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Laugwitz, L.* ; Seibt, A.* ; Herebian, D.* ; Peralta, S.* ; Kienzle, I.* ; Buchert, R.* ; Falb, R.* ; Gauck, D.* ; Müller, A.* ; Grimmel, M.* ; Beck-Woedel, S.* ; Kern, J.* ; Daliri, K.* ; Katibeh, P.* ; Danhauser, K. ; Leiz, S.* ; Alesi, V.* ; Baertling, F.* ; Vasco, G.* ; Steinfeld, R.* ; Wagner, M. ; Caglayan, A.O.* ; Gumus, H.* ; Burmeister, M.* ; Mayatepek, E.* ; Martinelli, D.* ; Tamhankar, P.M.* ; Tamhankar, V.* ; Joset, P.* ; Steindl, K.* ; Rauch, A.* ; Bonnen, P.E.* ; Froukh, T.* ; Groeschel, S.* ; Krägeloh-Mann, I.* ; Haack, T.B.* ; Distelmaier, F.*

Human COQ4 deficiency: Delineating the clinical, metabolic and neuroimaging phenotypes.

J. Med. Genet. 59, 878–887 (2022)
Postprint DOI PMC
Open Access Green
Background Human coenzyme Q4 (COQ4) is essential for coenzyme Q(10) (CoQ(10)) biosynthesis. Pathogenic variants in COQ4 cause childhood-onset neurodegeneration. We aimed to delineate the clinical spectrum and the cellular consequences of COQ4 deficiency. Methods Clinical course and neuroradiological findings in a large cohort of paediatric patients with COQ4 deficiency were analysed. Functional studies in patient-derived cell lines were performed. Results We characterised 44 individuals from 36 families with COQ4 deficiency (16 newly described). A total of 23 different variants were identified, including four novel variants in COQ4. Correlation analyses of clinical and neuroimaging findings revealed three disease patterns: type 1: early-onset phenotype with neonatal brain anomalies and epileptic encephalopathy; type 2: intermediate phenotype with distinct stroke-like lesions; and type 3: moderate phenotype with non-specific brain pathology and a stable disease course. The functional relevance of COQ4 variants was supported by in vitro studies using patient-derived fibroblast lines. Experiments revealed significantly decreased COQ4 protein levels, reduced levels of cellular CoQ(10) and elevated levels of the metabolic intermediate 6-demethoxyubiquinone. Conclusion Our study describes the heterogeneous clinical presentation of COQ4 deficiency and identifies phenotypic subtypes. Cell-based studies support the pathogenic characteristics of COQ4 variants. Due to the insufficient clinical response to oral CoQ(10) supplementation, alternative treatment strategies are warranted.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Nervous System Diseases ; Pediatrics ; Epilepsy ; Early Diagnosis; Pediatric Mitochondrial Disease; Coenzyme-q; Biosynthesis; Mutations; Ataxia; Muscle
Language english
Publication Year 2022
Prepublished in Year 2021
HGF-reported in Year 2021
ISSN (print) / ISBN 0022-2593
e-ISSN 1468-6244
Journal Journal of Medical Genetics
Quellenangaben Volume: 59, Issue: 9, Pages: 878–887 Article Number: , Supplement: ,
Publisher BMJ Publishing Group
Publishing Place British Med Assoc House, Tavistock Square, London Wc1h 9jr, England
Reviewing status Peer reviewed
Institute(s) Institute of Human Genetics (IHG)
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
Grants Elterninitiative Kinderkrebsklinik e.V.
German Research Foundation/Deutsche Forschungsgemeinschaft
European Reference Network for Rare Neurological Diseases
DOI 10.1136/jmedgenet-2021-107729
WOS ID WOS:000725042300001
PubMed ID 34656997
Erfassungsdatum 2021-12-17
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