Complex I deficiency is associated with 3243G:C mitochondrial DNA in osteosarcoma cell cybrids

143B.206 rho degrees cells were repopulated with mitochondria from a MELAS patient harbouring a mixture of 3243G:C and 3243A:T mitochondrial DNA. A number of biochemical assays were performed on selected cybrids with various proportions of the two types of mitochondrial DNA. These assays revealed a marked decrease in oxygen consumption with pyruvate, a complex I substrate, in cybrids containing 60% to 90% 3243G:C mitochondrial DNA. Moreover, these cybrids showed decreased synthesis of a number of polypeptides in a mitochondrial in vitro translation assay. A cybrid line with a very high level of 3243G:C mitochondrial DNA (95%) had additional deficiencies in complexes III and IV and there was a marked generalised decrease in mitochondrial translation in this cybrid. The observation of complex I deficiency is consistent with previously reported enzymatic measurements of muscle homogenates from MELAS patients with the 3243G:C mutation.      

Mitochondrial tRNALeu isoforms in lung carcinoma cybrid cells containing the np 3243 mtDNA mutation

We have investigated the representation of structural isoforms of the two mitochondrial leucyl tRNAs in lung carcinoma cybrid cell lines containing the np 3243 (MELAS) mtDNA mutation, alone or in combination with the np 12300 suppressor mutation. The mutant tRNALeu(UUR) is aminoacylated very poorly or not at all, whereas the suppressor tRNALeu(CUN) is efficiently aminoacylated. Deacylated mitochondrial tRNALeu(CUN) is present, in all human cells tested, in two structural isoforms that are separable on denaturing gels, indicating a difference in primary structure. The ratio of the two isoforms differs between cell types and is strongly biased towards one isoform in lung carcinoma cybrids containing high levels of the np 3243 mutation, compared with control cybrids. We propose that structural modification of tRNALeu(CUN) could be a natural suppression mechanism for the np 3243 and other mitochondrial tRNALeu(UUR) mutations and could underlie some of the phenotypic variability of np 3243 disease.      

Do sequence variants in the major non-coding region of the mitochondrial genome influence mitochondrial mutations associated with disease?

Several different mutations in human mitochondrial DNA (mtDNA) have been associated with disease, but their origins and the basis of the wide phenotypic variability remain to be elucidated. We initially investigated three patients with heteroplasmic disease associated mutations of mtDNA for the presence of cis mutations in the major non- coding region that might influence their origins or pathology. A T --> C transition at nt 16 189 previously identified in one patient with the 3243 G:C mutation was associated with heteroplasmic length variation. Identical length variation was found in patient-derived cybrid lines containing 0-97.5% 3243 G:C. Similarly, heteroplasmic length variation was demonstrated in 2/6 other probands with both the 3243 mutation and the 16,189 polymorphism. The distribution of length variants in probands and in asymptomatic family members was identical in all cases. Thus length variation appears to be independent of the level of 3243 mutant mtDNA and hence probably arose within both 3243 G:C and 3243 A:T mtDNAs. We suggest that the 16,189 polymorphism reflects a predisposition to the formation or fixation of several different mutations in mitochondrial tRNA-LeuUUR.      

Enhanced ROS production and antioxidant defenses in cybrids harbouring mutations in mtDNA

It has been suggested that mutations in mitochondrial DNA (mtDNA) can produce an increase in reactive oxygen species (ROS) and that this can play a major role in the pathogenic mechanisms of mitochondrial encephalomyopathies. Many studies exist using electron transport chain (ETC) inhibitors, however there are only a few studies that examine ROS production associated with mutations in the mtDNA. To investigate this issue, we have studied ROS production, antioxidant defences and oxidative damage to lipids and proteins in transmitochondrial cybrids carrying different mtDNA mutations. Here, we report that two different mutant cell lines carrying mutations in their mitochondrial tRNA genes (A3243G in tRNA LeuUUR and A8344G in tRNA Lys) showed an increased ROS production with a parallel increase in the antioxidant enzyme activities, which may protect cells from oxidative damage in our experimental conditions (no overt oxidative damage to lipids and proteins has been observed). In contrast, cytochrome c oxidase (COX) mutant cybrids (carrying the stop-codon mutation G6930A in the COXI gene) showed neither an increase in ROS production nor elevation of antioxidant enzyme activities or oxidative damage. These results suggest that the specific location of mutations in mtDNA has a strong influence on the phenotype of the antioxidant response. Therefore, this issue should be carefully considered when antioxidant therapies are investigated in patients with mitochondrial disorders.     

Depletion of mitochondrial DNA in leucocytes harbouring the 3243A->G mtDNA mutation

Background

The 3243A→G MTTL1 mutation is the most common heteroplasmic mitochondrial DNA (mtDNA) mutation associated with disease. Previous studies have shown that the percentage of mutated mtDNA decreases in blood as patients get older, but the mechanisms behind this remain unclear.

Objectives and method

To understand the dynamics of the process and the underlying mechanisms, an accurate fluorescent assay was established for 3243A→G heteroplasmy and the amount of mtDNA in blood with real‐time polymerase chain reaction was determined. The amount of mutated and wild‐type mtDNA was measured at two time points in 11 subjects.

Results

The percentage of mutated mtDNA decreases exponentially during life, and peripheral blood leucocytes in patients harbouring 3243A→G are profoundly depleted of mtDNA.

Conclusions

A similar decrease in mtDNA has been seen in other mitochondrial disorders, and in 3243A→G cell lines in culture, indicating that depletion of mtDNA may be a common secondary phenomenon in several mitochondrial diseases. Depletion of mtDNA is not always due to mutation of a nuclear gene involved in mtDNA maintenance.The 3243A→G MTTL1 gene mutation of mitochondrial DNA (mtDNA) is the most common heteroplasmic pathogenic mtDNA mutation and is found in approximately 1 in 6000 of the general population.¹ Although first described in mitochondrial encephalomyopathy with lactic acidosis and stroke‐like episodes (MELAS), the phenotypic spectrum is extremely diverse, including isolated diabetes and deafness, hypertrophic cardiomyopathy and retinitis pigmentosa.² The clinical variability can be explained partly by tissue‐specific differences in the percentage of mutated mtDNA.^3,4Intriguingly, the percentage of mutated mtDNA is consistently lower in peripheral blood than in post‐mitotic tissues such as skeletal muscle and brain.^3,5 Serial measurements in the same subject have shown that the percentage of the 3243A→G mutation in blood decreases over time,^6,7 but the reasons for this are not clear. One possibility is that vegetative segregation in rapidly proliferating leucocyte precursors leads to high percentages of mutated mtDNA in some cells. This causes a biochemical defect of the respiratory chain, which either impairs the further proliferation of that cell lineage or leads to cell death.⁷ This would ultimately lead to a decrease in the percentage of mutated mtDNA in the daughter cells present in the peripheral blood. However, it is currently not known whether the biochemical defect is primarily because of high amounts of mutated mtDNA,⁸ low amounts of wild‐type mtDNA⁹ or a combination of both.To advance our understanding of this process, we developed and validated a highly sensitive fluorescent assay to measure the changes in heteroplasmy over time, and also measured the absolute amount of mutated and wild‐type mtDNA in 11 subjects known to harbour 3243A→G.     

线粒体脑肌病伴乳酸血症和卒中样发作综合征的临床特征及遗传学研究

目的探讨线粒体脑肌病伴乳酸血症和卒中样发作（MELAS）综合征临床与分子遗传学特征,寻找MELAS线粒体DNA（mtDNA）A3243G点突变比例与临床特征的关联性。方法对2001年1月至2008年1月在首都医科大学附属北京儿童医院神经内科住院和门诊临床疑似线粒体脑肌病的患儿,行外周血白细胞mtDNA A3243G点突变筛查、血乳酸检测和神经影像学等检查。A3243G点突变阳性病例中选取符合MELAS临床疑似诊断标准的患儿（突变阳性组）,对其家系进行调查,采集家族成员血进行mtDNA A3243G点突变筛查;A3243G点突变阴性病例中选取符合MELAS临床疑似诊断标准的患儿行肌肉病理活检和肌肉A3243G点突变筛查（突变阴性组）。分析比较两组的临床资料及MELAS遗传学特征。结果研究期间共有272例疑似线粒体脑肌病的患儿进行了外周血白细胞A3243G点突变的筛查。A3243G点突变的20例阳性标本中,突变均为异胞质性（heteroplasmy）,18例符合MELAS的临床疑似诊断标准。血细胞中突变型mtDNA的比例为9.0%-50.0%,其中4例同时在肌肉组织检测到相同突变,突变比例为42.4%-64.8%。临床症状以惊厥、乏力、智力进行性倒退、发热、呕吐、视力障碍和失语为主,身材矮小和体毛增多为主要体征,13例合并癫,血乳酸均升高,头颅CT/MRI显示双侧对称性苍白球钙化和脑梗死信号。A3243G点突变筛查阴性标本中有4例临床符合MELAS临床疑似诊断标准,肌肉病理可见破碎红边纤维,肌肉A3243G点突变筛查阴性。14个家庭中的37名家庭成员采集了外周血进行mtDNA A3243G点突变筛查,突变阳性组中患儿母亲5名检测到A3243G点突变,突变比例分别为3.0%,5.0%,11.8%,21.3%和26.9%,同胞兄弟4名检测到A3243G突变,突变比例分别为19.3%、33.3%,37.5%和41.5%,均无临床症状,其他成员未检测到突变。本研究A3243G点突变比例与发病年龄和就诊年龄呈负相关趋势,与病程未?     

Clinical features of MELAS and its relation with A3243G gene point mutation

Mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS) mostly occur in children. The point mutation A3243G of mitochondrial DNA (mtDNA) may work as a specific bio-marker for mitochondrial disorders. The related clinical features, however, may vary among individuals. This study therefore investigated the relation between MELAS clinical features and point mutation A3243G of mtDNA, in an attempt to provide further evidences for genetic diagnosis of MELAS. Children with MELAS-like syndromes were tested for both blood lactate level and point mutation A3243G of mtDNA. Further family study was performed by mtDNA mutation screening at the same loci for those who had positive gene mutation at A3243G loci. Those who were negative for A3243G point mutation were examined by muscle biopsy and genetic screening. Both clinical and genetic features were analyzed. In all 40 cases with positive A3243G mutation, 36 children fitted clinical diagnosis of MELAS. In other 484 cases with negative mutation, only 8 children were clinically diagnosed with MELAS. Blood lactate levels in both groups were all elevated (P>0.05). In a further genetic screening of 28 families, 10 biological mothers and 8 silbings of MELAS children had positive A3243G point mutations but without any clinical symptoms. Certain difference existed in the clinical manifestations between children who were positive and negative for A3243G mutation of mtDNA but without statistical significance. MELAS showed maternal inheritance under most circumstances.     

Noninvasive diagnosis of the 3243A > G mitochondrial DNA mutation using urinary epithelial cells

The 3243A > G mutation is one of the most frequently observed mutations of mitochondrial DNA (mtDNA), and is associated with numerous clinical presentations including mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS), progressive external ophthalmoplegia (PEO) and diabetes and deafness. The routine diagnosis of the 3243A > G mutation in blood is difficult as mutation levels are known to decrease in this tissue over time, while in some patients it may be absent. We have directly compared the levels of the 3243A > G mutation in skeletal muscle, blood and urinary epithelial cells in 18 patients and observed a striking correlation between the mutation load in postmitotic muscle and urinary epithelium, a mitotic tissue. These data strongly support the use of urinary epithelial cells as the tissue of choice in the noninvasive diagnosis of the 3243A > G mutation.     

Detection of deafness-causing mutations in the Greek mitochondrial genome

Mitochondrion harbors its own DNA, known as mtDNA, encoding certain essential components of the mitochondrial respiratory chain and protein synthesis apparatus. mtDNA mutations have an impact on cellular ATP production and many of them are undoubtedly a factor that contributes to sensorineural deafness, including both syndromic and non-syndromic forms. Hot spot regions for deafness mutations are the MTRNR1 gene, encoding the 12S rRNA, the MTTS1 gene, encoding the tRNA for Ser^{(UCN)}, and the MTTL1 gene, encoding the tRNA for Leu^{(UUR)}. We investigated the impact of mtDNA mutations in the Greek hearing impaired population, by testing a cohort of 513 patients suffering from childhood onset prelingual or postlingual, bilateral, sensorineural, syndromic or non-syndromic hearing loss of any degree for six mitochondrial variants previously associated with deafness. Screening involved the MTRNR1 961delT/insC and A1555G mutations, the MTTL1 A3243G mutation, and the MTTS1 A7445G, 7472insC and T7510C mutations. Although two patients were tested positive for the A1555G mutation, we failed to identify any subject carrying the 961delT/insC, A3243G, A7445G, 7472insC, or T7510C mutations. Our findings strongly support our previously raised conclusion that mtDNA mutations are not a major risk factor for sensorineural deafness in the Greek population.     

The A8296G mtDNA mutation associated with several mitochondrial diseases does not cause mitochondrial dysfunction in cybrid cell lines

Transmitochondrial cybrid cell lines homoplasmic for the A8296G mtDNA transition, a mutation associated with several mitochondrial diseases, have a normal oxidative phosphorylation function, as shown by oxygen consumption, lactate production, respiratory enzyme activities, and growth using galactose as the only source of energy. The synthesis of mitochondrial proteins is also similar in mutant and wild-type cybrids. Our results suggest that the A8296G mutation is a polymorphism and reinforce the necessity of performing functional studies to assess the pathogenicity of mtDNA mutations.     

Presence of mitochondrial tRNA(Leu(UUR)) A to G 3243 mutation in DNA extracted from serum and plasma of patients with type 2 diabetes mellitus

AIMS/BACKGROUND: An A to G substitution at base pair 3243 in the mitochondrial tRNA(Leu(UUR)) gene (mt3243) is commonly associated with maternally inherited diabetes and deafness, and other diseases. It is possible that cell free mitochondrial DNA exists in serum and plasma from these patients, and these samples might be a source of material for the detection of such mutations. METHODS: Sixteen patients with type 2 diabetes mellitus and 25 healthy subjects were tested for the 3243 mutation by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) analysis. Plasma and serum from the 41 subjects were tested blind, without knowledge of the final diagnosis. RESULTS: PCR amplification of the mtRNA(Leu(UUR)) region in mitochondrial DNA (mtDNA) in serum samples revealed the presence of mtDNA in all samples. After ApaI digestion of the amplified DNA fragments, mt3243 was detected in the serum and plasma samples of the seven patients with diabetes who had previously been found to have this mutation in their leucocyte DNA. None of the serum/plasma samples from the healthy subjects or those patients negative for mt3243 in their leucocytes had this mutation (p < 0.001). In addition, the degree of heteroplasmy of mt3243 appeared to be higher in serum and plasma samples than in leucocytes among mt3243 carriers (p < 0.05). CONCLUSIONS: Therefore, mtDNA and associated mutations are present and detectable in serum and plasma. Plasma and serum might be alternative sources for the molecular diagnosis of mt3243 associated diabetes mellitus, as well as other mitochondrial mediated diseases.     

Heteroplasmic Segregation Associated with Trisomy-9 in Cultured Human Cells

In cybrid cells carrying the mitochondrial A3243G MELAS mutation, which were also heteroplasmic for the G12300A suppressor mutation, we observed a transient episode of heteroplasmic instability, resulting in a wide diversification in G12300A heteroplasmy levels and a shift in the average heteroplasmy level from 11 to 29%. These cells were found to be trisomic for chromosome 9, whereas a minority of cells that retained disomy-9 showed no instability. Coculture experiments implied that trisomy-9 cells exhibited a significant growth advantage, but neither heteroplasmy levels, respiratory phenotype nor trisomy-9 itself had direct selective value under standard culture conditions. Mitochondrial nucleoid number was the same (50–100) in cells that had or had not experienced transient heteroplasmic instability, but 1–2 orders of magnitude less than the segregation number in such cells. These findings support the idea that mtDNA partition is under nuclear genetic control, and implicate a locus on chromosome 9 in this regulation.     

Differentiation-specific effects of LHON mutations introduced into neuronal NT2 cells

Inheritance of one of three primary mutations at positions 11778, 3460 or 14484 of the mitochondrial genome in subunits of Complex I causes Leber's Hereditary Optic Neuropathy (LHON), a specific degeneration of the optic nerve, resulting in bilateral blindness. It has been unclear why inheritance of a systemic mitochondrial mutation would result in a specific neurodegeneration. To address the neuron-specific degenerative phenotype of the LHON genotype, we have created cybrids using a neuronal precursor cell line, Ntera 2/D1 (NT2), containing mitochondria from patient lymphoblasts bearing the most common LHON mutation (11778) and the most severe LHON mutation (3460). The undifferentiated LHON-NT2 mutant cells were not significantly different from the parental cell control in terms of mtDNA/nDNA ratio, mitochondrial membrane potential, reactive oxygen species (ROS) production or the ability to reduce Alamar Blue. Differentiation of NT2s resulted in a neuronal morphology and neuron-specific pattern of gene expression, and a 3-fold reduction in mtDNA/nDNA ratio in both mutant and control cells; however, the differentiation protocol yielded significantly less LHON cells than controls, by 30%, indicating either a decreased proliferative potential or increased cell death of the LHON-NT2 cells. Differentiation of the cells to the neuronal form also resulted in significant increases in ROS production in the LHON-NT2 neurons versus controls, which is abolished by rotenone, a specific inhibitor of Complex I. We infer that the LHON genotype requires a differentiated neuronal environment in order to induce increased mitochondrial ROS, which may be the cause of the reduced NT2 yield; and suggest that the LHON degenerative phenotype may be the result of an increase in mitochondrial superoxide which is caused by the LHON mutations, possibly mediated through neuron-specific alterations in Complex I structure.     

The A3243G tRNALeu(UUR) mutation induces mitochondrial dysfunction and variable disease expression without dominant negative acting translational defects in complex IV subunits at UUR codons

Mutations in the mitochondrial tRNA(Leu(UUR)) gene are associated with a large variety of human diseases through a largely undisclosed mechanism. The A3243G tRNA(Leu(UUR)) mutation leads to reduction of mitochondrial DNA (mtDNA)-encoded proteins and oxidative phosphorylation activity even when the cells are competent in mitochondrial translation. These two aspects led to the suggestion that a dominant negative factor may underlie the diversity of disease expression. Here we test the hypothesis that A3243G tRNA(Leu(UUR)) generates such a dominant negative gain-of-function defect through misincorporation of amino acids at UUR codons of mtDNA-encoded proteins. Using an anti-complex IV immunocapture technique and mass spectrometry, we show that the mtDNA-encoded cytochrome c oxidase I (COX I) and COX II exist exclusively with the correct amino acid sequences in A3243G cells in a misassembled complex IV. A dominant negative component therefore cannot account for disease phenotype, leaving tissue-specific accumulation by mtDNA segregation as the most likely cause of variable mitochondrial disease expression.     

Relative fitness of carriers of the mitochondrial DNA mutation 3243A > G

Deleterious point mutations in mitochondrial DNA (mtDNA) have been found in many human populations and always at a low frequency suggesting that they are under strong negative selection. It is assumed that this selection is caused by reduced genetic fitness of mutation carriers, but the fitness of carriers of any mtDNA mutation has not been determined. We estimated the reproductive disadvantage caused by the mitochondrial DNA mutation 3243A > G in a population-based group of female carriers (n = 32). The person-years method, Kaplan-Meier survival analysis and population statistics were used to estimate net reproduction rates of the mutation carriers and the general population. We found that women with 3243A > G reproduced at the same rate as women in the general population, suggesting that on average host-level selection against women harbouring the 3243A > G mutation is not strong.     

Single-fiber PCR in MELAS(3243) patients: correlations between intratissue distribution and phenotypic expression of the mtDNA(A3243G) genotype

We performed morphological, biochemical, and genetic studies, including single-fiber PCR (sf PCR), on muscle biopsies obtained from a mother and daughter with MELAS syndrome due to the A3243G transition of mitochondrial DNA (mtDNA). The severity of muscle involvement appeared quite distinct, in spite of the fact that both patients segregated similar mutant mtDNA levels on total muscle DNA. The daughter did not show any clinical muscle involvement: muscle biopsy revealed many ragged red fibers (RRFs) mostly positive for cytochrome-c oxidase (COX) activity. In contrast, her mother had developed a generalized myopathy without progressive external ophthalmoplegia (PEO), morphologically characterized by many COX-negative RRFs. Single-muscle fiber PCR demonstrated in both patients significantly higher percentages of wild-type mtDNA in normal fibers (daughter: 23.25 +/- 15.22; mother: 43.13 +/- 26.11) than in COX-positive RRFs (daughter: 11.25 +/- 5.22, P < 0.005; mother: 9.12 +/- 5.9, P < 0.001) and in COX-negative RRFs (daughter: 8.9 +/- 4.2, P < 0.001 mother: 4.8 +/- 2.8, P < 0.001). Wild-type mtDNA levels resulted higher also in COX-positive vs. COX-negative RRFs (daughter: P < 0.05; mother: P < 0.001). Our data confirm a direct correlation between A3243G levels and impairment of COX function at the single-muscle fiber level. Moreover, the evidence of a clinical myopathy in the patient with higher amounts of COX-negative RRFs bolsters the concept that a differential distribution of mutant mtDNAs at the cellular level may have effects on the clinical involvement of individual tissues. However, the occurrence of a similar morphological and biochemical muscle phenotype also in PEO(3243) patients suggests that other genetic factors involved in the interaction between mitochondrial and nuclear DNA, rather than the stochastic distribution of mtDNA genomes during embryogenesis, are primarily implicated in determining the various clinical expressions of the A3243G of mtDNA.     

非综合征型遗传性耳聋两家系线粒体基因突变分析

目的 探讨母系遗传非综合征型耳聋发病机理及7445^G点突变在这类家系及散发感音神经性耳聋病例中的发生率，为建立相应的基因诊断方法提供依据。方法 收集两个母系遗传非综合征型耳聋家系和14个感音神经性耳聋散发病例；抽外周血标本，从白细胞中提取DNA；聚合酶链反应扩增线粒体DNA（mitochondrial DNA,mtDNA）目的片段，分别以Alw 26Ⅰ、ApaⅠ及XbaⅠ限制性内切酶检测1555^G、3243^G及7445^G点突变；行mtDNA 12S r RNA、tRNA^Leu(UUR)、tRNA^Ser(UCN)基因测序。结果 经酶切检测，两家系中12例为7445^G点突变阳性，其余6例及14例散发病例均为阴性，所有病例1555^G、3243^G点突变均阴性；7445^G点突变呈母系遗传。mtDNA测序显示，所有病例1555^G、3243^G点突变均阴性；酶切显示为7445^G突变阳性病例经基因测序均发现有（nt)7445A→G替换。结论 7445^G点突变在母系遗传非综合征型耳聋家系中有较高的发生率，而在散发病例中发生率很低；7445^G结合1555^G点7突变筛查对这类耳聋的诊断有重要意义。     

A novel system for assigning the mode of inheritance in mitochondrial disorders using cybrids and rhodamine 6G.

When normal human cultured skin fibroblasts were treated with the fluorescent dye rhodamine 6G (R6G), there was a drastic reduction in numbers of intact mitochondria and electron transport chain enzyme activities, despite the fact that mitochondrial DNA (mtDNA) was still present in treated cells. We used this observation to develop a novel system for generating cybrids. When cultured skin fibroblast cells from a patient with the mitochondrial encephalopathy and ragged-red fibers (MERRF) syndrome harboring the A8344G mtDNA mutation and which showed a severe reduction in cytochrome c oxidase activity were treated with R6G and fused to enucleated HeLaCOT cells, the resulting cybrid clones showed recovery of cytochrome c oxidase activity, and were shown to have mtDNA derived solely from the HeLaCOT cell line. R6G has significant advantages over ethidium bromide in removing the mitochondrial elements from cultured cells, and the results reported here demonstrate that this strategy can be used to determine the origin of the genetic defect in patients with electron transport chain abnormalities.     

Tissue specific distribution of the 3243A->G mtDNA mutation

Background

The 3243A→G is a common pathogenic mitochondrial DNA (mtDNA) point mutation causing a variety of different phenotypes. Segregation of this mutation to different tissues during embryonic life and postnatally is still enigmatic.

Objective

To investigate the tissue distribution of this mutation.

Methods

In 65 individuals from nine families segregating the 3243A→G mutation, the mutation load (% mutated mtDNA) was determined in various tissues. Mutation load was measured in two to four cell types—blood leucocytes, buccal cells, skeletal muscle cells, and urine epithelial cells (UEC)—derived from all three embryogenic germ layers.

Results

There was a significant correlation among mutation loads in the four tissues (r = 0.80–0.89, p<0.0001). With blood serving as reference, the mutation load was increased by 16% in buccal mucosa, by 31% in UEC, and by 37% in muscle. There were significant differences between the mitotic tissues blood, buccal mucosa, and UEC (p<0.0001), but no difference between UEC and muscle. Using the present data as a cross sectional investigation, a negative correlation of age with the mutation load was found in blood, while the mutation load in muscle did not change with time; 75% of the children presented with higher mutation loads than their mothers in mitotic tissues but not in the post‐mitotic muscle.

Conclusions

There appears to be a uniform distribution of mutant mtDNA throughout the three germ layers in embryogenesis. The significant differences between mutation loads of the individual tissue types indicate tissue specific segregation of the 3243A→G mtDNA later in embryogenesis.