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A associated with mutations in POLG1 exonuclease domain
From Centro Dino Ferrari (Drs. Del Bo, Sciacco, Di Fonzo, Galbiati, Crimi, Bresolin, and Comi, and A. Bordoni), Dipartimento di Scienze Neurologiche, Università degli Studi di Milano, I.R.C.C.S. Ospedale Maggiore Policlinico and Centro di Eccellenza per le Malattie Neurodegenerative, Milan; and I.R.C.C.S. "E. Medea" de La Nostra Famiglia (Dr. Bresolin), Bosisio Parini, Italy.
Address correspondence and reprint requests to Dr. Roberto Del Bo, Dipartimento di Scienze Neurologiche, Padiglione Ponti, Via F. Sforza, 35, 20122 Milan, Italy; e-mail: neurogene{at}policlinico.mi.it
Objective: To better understand the still unknown pathologic mechanism involved in the accumulation of multiple mtDNA deletions in stable tissues.
Methods: A large-scale screening of mtDNA molecules from skeletal muscle was performed in 14 patients with progressive external ophthalmoplegia (PEO) and 2 patients with mitochondrial neurogastrointestinal encephalomyopathy carrying mutations on ANT1, C10ORF2 or POLG1, and TP genes.
Results: Patients with at least one mutation in the exonuclease domain of POLG1 showed the highest frequency of individually rare point mutations only in the mtDNA control region; in addition, high levels, in terms of frequency and heteroplasmy, of recurrent mutations (A189G, T408A, and T414G) and alterations affecting the (HT)D310 region were detectable in many of the patients. Two homozygous POLG1 mutations, within the exonuclease domain, were able to induce an increased mutational burden also in fibroblasts from patients with PEO.
Conclusions: Specific POLG1 mutations directly affect the integrity of the mtDNA by reducing its proof-reading exonuclease activity, resulting in the accumulation of heteroplasmic levels of both randomly rare and recurrent point mutations in the skeletal muscle tissue and fibroblasts.
Received March 28, 2003. Accepted in final form August 7, 2003.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the October 14 issue to find the title link for this article.
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