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Alston, C.L.* ; Stenton, S. ; Hudson, G.* ; Prokisch, H. ; Taylor, R.W.*

The genetics of mitochondrial disease: Dissecting mitochondrial pathology using multi-omic pipelines.

J. Pathol. 254, 430-442 (2021)
Publ. Version/Full Text DOI PMC
Open Access Gold (Paid Option)
Creative Commons Lizenzvertrag
Mitochondria play essential roles in numerous metabolic pathways including the synthesis of adenosine triphosphate through oxidative phosphorylation. Clinically, mitochondrial diseases occur when there is mitochondrial dysfunction - manifesting at any age and affecting any organ system; tissues with high energy requirements, such as muscle and the brain, are often affected. The clinical heterogeneity is parallel to the degree of genetic heterogeneity associated with mitochondrial dysfunction. Around 10% of human genes are predicted to have a mitochondrial function, and defects in over 300 genes are reported to cause mitochondrial disease. Some involve the mitochondrial genome (mtDNA), but the vast majority occur within the nuclear genome. Except for a few specific genetic defects, there remains no cure for mitochondrial diseases which means that a genetic diagnosis is imperative for genetic counselling and the provision of reproductive options for at-risk families. Next-generation sequencing strategies, particularly exome and whole-genome sequencing, have revolutionised mitochondrial diagnostics such that the traditional muscle biopsy has largely been replaced with a minimally-invasive blood sample for an unbiased approach to genetic diagnosis. Where these genomic approaches have not identified a causative defect, or where there is insufficient support for pathogenicity, additional functional investigations are required. The application of supplementary 'omics' technologies, including transcriptomics, proteomics, and metabolomics, has the potential to greatly improve diagnostic strategies. This review aims to demonstrate that, whilst a molecular diagnosis can be achieved for many cases through next-generation sequencing of blood DNA, the use of patient tissues and an integrated, multidisciplinary multi-omics approach is pivotal for diagnosing more challenging cases. Moreover, the analysis of clinically-relevant tissues from affected individuals remains crucial for understanding the molecular mechanisms underlying mitochondrial pathology. This article is protected by copyright. All rights reserved.
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Publication type Article: Journal article
Document type Review
Corresponding Author
Keywords Mitochondrial Pathology ; Genetic Diagnosis ; Genomics ; Metabolomics ; Mitochondrial Disease ; Proteomics
ISSN (print) / ISBN 0022-3417
e-ISSN 1096-9896
Journal Journal of Pathology, The
Quellenangaben Volume: 254, Issue: 4, Pages: 430-442 Article Number: , Supplement: ,
Publisher Wiley
Publishing Place 111 River St, Hoboken 07030-5774, Nj Usa
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Neurogenomics (ING)
Institute of Human Genetics (IHG)
Grants National Institute for Health Research (NIHR)
German Bundesministerium fur Bildung und Forschung (BMBF) through the German network for mitochondrial disorders (mitoNET)
German BMBF
Horizon2020 through the E-Rare project GENOMIT
Medical Research Council (MRC) International Centre for Genomic Medicine in Neuromuscular Disease, Newcastle University Centre for Ageing and Vitality
Biotechnology and Biological Sciences Research Council and Medical Research Council
MRC/ESPRC Newcastle Molecular Pathology Node
UK National Health Service Highly Specialised Service for Rare Mitochondrial Disorders
Lily Foundation
NIHR Newcastle Biomedical Research Centre (BRC) - National Institute for Health Research (NIHR)
Wellcome Centre for Mitochondrial Research