Journal
COLD SPRING HARBOR MOLECULAR CASE STUDIES
Volume 2, Issue 3, Pages -Publisher
COLD SPRING HARBOR LAB PRESS, PUBLICATIONS DEPT
DOI: 10.1101/mcs.a000786
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Funding
- William F. Milton fund from Harvard Medical School, Boston
- National Institute of Arthritis and Musculoskeletal and Skeletal Diseases (NIAMS) of the National Institute of Health (NIH) [1R01AR068429-01]
- National Institute of Child Health and Human Development (NICHD)/National Human Genome Research Institute (NHGRI)/NIH [U19HD077671]
- Gene Discovery Core of The Manton Center for Orphan Disease Research, Boston Children's Hospital
- National Institutes of Health [P30 HD18655]
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We describe a large Lebanese family with two affected members, a young female proband and her male cousin, who had multisystem involvement including profound global developmental delay, severe hypotonia and weakness, respiratory insufficiency, blindness, and lactic acidemia-findings consistent with an underlying mitochondrial disorder. Whole-exome sequencing was performed on DNA from the proband and both parents. The proband and her cousin carried compound heterozygous mutations in the PMPCA gene that encodes for alpha-mitochondrial processing peptidase (alpha-MPP), a protein likely involved in the processing of mitochondrial proteins. The variants were located dose to and postulated to affect the substrate binding glycine-rich loop of the alpha-MPP protein. Functional assays including immunofluorescence and western blot analysis on patient's fibroblasts revealed that these variants reduced alpha-MPP levels and impaired frataxin production and processing. We further determined that those defects could be rescued through the expression of exogenous wild-type PMPCA cDNA. Our findings link defective alpha-MPP protein to a severe mitochondrial disease.
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