Uzunköprü C, Subaşıoğlu A. Mitochondrial Mutations in Multiple Sclerosis Patients with Atypical Optic Neuropathy. Mult Scler Relat Disord 2021; 55:103166. [PMID: 34333271 DOI: 10.1016/j.msard.2021.103166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/03/2021] [Accepted: 07/22/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Multiple sclerosis-related optic neuritis is mostly associated with good recovery. The aim of this study was to investigate the causes of progressive visual worsening in multiple sclerosis patients despite treatment. METHODS We retrospectively reviewed the medical records of multiple sclerosis patients with optic neuritis admitted to the ward of our Neurology Department between 2001 and 2020. The patients with unilateral/bilateral progressive visual loss or non-substantial recovery of visual acuity were screened for genetic testing for Leber's hereditary optic neuropathy. RESULTS Of 1014 multiple sclerosis patients, 411 (39%) reported having optic neuritis. During follow-up, 11 patients manifested atypical characteristics of multiple sclerosis-related optic neuritis (presence of one of the following clinical findings: bilateral simultaneous or sequential eye involvement, progressive visual loss, or no response to corticosteroids during hospitalization), while others presented with typical multiple sclerosis-related optic neuritis. Those multiple sclerosis patients with atypical characteristics of optic neuritis were screened for other possible etiologies of optic neuropathy. We found pathogenic mitochondrial mutations in 5 patients with multiple sclerosis in our study group. CONCLUSION In our study group, the prevalence of mitochondrial mutations among all multiple sclerosis patients with optic neuritis was 0.12%. We strongly recommend investigating Leber's hereditary optic neuropathy mutations in MS patients if they suffer from severe or bilateral visual loss without recovery during follow-up. Because Leber's hereditary optic neuropathy mitochondrial mutations indicate relatively poor visual prognosis and have important implications for genetic counseling.
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Peron C, Maresca A, Cavaliere A, Iannielli A, Broccoli V, Carelli V, Di Meo I, Tiranti V. Exploiting hiPSCs in Leber's Hereditary Optic Neuropathy (LHON): Present Achievements and Future Perspectives. Front Neurol 2021; 12:648916. [PMID: 34168607 PMCID: PMC8217617 DOI: 10.3389/fneur.2021.648916] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/26/2021] [Indexed: 01/19/2023] Open
Abstract
More than 30 years after discovering Leber's hereditary optic neuropathy (LHON) as the first maternally inherited disease associated with homoplasmic mtDNA mutations, we still struggle to achieve effective therapies. LHON is characterized by selective degeneration of retinal ganglion cells (RGCs) and is the most frequent mitochondrial disease, which leads young people to blindness, in particular males. Despite that causative mutations are present in all tissues, only a specific cell type is affected. Our deep understanding of the pathogenic mechanisms in LHON is hampered by the lack of appropriate models since investigations have been traditionally performed in non-neuronal cells. Effective in-vitro models of LHON are now emerging, casting promise to speed our understanding of pathophysiology and test therapeutic strategies to accelerate translation into clinic. We here review the potentials of these new models and their impact on the future of LHON patients.
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Affiliation(s)
- Camille Peron
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alessandra Maresca
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy
| | - Andrea Cavaliere
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Angelo Iannielli
- San Raffaele Scientific Institute, Milan, Italy.,National Research Council (CNR), Institute of Neuroscience, Milan, Italy
| | - Vania Broccoli
- San Raffaele Scientific Institute, Milan, Italy.,National Research Council (CNR), Institute of Neuroscience, Milan, Italy
| | - Valerio Carelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences-DIBINEM, University of Bologna, Bologna, Italy
| | - Ivano Di Meo
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Valeria Tiranti
- Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Sun CB, Bai HX, Xu DN, Xiao Q, Liu Z. Mitochondrial 13513G>A Mutation With Low Mutant Load Presenting as Isolated Leber's Hereditary Optic Neuropathy Assessed by Next Generation Sequencing. Front Neurol 2021; 12:601307. [PMID: 33746872 PMCID: PMC7970004 DOI: 10.3389/fneur.2021.601307] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 02/10/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Mitochondrial 13513G>A mutation presenting as isolated Leber's hereditary optic neuropathy (LHON) without any extraocular pathology has not been reported in literature. We herein evaluate the clinical characteristics and heteroplasmy of m.13513G>A mutation manifesting as isolated LHON. Methods: Seven members of a Chinese family were enrolled in this study. All subjects underwent detailed systemic and ophthalmic examinations. Mitochondrial DNA in their blood was assessed by targeted PCR amplifications, next generation sequencing (NGS), and pyrosequencing. One hundred of blood samples from ethnic-matched healthy volunteers were tested by NGS and pyrosequencing as normal controls. Results: Isolated LHON without any other ocular or extraocular pathology was identified in a 16 year old patient in this family. Heteroplasmic m.13513G>A mutation was detected by NGS of the full mtDNA genome in the patient with mutant load of 33.56%, and of 26% 3 months and 3 years after the onset of LHON, respectively. No m.13513G>A mutation was detected in all his relatives by NGS. Pyrosequencing revealed the mutant load of m.13513G>A mutation of the LHON patient, his mother, father and sister were 22.4, 1.9, 0, and 0%, respectively. None of 100 healthy control subjects was detected to harbor m.13513G>A mutation either by NGS or by pyrosequencing of the full mt DNA genome. Conclusions: We first report m.13513G>A mutation with low mutant load presenting as isolated LHON. NGS of the full mitochondrial DNA genome is highly recommended for LHON suspects when targeted PCR amplification for main primary point mutations of LHON was negative.
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Affiliation(s)
- Chuan-Bin Sun
- Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Hai-Xia Bai
- Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Dan-Ni Xu
- Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Qing Xiao
- Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhe Liu
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
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Rovcanin B, Jancic J, Samardzic J, Rovcanin M, Nikolic B, Ivancevic N, Novakovic I, Kostic V. In silico model of mtDNA mutations effect on secondary and 3D structure of mitochondrial rRNA and tRNA in Leber's hereditary optic neuropathy. Exp Eye Res 2020; 201:108277. [PMID: 32991883 DOI: 10.1016/j.exer.2020.108277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 09/05/2020] [Accepted: 09/25/2020] [Indexed: 02/03/2023]
Abstract
The Leber's hereditary optic neuropathy (LHON) is a rare disease caused by mitochondrial DNA (mtDNA) mutations. Beside primary mutations, the effect of secondary mtDNA mutations in still unclear. We examined the effect of secondary mtDNA mutations on secondary structure of different mitochondrial RNAs. Whole mitochondrial genome sequence of LHON patients has been obtained from in six non related pedigrees by Sanger sequencing method. The effect of mutations located in mitochondrial RNA genes was examined by creating in silico models of RNA secondary and regional 3D structure, accompanied by sequence conservation analysis. All three primary LHON mutations (m.3460G>A, m.11778G>A and m.14484 T>C) were revealed in study families. Four mutations in MT-RNR1 gene (m.750A>G, m.956delC, m.1438A>G and m.1555A>G) were identified and only an m.1555A>G causes significant changes of secondary structure of mitochondrial 12S ribosomal RNA (rRNA), while it is the only mutation which does not alter its 3D structure. Five mutations (m.1811A>G, m.2706A>G, m.2831G>A, m.3010G>A and m.3197T>C) were discovered in MT-RNR2 gene and all of them induced substantial alterations of mitochondrial 16S rRNA secondary structure. Significant changes of mitochondrial 16S rRNA 3D structure are caused by m.1811A>G, m.2706A>G, m.3010G>A and m.3197T>C. A single insertion variant (m.15986insG) has been found in the MT-TP gene which encodes mitochondrial transfer RNA for Proline (tRNA Pro). This mutation does not cause substantial changes of tRNA for Proline secondary structure, while the 3D geometry remains without major changes. Most of the mutation loci exhibited high level of sequence conservation. Presence of multiple mutations in a single family appears to cause more extensive changes in mitochondrial 12S and 16S rRNA, then their individual influence. The effect of discovered mutations on in silico modelled RNA structure is in a significant correlation with the present knowledge about the potential of these mutation to participate in the pathophysiology of LHON and other human diseases. The presence of certain multiple mitochondrial RNA mutations could be a possible explanation of LHON clinical presentation in some families. All revealed mutations have been evaluated for the first time in terms of in silico structural modelling. The application of bioinformatics tools such as secondary and 3D RNA structure prediction can have a great advantage in better understanding of the molecular standpoint of the LHON pathophysiology and clinical phenotype.
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Affiliation(s)
- Branislav Rovcanin
- Center for Endocrine Surgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Jasna Jancic
- Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Janko Samardzic
- Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Rovcanin
- The Obstetrics and Gynecology Clinic Narodni Front, Belgrade, Serbia
| | - Blazo Nikolic
- Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nikola Ivancevic
- Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivana Novakovic
- Institute for Human Genetics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vladimir Kostic
- Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Liu H, Yuan J, Zhang Y, Tian Z, Li X, Wang D, Du Y, Song L, Li B. Factors associated with rapid improvement in visual acuity in patients with Leber's hereditary optic neuropathy after gene therapy. Acta Ophthalmol 2020; 98:e730-e733. [PMID: 32096343 DOI: 10.1111/aos.14379] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 01/27/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE To analyse the factors associated with rapid and significant improvement in visual acuity in patients with Leber's hereditary optic neuropathy (LHON) after gene therapy and explain the theory of this improvement. METHODS We recruited 149 patients with LHON, who underwent gene therapy, and divided them into two groups according to the absence or presence of rapid and significant visual acuity improvements within 3 days of treatment. A bivariate logistic regression model was used to analyse relevant factors including age, the period between onset and treatment, baseline values of best corrected visual acuity (BCVA), visual field index (VFI) and pretreatment average retinal nerve fibre-layer thickness (GRNFL). The corresponding parameters for the injected and non-injected eyes were analysed separately. RESULTS The period between onset and treatment, and pretreatment baseline BCVA was significantly associated with rapid and significant improvement in visual acuity for both, the injected and non-injected eyes. Moreover, pretreatment baseline VFI and GRNFL were not significantly associated with rapid and significant improvement in visual acuity. Age was significantly associated with rapid and significant improvement in visual acuity of the injected eyes. CONCLUSION The period between onset and treatment, and pretreatment baseline BCVA may be important predictors of rapid and significant improvement in visual acuity in patients with LHON after gene therapy.
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Affiliation(s)
- Hong‐li Liu
- Department of Ophthalmology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Jia‐jia Yuan
- Department of Ophthalmology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Yong Zhang
- Department of Ophthalmology Taihe Hospital Hubei University of Medicine Shiyan China
| | - Zhen Tian
- Department of Ophthalmology Taihe Hospital Hubei University of Medicine Shiyan China
| | - Xin Li
- Department of Ophthalmology Taihe Hospital Hubei University of Medicine Shiyan China
| | - Dan Wang
- Department of Ophthalmology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Yang‐yang Du
- Department of Ophthalmology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Lin Song
- Department of Ophthalmology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Bin Li
- Department of Ophthalmology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
- Department of Ophthalmology Taihe Hospital Hubei University of Medicine Shiyan China
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Ji Y, Zhang J, Lu Y, Yi Q, Chen M, Xie S, Mao X, Xiao Y, Meng F, Zhang M, Yang R, Guan MX. Complex I mutations synergize to worsen the phenotypic expression of Leber's hereditary optic neuropathy. J Biol Chem 2020; 295:13224-13238. [PMID: 32723871 DOI: 10.1074/jbc.ra120.014603] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/24/2020] [Indexed: 12/15/2022] Open
Abstract
Leber's hereditary optic neuropathy (LHON) is a maternal inheritance of eye disease because of the mitochondrial DNA (mtDNA) mutations. We previously discovered a 3866T>C mutation within the gene for the ND1 subunit of complex I as possibly amplifying disease progression for patients bearing the disease-causing 11778G>A mutation within the gene for the ND4 subunit of complex I. However, whether and how the ND1 mutation exacerbates the ND4 mutation were unknown. In this report, we showed that four Chinese families bearing both m.3866T>C and m.11778G>A mutations exhibited higher penetrances of LHON than 6 Chinese pedigrees carrying only the m.3866T>C mutation or families harboring only the m.11778G>A mutation. The protein structure analysis revealed that the m.3866T>C (I187T) and m.11778G>A (R340H) mutations destabilized the specific interactions with other residues of ND1 and ND4, thereby altering the structure and function of complex I. Cellular data obtained using cybrids, constructed by transferring mitochondria from the Chinese families into mtDNA-less (ρ°) cells, demonstrated that the mutations perturbed the stability, assembly, and activity of complex I, leading to changes in mitochondrial ATP levels and membrane potential and increasing the production of reactive oxygen species. These mitochondrial dysfunctions promoted the apoptotic sensitivity of cells and decreased mitophagy. Cybrids bearing only the m.3866T>C mutation displayed mild mitochondrial dysfunctions, whereas those harboring both m.3866T>C and m.11778G>A mutations exhibited greater mitochondrial dysfunctions. These suggested that the m.3866T>C mutation acted in synergy with the m.11778G>A mutation, aggravating mitochondrial dysfunctions and contributing to higher penetrance of LHON in these families carrying both mtDNA mutations.
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Affiliation(s)
- Yanchun Ji
- Department of Genetics and Metabolic Diseases, Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Division of Medical Genetics and Genomics, Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Juanjuan Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuanyuan Lu
- Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qiuzi Yi
- Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Mengquan Chen
- Department of Lab Medicine, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou, Zhejiang, China
| | - Shipeng Xie
- Department of Ophthalmology, Hebei Provincial Eye Hospital, Xingtai, Hebei, China
| | - Xiaoting Mao
- Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yun Xiao
- Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Feilong Meng
- Department of Genetics and Metabolic Diseases, Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Division of Medical Genetics and Genomics, Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Minglian Zhang
- Department of Ophthalmology, Hebei Provincial Eye Hospital, Xingtai, Hebei, China
| | - Rulai Yang
- Department of Genetics and Metabolic Diseases, Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Min-Xin Guan
- Division of Medical Genetics and Genomics, Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Key Lab of Reproductive Genetics, Ministry of Education of PRC, Zhejiang University, Hangzhou, Zhejiang, China; Joint Institute of Genetics and Genomic Medicine between Zhejiang University and University of Toronto, Hangzhou, Zhejiang, China.
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15
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Zhang Y, Yuan JJ, Liu HL, Tian Z, Liu SW, Li B. Three Cases of Leber's Hereditary Optic Neuropathy with Rapid Increase in Visual Acuity After Gene Therapy. Curr Gene Ther 2020; 19:134-138. [PMID: 31237206 PMCID: PMC6806533 DOI: 10.2174/1566523219666190618094505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/26/2019] [Accepted: 05/30/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND During the first few trials of gene therapy for Leber's hereditary optic neuropathy performed by our group, the visual acuity of the patients increased gradually over several months, or even years. However, in the current round of gene therapy for Leber's hereditary optic neuropathy, we noted that the visual acuity of three patients increased rapidly, within a few days after treatment. CASE PRESENTATION Three patients who were diagnosed with mitochondrial gene 11778 mutation (associated with a G-to-A transition at Mt-11778 in the ND4 subunit gene of complex I of mitochondrial DNA that changes an arginine to histidine at amino acid 340) by genetic diagnosis were followed up three times before gene therapy, which lasted for 1 year, without spontaneous improvement of vision. Visual acuity in one or both eyes of each of the three patients increased rapidly after the initial gene therapy treatment. CONCLUSION We suspect that in some patients with Leber's hereditary optic neuropathy, a portion of the retinal ganglion cells might remain in a "dormant" state for a certain period of time; these may be activated, within an optimal timeframe, during gene therapy for Leber's hereditary optic neuropathy.
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Affiliation(s)
- Yong Zhang
- Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Jia-Jia Yuan
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong-Li Liu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Tian
- Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Si-Wei Liu
- Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Bin Li
- Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China.,Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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16
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Bahr T, Welburn K, Donnelly J, Bai Y. Emerging model systems and treatment approaches for Leber's hereditary optic neuropathy: Challenges and opportunities. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165743. [PMID: 32105823 PMCID: PMC9252426 DOI: 10.1016/j.bbadis.2020.165743] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/17/2020] [Accepted: 02/21/2020] [Indexed: 12/24/2022]
Abstract
Leber's hereditary optic neuropathy (LHON) is a mitochondrial disease mainly affecting retinal ganglion cells (RGCs). The pathogenesis of LHON remains ill-characterized due to a historic lack of effective disease models. Promising models have recently begun to emerge; however, less effective models remain popular. Many such models represent LHON using non-neuronal cells or assume that mutant mtDNA alone is sufficient to model the disease. This is problematic because context-specific factors play a significant role in LHON pathogenesis, as the mtDNA mutation itself is necessary but not sufficient to cause LHON. Effective models of LHON should be capable of demonstrating processes that distinguish healthy carrier cells from diseased cells. In light of these considerations, we review the pathophysiology of LHON as it relates to old, new and future models. We further discuss treatments for LHON and unanswered questions that might be explored using these new model systems.
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Affiliation(s)
- Tyler Bahr
- University of Texas Health Science Center at San Antonio 7703 Floyd Curl Drive San Antonio, Texas 78229. First Author
| | - Kyle Welburn
- University of the Incarnate Word School of Medicine 7615 Kennedy Hill Drive, San Antonio, Texas 78235 Contributing Author
| | - Jonathan Donnelly
- University of Texas Health Science Center at San Antonio 7703 Floyd Curl Drive San Antonio, Texas 78229. Contributing author
| | - Yidong Bai
- University of Texas Health Science Center at San Antonio 7703 Floyd Curl Drive San Antonio, Texas 78229
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17
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Liu XT, Shen MX, Chen C, Huang SH, Zhuang XR, Ma QK, Chen Q, Lu F, Yuan YM. Foveal pit morphological changes in asymptomatic carriers of the G11778A mutation with Leber's hereditary optic neuropathy. Int J Ophthalmol 2020; 13:766-772. [PMID: 32420224 DOI: 10.18240/ijo.2020.05.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/12/2020] [Indexed: 12/31/2022] Open
Abstract
AIM To investigate the foveal pit morphology changes in unaffected carriers and affected Leber's hereditary optic neuropathy (LHON) patients with the G11778A mutation from one family. METHODS This study was a prospective cross-sectional study. Both eyes from 16 family members (age from 9 to 47y) with the G11778A mutation were analyzed and compared with 1 eye from 20 normal control subjects. Eleven family members with the G11778A mutation but without optic neuropathy were classified as unaffected carriers (n=22 eyes). Five family members (n=10 eyes) expressed the LHON phenotype and were classified as affected patients. Retinal images of all the subjects were taken by optical coherence tomography (OCT), and an automatic algorithm was used to segment the retina to eight layers. Horizontal and vertical OCT images centered on the fovea were used to measure intra-retinal layer thicknesses and foveal morphometry. RESULTS Thicker foveal thickness, thinner foveal pit depth, and flatter foveal slopes were observed in unaffected carriers and affected LHON patients (all P<0.001). Further, the slopes of all four sectors in the LHON were flatter than those in the unaffected carriers (all P<0.001). Compared with the control group, affected LHON patients had a thinner retinal nerve fiber layer (RNFL), ganglion cell layer and inner plexiform layer (GCL+IPL), and total retina (all P<0.01). The retinal nerve fiber layer (RNFL) of affected patients was 38.0% thinner than that of controls while the GCL+IPL was 40.1% thinner. CONCLUSION The foveal pit morphology shows changes in both unaffected carriers and affects patients. RNFL and GCL+IPL are thinner in affected LHON patients but not in unaffected carriers.
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Affiliation(s)
- Xin-Ting Liu
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Mei-Xiao Shen
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Chong Chen
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Sheng-Hai Huang
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Xi-Ran Zhuang
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Qing-Kai Ma
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Qi Chen
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Fan Lu
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Yi-Min Yuan
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
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18
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Asanad S, Frousiakis S, Wang MY, Fantini M, Sultan W, Wood T, Nwako FU, Karanjia R, Sadun AA. Improving the visual outcome in Leber's hereditary optic neuropathy: Framework for the future. J Curr Ophthalmol 2019; 31:251-253. [PMID: 31528757 PMCID: PMC6742611 DOI: 10.1016/j.joco.2019.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Samuel Asanad
- Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Internal Medicine, Huntington Memorial Hospital, Pasadena, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, Southern California Permanente Medical Group, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,University of Udine, Department of Ophthalmology, Udine, Italy.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Ophthalmology, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Starleen Frousiakis
- Doheny Eye Institute, Los Angeles, CA, USA.,Department of Internal Medicine, Huntington Memorial Hospital, Pasadena, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, Southern California Permanente Medical Group, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,University of Udine, Department of Ophthalmology, Udine, Italy.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Ophthalmology, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Michelle Y Wang
- Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, Southern California Permanente Medical Group, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,University of Udine, Department of Ophthalmology, Udine, Italy.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Ophthalmology, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Michele Fantini
- Doheny Eye Institute, Los Angeles, CA, USA.,University of Udine, Department of Ophthalmology, Udine, Italy.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Ophthalmology, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - William Sultan
- Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Ophthalmology, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Terry Wood
- Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Ophthalmology, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Francis U Nwako
- Doheny Eye Institute, Los Angeles, CA, USA.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Ophthalmology, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Rustum Karanjia
- Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Ophthalmology, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Alfredo A Sadun
- Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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19
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Zhang Y, Li X, Yuan J, Tian Z, Liu H, Wang D, Li B. Prognostic factors for visual acuity in patients with Leber's hereditary optic neuropathy after rAAV2-ND4 gene therapy. Clin Exp Ophthalmol 2019; 47:774-778. [PMID: 30968497 PMCID: PMC6767190 DOI: 10.1111/ceo.13515] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/19/2019] [Accepted: 04/02/2019] [Indexed: 12/21/2022]
Abstract
Importance Factors affecting visual acuity prognosis after gene therapy in Leber's hereditary optic neuropathy (LHON) patients with mutation at site 11 778 are unknown. Background To analyse correlations between visual acuity prognosis and baseline characteristics of LHON after rAAV2‐ND4 gene therapy. Design Retrospective study. Participants Fifty‐three LHON patients with a mutation at site 11 778. Methods Single‐eye intravitreal injection of rAAV2‐ND4. Main Outcome Measures Sex, onset age, duration of disease, best‐corrected visual acuity (BCVA), visual field index (VFI) and mean deviation (MD) were recorded for all patients at baseline. BCVA was recorded at 1‐ and 3‐month follow‐up visits after gene therapy. Correlations between BCVA prognosis and baseline characteristics were analysed by univariate analysis. Logistic regression analysis was performed on independent factors affecting BCVA prognosis. Results Univariate analysis showed significant differences in the VFI and MD of the injected eye between BCVA improvement and non‐improvement groups after 3 months of treatment, with greater VFI and smaller absolute MD in the BCVA improvement group. Logistic regression showed that VFI and baseline BCVA were independent prognostic factors for visual acuity. The correlation between VFI and MD was statistically significant. Conclusions and Relevance VFI and baseline BCVA were correlated with the visual acuity prognosis of LHON patients receiving gene therapy, with greater baseline VFI and better baseline BCVA predicting better visual acuity prognosis. MD was strongly correlated with VFI and might be correlated with gene therapy prognosis. This finding may form a basis for predicting the efficacy of gene therapy in these patients and guiding subsequent treatment.
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Affiliation(s)
- Yong Zhang
- Department of Ophthalmology, Taihe Hospital (Affiliated Hospital of Hubei University of Medicine), Shiyan, China
| | - Xin Li
- Department of Ophthalmology, Taihe Hospital (Affiliated Hospital of Hubei University of Medicine), Shiyan, China
| | - Jiajia Yuan
- Department of Ophthalmology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Tian
- Department of Ophthalmology, Taihe Hospital (Affiliated Hospital of Hubei University of Medicine), Shiyan, China
| | - Hongli Liu
- Department of Ophthalmology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Wang
- Department of Ophthalmology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Bin Li
- Department of Ophthalmology, Taihe Hospital (Affiliated Hospital of Hubei University of Medicine), Shiyan, China.,Department of Ophthalmology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
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Takemura H, Ogawa S, Mezer AA, Horiguchi H, Miyazaki A, Matsumoto K, Shikishima K, Nakano T, Masuda Y. Diffusivity and quantitative T1 profile of human visual white matter tracts after retinal ganglion cell damage. Neuroimage Clin 2019; 23:101826. [PMID: 31026624 PMCID: PMC6482365 DOI: 10.1016/j.nicl.2019.101826] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/27/2019] [Accepted: 04/13/2019] [Indexed: 02/04/2023]
Abstract
In patients with retinal ganglion cell diseases, recent diffusion tensor imaging (DTI) studies have revealed structural abnormalities in visual white matter tracts such as the optic tract, and optic radiation. However, the microstructural origin of these diffusivity changes is unknown as DTI metrics involve multiple biological factors and do not correlate directly with specific microstructural properties. In contrast, recent quantitative T1 (qT1) mapping methods provide tissue property measurements relatively specific to myelin volume fractions in white matter. This study aims to improve our understanding of microstructural changes in visual white matter tracts following retinal ganglion cell damage in Leber's hereditary optic neuropathy (LHON) patients by combining DTI and qT1 measurements. We collected these measurements from seven LHON patients and twenty age-matched control subjects. For all individuals, we identified the optic tract and the optic radiation using probabilistic tractography, and evaluated diffusivity and qT1 profiles along them. Both diffusivity and qT1 measurements in the optic tract differed significantly between LHON patients and controls. In the optic radiation, these changes were observed in diffusivity but were not evident in qT1 measurements. This suggests that myelin loss may not explain trans-synaptic diffusivity changes in the optic radiation as a consequence of retinal ganglion cell disease. Retinal ganglion cell damage affects diffusivity and T1 along visual pathways. DTI metric identified white matter change in both optic tract and optic radiation. T1 measurement in optic radiation did not exhibit abnormality, unlike DTI metric. Myelin loss may not be a major cause of diffusivity change along optic radiation.
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Affiliation(s)
- Hiromasa Takemura
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology, and Osaka University, Suita, Japan; Graduate School of Frontier Biosciences, Osaka University, Suita, Japan.
| | - Shumpei Ogawa
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan; Department of Ophthalmology, Atsugi city hospital, Atsugi, Japan.
| | - Aviv A Mezer
- The Edmond and Lily Safra Center for Brain Science, The Hebrew University of Jerusalem, Israel
| | - Hiroshi Horiguchi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Kenji Matsumoto
- Brain Science Institute, Tamagawa University, Machida, Japan
| | - Keigo Shikishima
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tadashi Nakano
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yoichiro Masuda
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
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21
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Jancic J, Samardzic J, Stojanovic S, Stojanovic A, Milanovic AM, Nikolic B, Ivancevic N, Kostic V. Leber's Hereditary Optic Neuropathy: Novel Views and Persisting Challenges. CNS Neurol Disord Drug Targets 2019; 16:927-935. [PMID: 28745242 DOI: 10.2174/1871527316666170724172455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/03/2017] [Accepted: 07/18/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND & OBJECTIVE Leber's hereditary optic neuropathy is an inherited form of optic neuropathy, genetically and pathophysiologically based on mitochondrial insufficiency causing bilateral loss of central vision mostly amongst young adults. Despite being one of the most common mitochondrial diseases, the explanation for its pathophysiological background and effective clinical solutions remain elusive. Widening the scope in the search for pathological findings beyond the optic system has yielded several non-ophthalmologic findings, which might imply that Leber's hereditary optic neuropathy is in fact a multi-systemic disease. CONCLUSION The aim of this review is to provide an overview of literature regarding the epidemiology, etiology, pathogenesis, clinical features, diagnostics and possible treatment options and drug targets, as well as presenting challenges related to the disease and proposing a diagnostic algorithm based on current clinical experience.
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Affiliation(s)
- Jasna Jancic
- Clinic of Neurology and Psychiatry for Children and Youth, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Janko Samardzic
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Stevan Stojanovic
- Clinic of Neurology and Psychiatry for Children and Youth, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | | | | | - Blazo Nikolic
- Clinic of Neurology and Psychiatry for Children and Youth, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Nikola Ivancevic
- Clinic of Neurology and Psychiatry for Children and Youth, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Vladimir Kostic
- Clinic of Neurology, Medical Faculty, University of Belgrade, Belgrade, Serbia
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22
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Orssaud C, Bidot S, Lamirel C, Brémond Gignac D, Touitou V, Vignal C. [Raxone in the Leber optical neuropathy: Parisian experience]. J Fr Ophtalmol 2019; 42:269-275. [PMID: 30712826 DOI: 10.1016/j.jfo.2018.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/19/2018] [Accepted: 06/27/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Leber's Hereditary Optic Neuropathy (LHON) causes a rapid and severe decrease in visual acuity. Raxone® (Idebenone, Santhera) is the only drug to have a European Marketing Authorization for the treatment of this optic neuropathy. It can be proposed in the first months after the onset of this optic neuropathy, according to an international consensus meeting. PATIENTS AND METHODS Retrospective study of the efficacy of Raxone® on the visual acuity of patients with genetically confirmed LHON who were followed in four Parisian hospitals. The primary endpoint is the best recovery of LogMar visual acuity between baseline and the end of follow-up. The secondary endpoints are the evolution of LogMar visual acuity of the best eye at baseline and change in LogMar visual acuity for each eye considered separately. RESULTS Seventeen patients, three women and 14 men, mean age 34.2 years, naive to treatment with Raxone® were included in this study. The mean duration of treatment was 11.0±6.6 months. A mitochondrial DNA mutation was found in all patients. Only 2 had the 14484 mutation. A recovery of better LogMar visual acuity was found at the end of the treatment for 4 eyes (23.5 %), and a deterioration was observed for 8 (47.0 %). Only 2 eyes (11.7 %) with the best visual acuity at baseline improved. On the other hand, 17.6 % of the eyes considered separately had an improvement in their LogMar visual acuity at the end of the treatment. CONCLUSION The results confirm the trend of Raxone® treatment to improve patients' visual acuity. Given the recommendations of a consensus conference, this treatment should be started early after the onset of LHON. It is therefore important to look for this diagnosis in the presence of any hereditary optic neuropathy, in order to be able to initiate this treatment.
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Affiliation(s)
- C Orssaud
- UF d'ophtalmologie, CRMR Ophtara, HUPO/HEGP, AP-HP, 20, rue Leblanc, 75015 Paris, France.
| | - S Bidot
- Fondation ophtalmologique A-de-Rothschild, 75019 Paris, France; Service d'ophtalmologie, CRMR Ophtara, hôpital de la Pitiè-Salpétrière, AP-HP, 75013 Paris, France
| | - C Lamirel
- Fondation ophtalmologique A-de-Rothschild, 75019 Paris, France
| | - D Brémond Gignac
- Service d'ophtalmologie, CRMR Ophtara, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France
| | - V Touitou
- Service d'ophtalmologie, CRMR Ophtara, hôpital de la Pitiè-Salpétrière, AP-HP, 75013 Paris, France
| | - C Vignal
- Fondation ophtalmologique A-de-Rothschild, 75019 Paris, France; CRMR maladies neuro rétiniennes, Centre nationale d'ophtalmologie des Quinze-Vingts, 75012 Paris, France
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Asanad S, Meer E, Tian JJ, Fantini M, Nassisi M, Sadun AA. Leber's hereditary optic neuropathy: Severe vascular pathology in a severe primary mutation. Intractable Rare Dis Res 2019; 8:52-55. [PMID: 30881859 PMCID: PMC6409112 DOI: 10.5582/irdr.2018.01126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The purpose of the present article was to evaluate the previously unreported vascular alterations in Leber's Hereditary Optic Neuropathy (LHON) 3460 mitochondrial DNA (mtDNA) mutation. Among the three primary mtDNA mutations, namely 11778, 14484, and 3460, LHON 3460 is the most rare and historically recognized as having the poorest visual prognosis. Optical coherence tomography angiography (OCTA) is a novel imaging modaility providing high-resolution microcirculation maps and enhancing visualization of the optic disc and peripapillary capillary beds. We herein exploit the advantages of OCTA, for the first time, to assess the optic nerve head and peripapillary microvasculature changes in an affected patient and compare these vascular changes with an asymptomatic carrier for LHON 3460, serving as a control. Vascular changes in LHON 11778 and 14484 have classically shown microvasculature attenuation localized specifically to the temporal peripapillary quadrant. In the present case, however, OCTA in LHON 3460, the most severe of the three mutational subtypes, illustrated significant vascular attenuation involving the nasal peripapillary region in addition to the temporal peripapillary microvascular changes classically seen in LHON. Our findings suggest that vascular measures may serve useful for objectively assessing mitochondrial disease. Further OCTA studies involving the nasal peripapillary region may be warranted to further understand vascular pathogenesis in LHON.
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Affiliation(s)
- Samuel Asanad
- Doheny Eye Institute, Los Angeles, CA, USA
- Department of Ophthalmology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
- Address correspondence to:Dr. Samuel Asanad, Department of Ophthalmology, David Geffen School of Medicine at University of California Los Angeles, 10833 Le Conte Ave, Los Angeles, CA 90095, USA. E-mail:
| | - Elana Meer
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Michele Fantini
- Doheny Eye Institute, Los Angeles, CA, USA
- Department of Ophthalmology, University of Udine, Udine, Italy
| | | | - Alfredo A. Sadun
- Doheny Eye Institute, Los Angeles, CA, USA
- Department of Ophthalmology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
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Asanad S, Meer E, Fantini M, Borrelli E, Sadun AA. Leber's hereditary optic neuropathy: Shifting our attention to the macula. Am J Ophthalmol Case Rep 2019; 13:13-5. [PMID: 30505979 DOI: 10.1016/j.ajoc.2018.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 10/22/2018] [Accepted: 11/12/2018] [Indexed: 11/29/2022] Open
Abstract
Purpose Peripapillary vascular alterations have been classically described as hallmarks of Leber's Hereditary Optic Neuropathy (LHON). We recently demonstrated microvascular pathology involving the macula in patients affected with chronic LHON using optical coherence tomography angiography (OCTA). Macular vascular pathology in acute LHON has not previously been reported. Methods The macular superficial vasculature of an asymptomatic carrier and an affected patient with acute LHON, mitochondrial DNA mutation 3460, was assessed by OCTA. Results Similar findings of peripapillary microangiopathy and vascular telangiectasias were seen the affected patient, but in the parafoveal macula. These changes were most prominent nasally and inferiorly, corresponding to the proximal portions of the papillomacular bundle. The foveal avascular zone was markedly enlarged in the affected patient relative to the asymptomatic mother. Conclusions These findings in acute LHON further supports the clinical utility of vascular parameters and suggest that further studies focused on macular pathology may be warranted to assess the natural history of LHON.
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25
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Fantini M, Asanad S, Karanjia R, Sadun A. Hormone replacement therapy in Leber's hereditary optic neuropathy: Accelerated visual recovery in vivo. J Curr Ophthalmol 2018; 31:102-105. [PMID: 30899856 PMCID: PMC6407313 DOI: 10.1016/j.joco.2018.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/02/2018] [Accepted: 10/05/2018] [Indexed: 12/05/2022] Open
Abstract
Purpose To report an accelerated course of visual recovery in a case of Leber's hereditary optic neuropathy (LHON) following treatment with idebenone and hormone replacement therapy (HRT). We hereby demonstrate the clinical utility of estrogen's protective role in LHON in vivo. Methods We present a case of LHON in a menopausal woman carrying the 10197 mitochondrial DNA (mtDNA) mutation, who experienced loss of vision shortly after discontinuing her estrogen replacement regimen. Functional visual outcomes are reported following treatment with idebenone and HRT. Results The patient exhibited an accelerated course of visual recovery, experiencing improvement in vision as early as one month and complete reversal of vision loss by eight months post-therapy. Conclusion Idebenone treatment combined with HRT may have a synergistic effect in enhancing cellular bioenergetics and may explain the patient's accelerated visual improvement.
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Affiliation(s)
- Michele Fantini
- University of Udine, Department of Ophthalmology, Udine, Italy.,Doheny Eye Institute, Los Angeles, CA, USA
| | - Samuel Asanad
- Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Rustum Karanjia
- Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Department of Ophthalmology, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Alfredo Sadun
- Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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26
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Kogachi K, Ter-Zakarian A, Asanad S, Sadun A, Karanjia R. Toxic medications in Leber's hereditary optic neuropathy. Mitochondrion 2018; 46:270-277. [PMID: 30081212 DOI: 10.1016/j.mito.2018.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/23/2018] [Accepted: 07/31/2018] [Indexed: 12/18/2022]
Abstract
Leber's hereditary optic neuropathy (LHON) is a maternally inherited mitochondrial disorder characterized by acute bilateral vision loss. The pathophysiology involves reactive oxygen species (ROS), which can be affected by medications. This article reviews the evidence for medications with demonstrated and theoretical effects on mitochondrial function, specifically in relation to increased ROS production. The data reviewed provides guidance when selecting medications for individuals with LHON mutations (carriers) and are susceptible to conversion to affected. However, as with all medications, the proven benefits of these therapies must be weighed against, in some cases, purely theoretical risks for this unique patient population.
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Affiliation(s)
- Kaitlin Kogachi
- Doheny Eye Institute, 1355 San Pablo Street, Los Angeles, CA 90033, USA.
| | - Anna Ter-Zakarian
- Doheny Eye Institute, 1355 San Pablo Street, Los Angeles, CA 90033, USA
| | - Samuel Asanad
- Doheny Eye Institute, 1355 San Pablo Street, Los Angeles, CA 90033, USA; Doheny Eye Center, Department of Ophthalmology, David Geffen School of Medicine at UCLA, 800 South Fairmount Avenue, Suite 215, Pasadena, CA 91105, USA
| | - Alfredo Sadun
- Doheny Eye Institute, 1355 San Pablo Street, Los Angeles, CA 90033, USA; Doheny Eye Center, Department of Ophthalmology, David Geffen School of Medicine at UCLA, 800 South Fairmount Avenue, Suite 215, Pasadena, CA 91105, USA
| | - Rustum Karanjia
- Doheny Eye Institute, 1355 San Pablo Street, Los Angeles, CA 90033, USA; Doheny Eye Center, Department of Ophthalmology, David Geffen School of Medicine at UCLA, 800 South Fairmount Avenue, Suite 215, Pasadena, CA 91105, USA; The Ottawa Eye Institute, University of Ottawa, 501 Smyth Rd, Ottawa, ON K1H 8M2, Canada; Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada
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27
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Hung SSC, Van Bergen NJ, Jackson S, Liang H, Mackey DA, Hernández D, Lim SY, Hewitt AW, Trounce I, Pébay A, Wong RCB. Study of mitochondrial respiratory defects on reprogramming to human induced pluripotent stem cells. Aging (Albany NY) 2017; 8:945-57. [PMID: 27127184 PMCID: PMC4931846 DOI: 10.18632/aging.100950] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/17/2016] [Indexed: 01/19/2023]
Abstract
Reprogramming of somatic cells into a pluripotent state is known to be accompanied by extensive restructuring of mitochondria and switch in metabolic requirements. Here we utilized Leber's hereditary optic neuropathy (LHON) as a mitochondrial disease model to study the effects of homoplasmic mtDNA mutations and subsequent oxidative phosphorylation (OXPHOS) defects in reprogramming. We obtained fibroblasts from a total of 6 LHON patients and control subjects, and showed a significant defect in complex I respiration in LHON fibroblasts by high-resolution respiratory analysis. Using episomal vector reprogramming, our results indicated that human induced pluripotent stem cell (hiPSC) generation is feasible in LHON fibroblasts. In particular, LHON-specific OXPHOS defects in fibroblasts only caused a mild reduction and did not significantly affect reprogramming efficiency, suggesting that hiPSC reprogramming can tolerate a certain degree of OXPHOS defects. Our results highlighted the induction of genes involved in mitochondrial biogenesis (TFAM, NRF1), mitochondrial fusion (MFN1, MFN2) and glycine production (GCAT) during reprogramming. However, LHON-associated OXPHOS defects did not alter the kinetics or expression levels of these genes during reprogramming. Together, our study provides new insights into the effects of mtDNA mutation and OXPHOS defects in reprogramming and genes associated with various aspects of mitochondrial biology.
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Affiliation(s)
- Sandy S C Hung
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital and Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Nicole J Van Bergen
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital and Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Stacey Jackson
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital and Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Helena Liang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital and Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - David A Mackey
- Lions Eye Institute and University of Western Australia, Nedlands, Australia
| | - Damián Hernández
- O'Brien Institute Department, St Vincent's Institute of Medical Research, Fitzroy, Australia
| | - Shiang Y Lim
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital and Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia.,O'Brien Institute Department, St Vincent's Institute of Medical Research, Fitzroy, Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital and Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia.,School of Medicine, Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Ian Trounce
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital and Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Alice Pébay
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital and Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Raymond C B Wong
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital and Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
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Dai Y, Wang C, Nie Z, Han J, Chen T, Zhao X, Ai C, Ji Y, Gao T, Jiang P. Mutation analysis of Leber's hereditary optic neuropathy using a multi-gene panel. Biomed Rep 2017; 8:51-58. [PMID: 29387390 DOI: 10.3892/br.2017.1014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/02/2017] [Indexed: 12/22/2022] Open
Abstract
The present study investigates the spectrum and incidence of mitochondrial DNA (mtDNA) mutations associated with Leber's hereditary optic neuropathy (LHON) in a Han population using a multi-gene panel with 46 LHON-associated mutations among 13 mitochondrial genes. A total of 23 mutations were observed in a cohort of 275 patients and 281 control subjects using multi-gene panel analysis. The causative mutations associated with LHON were identified to be m.11778G>A, m.14484T>C, m.3460 G>A, m.3635G>A, m.3866T>C and m.3733G>A, responsible for 70.55% cases in the patient cohort. The secondary mutations in the Chinese LHON population were m.12811T>C, m.11696 G>A, m.3316G>A, m.3394T>C, m.14502T>C, m.3497C>T, m.3571C>T, m.12338T>C, m.14693A>G, m.4216T>C and m.15951A>G, with incidences of 5.09, 4.36, 4.00, 4.00, 4.00, 2.55, 1.82, 1.82, 1.45, 1.09 and 1.09%, respectively. Besides three hotspot genes, MT-ND1, MT-ND4 and MT-ND6, MT-ND5 also had a high incidence of secondary mutations. Those mutations reported as rare causative mutations in a European LHON population, m.3376G>A, m.3700G>A and m.4171C>A, m.10663T>C, m.13051G>A, m.14482C>G/A, m.14495A>G and m.14568C>T were undetected in the present study. The primary and secondary mutations associated with LHON in the present multi-gene panel will advance the current understanding of the clinical phenotype of LHON, and provide useful information for early diagnosis.
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Affiliation(s)
- Yu Dai
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Chenghui Wang
- Division of Medical Genetics and Genomics, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, P.R. China.,Institute of Genetics, Zhejiang University, and Department of Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, P.R. China
| | - Zhipeng Nie
- Division of Medical Genetics and Genomics, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, P.R. China.,Institute of Genetics, Zhejiang University, and Department of Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, P.R. China
| | - Jiamin Han
- Institute of Genetics, Zhejiang University, and Department of Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, P.R. China
| | - Ting Chen
- Division of Medical Genetics and Genomics, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, P.R. China
| | - Xiaoxu Zhao
- Division of Medical Genetics and Genomics, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, P.R. China.,Institute of Genetics, Zhejiang University, and Department of Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, P.R. China
| | - Cheng Ai
- Institute of Genetics, Zhejiang University, and Department of Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, P.R. China
| | - Yanchun Ji
- Division of Medical Genetics and Genomics, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, P.R. China
| | - Tao Gao
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Pingping Jiang
- Division of Medical Genetics and Genomics, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, P.R. China.,Institute of Genetics, Zhejiang University, and Department of Genetics, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, P.R. China
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Kalinska-Bienias A, Pollak A, Kowalewski C, Lechowicz U, Stawinski P, Gergont A, Kosinska J, Pronicka E, Kowalski P, Wozniak K, Ploski R. Coexistence of mutations in keratin 10 (KRT10) and the mitochondrial genome in a patient with ichthyosis with confetti and Leber's hereditary optic neuropathy. Am J Med Genet A 2017; 173:3093-3097. [PMID: 28944608 DOI: 10.1002/ajmg.a.38403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 11/11/2022]
Abstract
Ichthyosis with confetti (IWC) is a severe congenital genodermatosis characterized by ichthyosiform erythroderma since birth and confetti-like spots of normal skin appearing in childhood as a results of revertant mosaicism. This disorder is caused by mutations in KRT10 or KRT1 genes. We report a 16-year-old boy who presented ichthyosiform erythroderma with severe desquamation since birth and gradually worsening psycho-neurological symptoms (mental retardation, ataxia, dystonia, hypoacusis). The patient conspicuously lacked typical confetti-like spots at the age of 16. The molecular diagnostics by the whole exome sequencing showed a novel de novo (c.1374-2A>C) mutation in the KRT10 gene responsible for the development of IWC (KRT10 defect was confirmed by immunofluorescent study). Concurrently, the m.14484T>C mutation in mitochondrial MTND6 gene (characteristic for Leber's hereditary optic neuropathy or LHON) was detected in patient, his mother and brother. LHON causes frequent inherited blindness typically appearing during young adult life whose expression can be triggered by additional factors such as smoking or alcohol exposure. We speculate the effects of KRT10 and LHON mutations influence each other-skin inflammatory reaction due to severe ichthyosis might trigger the development of psychoneurological abnormalities whereas the mitochondrial mutation may reduce revertant mosaicism phenomenon resulting in the lack of confetti-like spots characteristic for IWC. However, based on a single case we should be cautious about attributing phenotypes to digenic mechanisms without functional data.
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Affiliation(s)
| | - Agnieszka Pollak
- Department of Genetics, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Cezary Kowalewski
- Department of Dermatology and Immunodermatology, Medical University of Warsaw, Warsaw, Poland
| | - Urszula Lechowicz
- Department of Genetics, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Piotr Stawinski
- Department of Genetics, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Gergont
- Chair of Children and Adolescents' Neurology, University Children's Hospital, Jagiellonian University Medical College, Krakow, Poland
| | - Joanna Kosinska
- Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Pronicka
- The Children's Memorial Health Institute, Warsaw, Poland
| | - Pawel Kowalski
- The Children's Memorial Health Institute, Warsaw, Poland
| | - Katarzyna Wozniak
- Department of Dermatology and Immunodermatology, Medical University of Warsaw, Warsaw, Poland
| | - Rafal Ploski
- Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland
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Georg B, Ghelli A, Giordano C, Ross-Cisneros FN, Sadun AA, Carelli V, Hannibal J, La Morgia C. Melanopsin-expressing retinal ganglion cells are resistant to cell injury, but not always. Mitochondrion 2017; 36:77-84. [PMID: 28412540 DOI: 10.1016/j.mito.2017.04.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 03/14/2017] [Accepted: 04/07/2017] [Indexed: 12/12/2022]
Abstract
Melanopsin retinal ganglion cells (mRGCs) are intrinsically photosensitive RGCs deputed to non-image forming functions of the eye such as synchronization of circadian rhythms to light-dark cycle. These cells are characterized by unique electrophysiological, anatomical and biochemical properties and are usually more resistant than conventional RGCs to different insults, such as axotomy and different paradigms of stress. We also demonstrated that these cells are relatively spared compared to conventional RGCs in mitochondrial optic neuropathies (Leber's hereditary optic neuropathy and Dominant Optic Atrophy). However, these cells are affected in other neurodegenerative conditions, such as glaucoma and Alzheimer's disease. We here review the current evidences that may underlie this dichotomy. We also present our unpublished data on cell experiments demonstrating that melanopsin itself does not explain the robustness of these cells and some preliminary data on immunohistochemical assessment of mitochondria in mRGCs.
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Affiliation(s)
- Birgitte Georg
- Department of Clinical Biochemistry, Bispebjerg and Frederiksberg Hospital, Faculty Health Sciences, University of Copenhagen, Denmark
| | - Anna Ghelli
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Carla Giordano
- Department of Radiology, Oncology and Pathology, Sapienza, University of Rome, Rome, Italy
| | | | - Alfredo A Sadun
- Doheny Eye Institute, Los Angeles, CA, USA; Department of Ophthalmology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Valerio Carelli
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Jens Hannibal
- Department of Clinical Biochemistry, Bispebjerg and Frederiksberg Hospital, Faculty Health Sciences, University of Copenhagen, Denmark.
| | - Chiara La Morgia
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.
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Seong MW, Choi J, Park SS, Kim JY, Hwang JM. Novel MT-ND5 gene mutation identified in Leber's hereditary optic neuropathy patient using mitochondrial genome sequencing. J Neurol Sci 2017; 375:301-303. [PMID: 28320155 DOI: 10.1016/j.jns.2017.01.064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/10/2017] [Accepted: 01/23/2017] [Indexed: 10/20/2022]
Affiliation(s)
- Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jongmoon Choi
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung Sup Park
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ji Yeon Kim
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Jeong-Min Hwang
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
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Jankauskaitė E, Bartnik E, Kodroń A. Investigating Leber's hereditary optic neuropathy: Cell models and future perspectives. Mitochondrion 2017; 32:19-26. [PMID: 27847334 DOI: 10.1016/j.mito.2016.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 11/09/2016] [Accepted: 11/11/2016] [Indexed: 01/19/2023]
Abstract
Leber's hereditary optic neuropathy (LHON) was the first human disease found to be associated with a mitochondrial DNA (mtDNA) point mutation. The most common LHON mutations are 11778G>A, 3460G>A or 14484T>C. The most common clinical features of LHON are optic nerve and retina atrophy. The affected tissue is not available for studies, therefore a variety of other cell types are used. However, all models face difficulties and limitations in mitochondrial disease research. The advantages and disadvantages of different cell models used to study LHON, recent advances in animal model generation and novel approaches in this field are discussed.
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Saikia BB, Dubey SK, Shanmugam MK, Sundaresan P. Whole mitochondrial genome analysis in South Indian patients with Leber's hereditary optic neuropathy. Mitochondrion 2017; 36:21-8. [PMID: 27989883 DOI: 10.1016/j.mito.2016.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/22/2016] [Accepted: 10/26/2016] [Indexed: 11/27/2022]
Abstract
Leber's hereditary optic neuropathy (LHON) is a mitochondrial DNA (mtDNA) associated neurodegenerative disorder of retinal ganglion cells. In this study, whole mitochondrial genome sequencing of 75 LHON patients and 40 controls was performed to identify the mutation frequency and haplogroup background of South Indian population. Analysis of mtDNA revealed 559 different variants in LHON patients, including 7 pathogenic mutations, 30 private, and 22 other disease associated variants. A significantly higher (p=0.0008) overall variation load per individual was noted among LHON patients versus controls. We reported for the first time, the association of M haplogroup (p=0.028) with LHON in this cohort.
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Yang S, Ma SQ, Wan X, He H, Pei H, Zhao MJ, Chen C, Wang DW, Dong XY, Yuan JJ, Li B. Long-term outcomes of gene therapy for the treatment of Leber's hereditary optic neuropathy. EBioMedicine 2016; 10:258-68. [PMID: 27426279 PMCID: PMC5006665 DOI: 10.1016/j.ebiom.2016.07.002] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 07/03/2016] [Accepted: 07/04/2016] [Indexed: 12/18/2022] Open
Abstract
Leber's hereditary optic neuropathy (LHON) is a disease that leads to blindness. Gene therapy has been investigated with some success, and could lead to important advancements in treating LHON. This was a prospective, open-label trial involving 9 LHON patients at Tongji Hospital, Wuhan, China, from August 2011 to December 2015. The purpose of this study was to evaluate the long-term outcomes of gene therapy for LHON. Nine LHON patients voluntarily received an intravitreal injection of rAAV2-ND4. Systemic examinations and visual function tests were performed during the 36-month follow-up period to determine the safety and efficacy of this gene therapy. Based on successful experiments in an animal model of LHON, 1 subject also received an rAAV2-ND4 injection in the second eye 12 months after gene therapy was administered in the first eye. Recovery of visual acuity was defined as the primary outcome of this study. Changes in the visual field, visual evoked potential (VEP), optical coherence tomography findings, liver and kidney function, and antibodies against AAV2 were defined as secondary endpoints. Eight patients (Patients 2–9) received unilateral gene therapy and visual function improvement was observed in both treated eyes (Patients 4, 6, 7, and 8) and untreated eyes (Patients 2, 3, 4, 6 and 8). Visual regression fluctuations, defined as changes in visual acuity greater than or equal to 0.3 logMAR, were observed in Patients 2 and 9. Age at disease onset, disease duration, and the amount of remaining optic nerve fibers did not have a significant effect on the visual function improvement. The visual field and pattern reversal VEP also improved. The patient (Patient 1) who received gene therapy in both eyes had improved visual acuity in the injected eye after the first treatment. Unfortunately, visual acuity in this eye decreased 3 months after he received gene therapy in the second eye. Animal experiments suggested that ND4 expression remains stable in the contralateral eye after intravitreal injections. No serious safety problem was observed in the 3-year follow-up of the 9 participants enrolled in this virus-based gene therapy. Meanwhile, our results support the use of intravitreal rAAV2-ND4 as an aggressive maneuver in our clinical trial. Further study in additional patients and in these 9 subjects is needed to better understand the effects of rAAV2-ND4 gene therapy on LHON and to increase the applications of this technique. A long-term study of efficacy of gene therapy for Leber's hereditary optic neuropathy. No serious adverse effects were noted in the 9 participants over a 3-year period. Five patients experienced an improvement in visual function. Gene therapy is a promising treatment for Leber's hereditary optic neuropathy.
There are currently no effective treatments for Leber's hereditary optic neuropathy (LHON). Short-term studies using virus-based gene therapy have yielded promising results. We performed systemic examinations and visual function tests to evaluate the long-term safety and efficacy of gene therapy for LHON. Over a 3-year follow-up period, five out of nine patients had visual function improvement, and no serious adverse effects were noted.
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Affiliation(s)
- Shuo Yang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Si-Qi Ma
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xing Wan
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Heng He
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Han Pei
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Min-Jian Zhao
- Department of Oncology, Central Hospital, Ezhou City, People's Republic of China
| | - Chen Chen
- Genetic Diagnosis Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Dao-Wen Wang
- Genetic Diagnosis Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xiao-Yan Dong
- Beijing FivePlus Molecular Medicine Institute Co. Ltd., Beijing, People's Republic of China
| | - Jia-Jia Yuan
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Bin Li
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Wuhan Phoebus Biological Technology Limited Company, Wuhan, People's Republic of China.
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Xie S, Zhang J, Sun J, Zhang M, Zhao F, Wei QP, Tong Y, Liu X, Zhou X, Jiang P, Ji Y, Guan MX. Mitochondrial haplogroup D4j specific variant m.11696G > a(MT-ND4) may increase the penetrance and expressivity of the LHON-associated m.11778G > a mutation in Chinese pedigrees. Mitochondrial DNA A DNA Mapp Seq Anal 2016; 28:434-441. [PMID: 27159682 DOI: 10.3109/19401736.2015.1136304] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Leber's hereditary optic neuropathy (LHON) is one of the most common mitochondrial disorders. We report here the clinical, genetic and molecular analysis of mitochondrial DNA (mtDNA) in eight Han Chinese families carrying the known mitochondrial 11778G > A(MT-ND4) mutation. Thirty-seven (26 males/11 females) of 77 matrilineal relatives in these families exhibited the variable severity and age-at-onset of optic neuropathy. The penetrances were from 25% to 75%, with the average of 42%, and the age-at-onset for visual impairment varied from 10 to 25 years, with the average of 17 in these Chinese pedigrees. Molecular analysis of their mtDNA identified distinct sets of variants belonging to the Eastern Asian haplogroupD4j. Except the known m.11778G > A mutation, the m.11696G > A(MT-ND4) mutation caused the substitution of an isoleucine for valineat amino acid position 313, located in a predicted transmembrane region of ND4. And, it is reported that the m.11696G > A mutation was associated with LHON, and appeared to contribute to higher penetrance in these nine Chinese families than other Chinese families carrying only the m.11778G > A mutation. Therefore, the mitochondrial haplogroup D4j specific m.11696G > A mutation may act in synergy with the primary LHON-associated m.11778G > A mutation, thereby increasing the penetrance and expressivity of visual loss in these Chinese families.
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Affiliation(s)
- Shipeng Xie
- a Department of Ophthalmology , Xingtai Eye Hospital , Xingtai , Hebei , China
| | - Juanjuan Zhang
- b Institute of Genetics , Zhejiang University School of Medicine , Hangzhou , Zhejiang , China.,c School of Ophthalmology and Optometry , Wenzhou Medical University , Wenzhou , Zhejiang , China
| | - Jiji Sun
- b Institute of Genetics , Zhejiang University School of Medicine , Hangzhou , Zhejiang , China
| | - Minglian Zhang
- a Department of Ophthalmology , Xingtai Eye Hospital , Xingtai , Hebei , China
| | - Fuxin Zhao
- c School of Ophthalmology and Optometry , Wenzhou Medical University , Wenzhou , Zhejiang , China.,d Attardi Institute of Mitochondrial Biomedicine , Wenzhou Medical University , Wenzhou , Zhejiang , China
| | - Qi-Ping Wei
- e Department of Ophthalmology , Dongfang Hospital, Beijing University of Chinese Medicine and Pharmacology , Beijing , China
| | - Yi Tong
- c School of Ophthalmology and Optometry , Wenzhou Medical University , Wenzhou , Zhejiang , China
| | - Xiaoling Liu
- c School of Ophthalmology and Optometry , Wenzhou Medical University , Wenzhou , Zhejiang , China
| | - Xiangtian Zhou
- c School of Ophthalmology and Optometry , Wenzhou Medical University , Wenzhou , Zhejiang , China
| | - Pingping Jiang
- b Institute of Genetics , Zhejiang University School of Medicine , Hangzhou , Zhejiang , China.,f Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Zhejiang University , Hangzhou , China
| | - Yanchun Ji
- b Institute of Genetics , Zhejiang University School of Medicine , Hangzhou , Zhejiang , China
| | - Min-Xin Guan
- a Department of Ophthalmology , Xingtai Eye Hospital , Xingtai , Hebei , China.,f Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Zhejiang University , Hangzhou , China.,g Division of Pathology , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
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Weiss JN, Levy S, Benes SC. Stem Cell Ophthalmology Treatment Study (SCOTS): bone marrow-derived stem cells in the treatment of Leber's hereditary optic neuropathy. Neural Regen Res 2016; 11:1685-1694. [PMID: 27904503 PMCID: PMC5116851 DOI: 10.4103/1673-5374.193251] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [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: 12/11/2022] Open
Abstract
The Stem Cell Ophthalmology Treatment Study (SCOTS) is currently the largest-scale stem cell ophthalmology trial registered at ClinicalTrials.gov (identifier: NCT01920867). SCOTS utilizes autologous bone marrow-derived stem cells (BMSCs) to treat optic nerve and retinal diseases. Treatment approaches include a combination of retrobulbar, subtenon, intravitreal, intra-optic nerve, subretinal, and intravenous injection of autologous BMSCs according to the nature of the disease, the degree of visual loss, and any risk factors related to the treatments. Patients with Leber's hereditary optic neuropathy had visual acuity gains on the Early Treatment Diabetic Retinopathy Study (ETDRS) of up to 35 letters and Snellen acuity improvements from hand motion to 20/200 and from counting fingers to 20/100. Visual field improvements were noted. Macular and optic nerve head nerve fiber layer typically thickened. No serious complications were seen. The increases in visual acuity obtained in our study were encouraging and suggest that the use of autologous BMSCs as provided in SCOTS for ophthalmologic mitochondrial diseases including Leber's hereditary optic neuropathy may be a viable treatment option.
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Affiliation(s)
- Jeffrey N Weiss
- Retina Associates of South Florida, 5800 Colonial Drive, Suite 300, Margate, FL, USA
| | - Steven Levy
- MD Stem Cells, 3 Sylvan Road South, Westport, CT, USA
| | - Susan C Benes
- The Eye Center of Columbus, The Ohio State University, Columbus, OH, USA
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Grzybowski A, Zülsdorff M, Wilhelm H, Tonagel F. Toxic optic neuropathies: an updated review. Acta Ophthalmol 2015; 93:402-410. [PMID: 25159832 DOI: 10.1111/aos.12515] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 07/03/2014] [Indexed: 01/29/2023]
Abstract
Toxic optic neuropathy (TON) is caused by the damage to the optic nerve through different toxins, including drugs, metals, organic solvents, methanol and carbon dioxide. A similar clinical picture may also be caused by nutritional deficits, including B vitamins, folic acid and proteins with sulphur-containing amino acids. This review summarizes the present knowledge on disease-causing factors, clinical presentation, diagnostics and treatment in TON. It discusses in detail known and hypothesized relations between drugs, including tuberculostatic drugs, antimicrobial agents, antiepileptic drugs, antiarrhythmic drugs, disulfiram, halogenated hydroquinolones, antimetabolites, tamoxifen and phosphodiesterase type 5 inhibitors and optic neuropathy.
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Affiliation(s)
- Andrzej Grzybowski
- Department of Ophthalmology; Poznań City Hospital; Poznań Poland
- Departtment of Ophthalmology; University of Warmia and Mazury; Olsztyn Poland
| | | | - Helmut Wilhelm
- Centre for Ophthalmology; University of Tuebingen; Tuebingen Germany
| | - Felix Tonagel
- Centre for Ophthalmology; University of Tuebingen; Tuebingen Germany
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Zhang J, Jiang P, Jin X, Liu X, Zhang M, Xie S, Gao M, Zhang S, Sun YH, Zhu J, Ji Y, Wei QP, Tong Y, Guan MX. Leber's hereditary optic neuropathy caused by the homoplasmic ND1 m.3635G>A mutation in nine Han Chinese families. Mitochondrion 2014; 18:18-26. [PMID: 25194554 DOI: 10.1016/j.mito.2014.08.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 08/28/2014] [Accepted: 08/29/2014] [Indexed: 11/18/2022]
Abstract
In this report, we investigated the molecular mechanism underlying Leber's hereditary optic neuropathy (LHON)-associated mitochondrial m.3635G>A (p.S110N, ND1) mutation. A mutational screening of ND1 gene in a cohort of 1070 Han Chinese subjects LHON identified the m.3635G>A mutation in nine Chinese families with suggestively maternally transmitted LHON. Thirty-eight (22 males/16 females) of 162 matrilineal relatives in these families exhibited the variable severity and age-at-onset of optic neuropathy. Molecular analysis of their mitochondrial genomes identified the homoplasmic m.3635G>A mutation and distinct sets of polymorphisms belonging to the Asian haplogroups G2a1, R11a, D4, R11a, M7b2, G1a, F1a1, B4, and N9a3, respectively. Using cybrids constructed by transferring mitochondria from lymphoblastoid cell lines derived from one Chinese family into mtDNA-less (ρ(0)) cells, we showed ~27% decrease in the activity of NADH:ubiquinone oxidoreductase (complex I) in mutant cybrids carrying the m.3635G>A mutation, compared with control cybrids. The respiratory deficiency caused by the m.3635G>A mutation results in decreased efficiency of mitochondrial ATP synthesis. These mitochondrial dysfunctions caused an increase in the production of reactive oxygen species in the mutant cybrids. The data provide the direct evidence for the m.3635G>A mutation leading to LHON. Our findings may provide new insights into the understanding of pathophysiology of LHON.
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Affiliation(s)
- Juanjuan Zhang
- Institute of Genetics, Zhejiang University, Hangzhou, Zhejiang, China; School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Pingping Jiang
- Institute of Genetics, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaofen Jin
- Institute of Genetics, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaoling Liu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; Attardi Institute of Mitochondrial Biomedicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Minglian Zhang
- Department of Ophthalmology, Hebei Provincial Eye Hospital, Xingtai, Hebei, China
| | - Shipeng Xie
- Department of Ophthalmology, Hebei Provincial Eye Hospital, Xingtai, Hebei, China
| | - Min Gao
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; Attardi Institute of Mitochondrial Biomedicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Sai Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; Attardi Institute of Mitochondrial Biomedicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yan-Hong Sun
- Department of Ophthalmology, Beijing University of Chinese Medicine and Pharmacology, Beijing, China
| | - Jinping Zhu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; Attardi Institute of Mitochondrial Biomedicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yanchun Ji
- Institute of Genetics, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qi-Ping Wei
- Department of Ophthalmology, Beijing University of Chinese Medicine and Pharmacology, Beijing, China
| | - Yi Tong
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Min-Xin Guan
- Institute of Genetics, Zhejiang University, Hangzhou, Zhejiang, China; Attardi Institute of Mitochondrial Biomedicine, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Liang M, Jiang P, Li F, Zhang J, Ji Y, He Y, Xu M, Zhu J, Meng X, Zhao F, Tong Y, Liu X, Sun Y, Zhou X, Mo JQ, Qu J, Guan MX. Frequency and spectrum of mitochondrial ND6 mutations in 1218 Han Chinese subjects with Leber's hereditary optic neuropathy. Invest Ophthalmol Vis Sci 2014; 55:1321-31. [PMID: 24398099 DOI: 10.1167/iovs.13-13011] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To investigate the molecular pathogenesis of Leber's hereditary optic neuropathy (LHON) in Chinese families. METHODS A cohort of 1218 Han Chinese subjects with LHON and 316 control subjects underwent the clinical and genetic evaluation and molecular analysis of mitochondrial (mt)DNA. RESULTS The age at onset of optic neuropathy in these subjects ranged from 5 to 55 years, with the average of 18 years. Mutational analysis of ND6 gene identified 92 (73 known and 19 novel) variants in these subjects. These variants included 29 (9 novel and 20 known) missense mutations and 63 silence variants. A total of 94 subjects carrying one of the known T14484C, T14502C, and G14459A mutations accounted for 7.7% cases of this cohort, particularly 4.4% for T14484C mutation. Furthermore, eight putative LHON-associated ND6 mutations accounted for 1.1% case of this cohort. Thus, 106 subjects carrying one of ND6 mutations accounted for 8.7% cases of this cohort. Low penetrance of optic neuropathy in pedigrees carrying one of eight putative mutations indicated that the mutation(s) is necessary, but itself insufficient to produce a clinical phenotype. Mitochondrial DNAs in 98 probands carrying the ND6 mutation(s) were widely dispersed among 12 Eastern Asian subhaplogroups. In particular, the occurrences of haplogroups M9, M10, M11, and H2 in patients carrying the ND6 mutations were higher than those in controls. CONCLUSIONS These data further support that the ND6 gene is the hot spot for mutations associated with LHON. Thus, our findings may provide valuable information for the further understanding of pathophysiology and management of LHON.
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Affiliation(s)
- Min Liang
- Institute of Genetics, Zhejiang University, Hangzhou, Zhejiang, China
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Ziccardi L, Sadun F, De Negri AM, Barboni P, Savini G, Borrelli E, La Morgia C, Carelli V, Parisi V. Retinal function and neural conduction along the visual pathways in affected and unaffected carriers with Leber's hereditary optic neuropathy. Invest Ophthalmol Vis Sci 2013; 54:6893-901. [PMID: 24071953 DOI: 10.1167/iovs.13-12894] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We assessed retinal ganglion cell (RGC) function, and established a correlation between the neural conduction along the visual pathways and the retinal involvement in Leber's hereditary optic neuropathy (LHON). METHODS A total of 39 individuals carrying a LHON mutation (mean age, 33.35 ± 8.4 years), LHON-unaffected (LU, 22 eyes) or LHON-affected (LA, 17 eyes), underwent visual acuity and visual field examinations. A total of 22 age-similar normal subjects (mean age, 38.2 ± 6.0 years) served as controls. In all subjects, simultaneous pattern electroretinograms (PERGs) and visual evoked potentials (VEPs) were recorded in response to 60-minute (60') and 15-minute (15') checkerboard stimuli. RESULTS When compared to controls, LU eyes did not show any statistically significant difference in 60' and 15' VEP P100 implicit times (ITs), VEP N75-P100 amplitudes, and 60' PERG P50 ITs, whereas 15' PERG P50-N95 amplitudes were significantly (P < 0.01) reduced. When compared to control and LU eyes, LA eyes showed significant differences in PERG and VEP ITs, and amplitudes with both stimulations (60' and 15' checks). No significant correlations between PERG and VEP parameters were found in LU eyes, while in LA eyes, PERG P50 and VEP P100 ITs correlated significantly only when using 60' checks. CONCLUSIONS The LHON-unaffected eyes showed a retinal dysfunction detected by abnormal PERG responses that was not associated with changes along the visual pathways assessed by normal VEP responses. In LA eyes, the impaired neural conduction recorded by VEPs in response to larger (60' VEP responses) and smaller (15' VEP responses) checks were associated and not associated, respectively, with the detected retinal dysfunction.
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Affiliation(s)
- Lucia Ziccardi
- Fondazione per l'Oftalmologia "G.B. Bietti" - IRCCS, Rome, Italy
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Abstract
Alzheimer disease (AD) and Parkinson disease (PD) are the two most common age-related neurodegenerative diseases characterized by prominent neurodegeneration in selective neural systems. Although a small fraction of AD and PD cases exhibit evidence of heritability, among which many genes have been identified, the majority are sporadic without known causes. Molecular mechanisms underlying neurodegeneration and pathogenesis of these diseases remain elusive. Convincing evidence demonstrates oxidative stress as a prominent feature in AD and PD and links oxidative stress to the development of neuronal death and neural dysfunction, which suggests a key pathogenic role for oxidative stress in both AD and PD. Notably, mitochondrial dysfunction is also a prominent feature in these diseases, which is likely to be of critical importance in the genesis and amplification of reactive oxygen species and the pathophysiology of these diseases. In this review, we focus on changes in mitochondrial DNA and mitochondrial dynamics, two aspects critical to the maintenance of mitochondrial homeostasis and function, in relationship with oxidative stress in the pathogenesis of AD and PD.
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Affiliation(s)
| | - Xinglong Wang
- Department of Pathology; Department of Neurology, Case Western Reserve University, Cleveland, OH 44106, USA.
| | - Xiongwei Zhu
- Department of Pathology; Department of Neurology, Case Western Reserve University, Cleveland, OH 44106, USA.
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Sadun AA, La Morgia C, Carelli V. Mitochondrial optic neuropathies: our travels from bench to bedside and back again. Clin Exp Ophthalmol 2013; 41:702-12. [PMID: 23433229 DOI: 10.1111/ceo.12086] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 01/21/2013] [Indexed: 01/02/2023]
Abstract
The standard scientific method requires that you make an interesting observation, generate a hypothesis and then design an experiment to test the hypothesis. In ophthalmology, as in most fields of medicine, the observations and hypotheses tend to have more degrees of freedom, and the interpretation of experiments is also more complicated and often indeterminate. But sometimes it works out, going back and forth from bench to bedside to bench, in reiterative cycles. A successful example of alternating bench and bedside studies was presented (AAS) at the 2012 Alper Memorial given at the Washington Hospital Medical Center, illustrating a series of questions and investigations that pertain to mitochondrial optic neuropathies, beginning two decades ago, before the concept of mitochondrial optic neuropathies had much meaning. Basic science questions are often best answered by that extraordinary experiment of nature that we call clinical disease, and clinical questions are often best tested in the laboratory.
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Affiliation(s)
- Alfredo A Sadun
- Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Allen D, Riordan-Eva P, Paterson RW, Hadden RDM. Subacute peripheral and optic neuropathy syndrome with no evidence of a toxic or nutritional cause. Clin Neurol Neurosurg 2013; 115:1389-93. [PMID: 23384546 DOI: 10.1016/j.clineuro.2013.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Revised: 01/03/2013] [Accepted: 01/05/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND The syndrome of subacute simultaneous peripheral neuropathy and bilateral optic neuropathy is known to occur in tropical countries, probably due to malnutrition or toxicity, but not often seen in developed countries. We report seven patients in London who were not malnourished or alcoholic, and in whom no clear cause was found. METHODS We retrospectively reviewed the case notes and arranged some further investigations. RESULTS All patients developed peripheral and bilateral optic neuropathy within 6 months. Patients were aged 30-52, and all of Jamaican birth and race but lived in the UK. Most had subacute, painful ataxic sensory axonal neuropathy or neuronopathy, some with myelopathy. Nerve conduction studies revealed minor demyelinating features in two cases. The optic neuropathy was symmetrical, subacute and monophasic, usually with marked reduction in visual acuity. CSF protein concentration was usually elevated but other laboratory investigations were normal. Patients showed only modest improvement at follow-up. CONCLUSION These patients share a common clinical and electrophysiological phenotype, age, ethnicity and elevated CSF protein, but otherwise normal laboratory investigations. The syndrome is a cause of significant morbidity in young people. The cause remains uncertain despite thorough investigation.
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Affiliation(s)
- D Allen
- Department of Clinical Neurophysiology, King's College Hospital, London, UK.
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Nakaso K, Adachi Y, Fusayasu E, Doi K, Imamura K, Yasui K, Nakashima K. Leber's Hereditary Optic Neuropathy with Olivocerebellar Degeneration due to G11778A and T3394C Mutations in the Mitochondrial DNA. J Clin Neurol 2012; 8:230-4. [PMID: 23091534 PMCID: PMC3469805 DOI: 10.3988/jcn.2012.8.3.230] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 10/21/2011] [Accepted: 10/21/2011] [Indexed: 11/30/2022] Open
Abstract
Background Leber's hereditary optic neuropathy (LHON) is a mitochondrial disorder with optic nerve atrophy. Although there are no other associated neurological abnormalities in most cases of LHON, cases of "LHON plus" have been reported. Case Report The proband was a 37-year-old man who had visual and gait disturbances that had first appeared at 10 years of age. He showed horizontal gaze palsy, gaze-evoked nystagmus, dysarthria, and cerebellar ataxia. Brain and orbit MRI disclosed atrophy of the optic nerve and cerebellum, and degenerative changes in the bilateral inferior olivary nucleus. Mutational analyses of mitochondrial DNA identified the coexistence of heteroplasmic G11778A and homoplasmic T3394C mutations. Conclusions These results suggest that the combination of G11778A and T3394C mutations leads to an atypical LHON phenotype.
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Affiliation(s)
- Kazuhiro Nakaso
- Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
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