Danhauser, K.* ; Herebian, D.* ; Haack, T.B. ; Rodenburg, R.J.* ; Strom, T.M. ; Meitinger, T. ; Klee, D.* ; Mayatepek, E.* ; Prokisch, H. ; Distelmaier, F.*
     
    
        
Fatal neonatal encephalopathy and lactic acidosis caused by a homozygous loss-of-function variant in COQ9.
    
    
        
    
    
        
        Eur. J. Hum. Genet. 24, 450-454 (2016)
    
    
    
      
      
	
	    Coenzyme Q10 (CoQ10) has an important role in mitochondrial energy metabolism by way of its functioning as an electron carrier in the respiratory chain. Genetic defects disrupting the endogenous biosynthesis pathway of CoQ10 may lead to severe metabolic disorders with onset in early childhood. Using exome sequencing in a child with fatal neonatal lactic acidosis and encephalopathy, we identified a homozygous loss-of-function variant in COQ9. Functional studies in patient fibroblasts showed that the absence of the COQ9 protein was concomitant with a strong reduction of COQ7, leading to a significant accumulation of the substrate of COQ7, 6-demethoxy ubiquinone10. At the same time, the total amount of CoQ10 was severely reduced, which was reflected in a significant decrease of mitochondrial respiratory chain succinate-cytochrome c oxidoreductase (complex II/III) activity. Lentiviral expression of COQ9 restored all these parameters, confirming the causal role of the variant. Our report on the second COQ9 patient expands the clinical spectrum associated with COQ9 variants, indicating the importance of COQ9 already during prenatal development. Moreover, the rescue of cellular CoQ10 levels and respiratory chain complex activities by CoQ10 supplementation points to the importance of an early diagnosis and immediate treatment.
	
	
	    
	
       
      
	
	    
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        Publication type
        Article: Journal article
    
 
    
        Document type
        Scientific Article
    
 
    
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        Keywords
        Coenzyme-q Biosynthesis; Mutations Cause; Deficiency; Spectrum; Protein; Disease
    
 
    
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        Language
        english
    
 
    
        Publication Year
        2016
    
 
    
        Prepublished in Year
        2015
    
 
    
        HGF-reported in Year
        2015
    
 
    
    
        ISSN (print) / ISBN
        1018-4813
    
 
    
        e-ISSN
        1476-5438
    
 
    
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	    Volume: 24,  
	    Issue: 3,  
	    Pages: 450-454 
	    Article Number: ,  
	    Supplement: ,  
	
    
 
    
        
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            Publisher
            Nature Publishing Group
        
 
        
            Publishing Place
            London
        
 
	
        
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        Reviewing status
        Peer reviewed
    
 
     
    
        POF-Topic(s)
        30501 - Systemic Analysis of Genetic and Environmental Factors that Impact Health
    
 
    
        Research field(s)
        Genetics and Epidemiology
    
 
    
        PSP Element(s)
        G-500700-001
    
 
    
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        Erfassungsdatum
        2015-06-19