Molecular mechanisms of mitochondrial diabetes (MIDD)

Mitochondria provide cells with most of the energy in the form of adenosine triphosphate (ATP). Mitochondria are complex organelles encoded both by nuclear and mtDNA. Only a few mitochondrial components are encoded by mtDNA, most of the mt-proteins are nuclear DNA encoded. Remarkably, the majority of the known mutations leading to a mitochondrial disease have been identified in mtDNA rather than in nuclear DNA. In general, the idea is that these pathogenic mutations in mtDNA affect energy supply leading to a disease state. Remarkably, different mtDNA mutations can associate with distinct disease states, a situation that is difficult to reconcile with the idea that a reduced ATP production is the sole pathogenic factor. This review deals with emerging insight into the mechanism by which the A3243G mutation in the mitochondrial tRNA (Leu, UUR) gene associates with diabetes as major clinical expression. A decrease in glucose-induced insulin secretion by pancreatic beta-cells and a premature aging of these cells seem to be the main process by which this mutation causes diabetes. The underlying mechanisms and variability in clinical presentation are discussed.     

Late onset of type 2 diabetes is associated with mitochondrial tRNATrp A5514G and tRNASer(AGY) C12237T mutations

BackgroundMitochondrial dysfunctions caused by mitochondrial DNA (mtDNA) pathogenic mutations play putative roles in type 2 diabetes mellitus (T2DM) progression. But the underlying mechanism remains poorly understood.MethodsA large Chinese family with maternally inherited diabetes and deafness (MIDD) underwent clinical, genetic, and molecular assessment. PCR and sequence analysis are carried out to detect mtDNA variants in affected family members, in addition, phylogenetic conservation analysis, haplogroup classification, and pathogenicity scoring system are performed. Moreover, the GJB2, GJB3, GJB6, and TRMU genes mutations are screened by PCR‐Sanger sequencing.ResultsSix of 18 matrilineal subjects manifested different clinical phenotypes of diabetes. The average age at onset of diabetic patients is 52 years. Screening for the entire mitochondrial genomes suggests the co‐existence of two possibly pathogenic mutations: tRNA^Trp A5514G and tRNA^Ser(AGY) C12237T, which belongs to East Asia haplogroup G2a. By molecular level, m.A5514G mutation resides at acceptor stem of tRNA^Trp (position 3), which is critical for steady‐state level of tRNA^Trp. Conversely, m.C12237T mutation occurs in the variable region of tRNA^Ser(AGY) (position 31), which creates a novel base‐pairing (11A‐31T). Thus, the mitochondrial dysfunctions caused by tRNA^Trp A5514G and tRNA^Ser(AGY) C12237T mutations, may be associated with T2DM in this pedigree. But we do not find any functional mutations in those nuclear genes.ConclusionOur findings suggest that m.A5514G and m.C12337T mutations are associated with T2DM, screening for mt‐tRNA mutations is useful for molecular diagnosis and prevention of mitochondrial diabetes.     

Molecular mechanisms underlying hemophilia A phenotype in seven females

Summary.  Background:  Hemophilia A (HA) in females is a rare observation. Here we describe various genetic mechanisms that result in phenotypic expression of HA in seven females. Methods:  The F8 gene was examined in all patients and relatives by direct sequencing. Multiplex ligation-dependent probe amplification (MLPA) was performed for large deletion screening. X chromosome inactivation was studied by PCR analysis of a polymorphic CAG repeat in the first exon of the human androgen receptor (HUMARA) gene. Results:  In two females sequencing of the F8 gene revealed homozygous missense mutations (Arg593Cys and Tyr1680Phe) as a consequence of consanguineous marriage. The third case was due to compound heterozygosity comprising the missense mutation Leu412Phe inherited from the carrier mother, together with a de novo large deletion spanning exon 9–22, probably originating from the germ cells of the healthy father. Three further cases shared a common mechanism representing heterozygous mutations in the F8 gene (Arg1781His, Arg327His, small deletion in exon 10) combined with non-random inactivation of the X chromosome. The final case describes a coincidental inheritance of HA and Coffin–Lowry syndrome in the same family. The HA phenotype results from a heterozygous small deletion affecting the F8 gene (c.6872 del CT leading to Thr2272 fs ) and a complete inactivation of the maternal X chromosome, which segregates with Coffin–Lowry syndrome in the two brothers of the proposita. Conclusions:  In conclusion, molecular genetic analysis represents an essentially valuable tool in elucidating the nature of the molecular mechanisms underlying the HA phenotype in females.     

线粒体DNA 5178C/A多态性与2型糖尿病关系的研究

目的研究线粒体DNA5178C/A多态性与2型糖尿病(T2DM)及其并发症的关系。方法采用聚合酶链反应(PCR)与PCR产物直接测序的方法,对2型糖尿组(220例)及正常对照组(126例)进行基因分析。结果 5178C基因型与5178A基因型的T2DM患者在性别、发病年龄、体重指数、血糖、血脂等水平差异无统计学意义,但T2DM患者中5178C基因型并发视网膜病变的频率要高于5178A基因型(P0.05)。结论线粒体DNA5178C/A多态性可能与T2DM患者并发视网膜病变负相关。     

Molecular taxonomy using single-strand conformation polymorphism (SSCP) analysis of mitochondrial ribosomal DNA genes

Single-strand conformation polymorphism (SSCP) analysis detects single point mutations in DNA molecules. We demonstrate that SSCP analysis of mitochondrial ribosomal DNA (rDNA) genes is a sensitive taxonomic tool because these genes often differ at numerous sites among closely related species. Using conserved primers, portions of the 12S or 16S rDNA genes were amplified using the polymerase chain reaction (PCR) in congeneric species of ticks, leaf hoppers, mosquitoes, and closely related endoparasitic wasps. SSCP was performed and products were visualized with silver staining. Species-specific patterns were observed in all taxa. Intraspecific variation at the level of single nucleotide substitutions was detected. SSCP diagnostics are less expensive and time consuming to develop than PCR with species-specific primers, and, unlike PCR with arbitrary primers, there is minimal concern with DNA contamination from non-target organisms.     

脱落细胞线粒体基因A1555G突变在诊断线粒体耳聋中的应用

目的用PCR-RFLP技术检测脱落细胞(尿液沉渣细胞和颊黏膜细胞)线粒体基因A1555G突变,探讨脱落细胞用于诊断线粒体基因突变相关耳聋的可行性。方法收集福建省某特殊教育学校126名聋哑学生和1个线粒体基因A1555G突变的遗传性耳聋家系6例患者外周血及尿液沉渣细胞和颊黏膜细胞,用PCR-RFLP技术筛查患者是否携带线粒体DNA A1555G突变,并与测序法进行比较。结果尿液沉渣细胞检测线粒体DNA A1555G突变的检出率最高(9/132),颊黏膜细胞和外周血细胞均为7/132。PCR-RFLP筛查结果与直接测序法基本相符。结论脱落细胞适用于耳聋相关线粒体DNA A1555G突变检测。     

The mitochondrial genome of the bristletail Petrobius brevistylis (Archaeognatha: Machilidae)

The complete mitochondrial genome of the bristletail Petrobius brevistylis has been determined. The genome is 15,698 bp long and bears the standard set of genes common to all arthropods as well as a major non-coding A+T-rich region, the putative mitochondrial control region. A unique gene order was revealed as it differs from other hexapod and crustacean mitochondrial genomes in the position of tRNA-Tyr. Genome features like nucleotide composition and codon usage are compared with that of other insect taxa. A+T content is similar in species of Archaeognatha and Zygentoma, but obviously lower than in Collembola and Pterygota. This A+T bias significantly affects also amino acid frequencies and may be a problem for phylogenetic analyses.     

Maternally transmitted nonsyndromic hearing impairment may be associated with mitochondrial tRNAAla 5601C>T and tRNALeu(CUN) 12311T>C mutations

BackgroundSequence alternations in mitochondrial genomes, especially in genes encoding mitochondrial tRNA (mt‐tRNA), were the important contributors to nonsyndromic hearing loss (NSHL); however, the molecular mechanisms remained largely undetermined.MethodsA maternally transmitted Chinese pedigree with NSHL underwent clinical, genetic, and biochemical assessment. PCR and direct sequence analyses were performed to detect mitochondrial DNA (mtDNA), GJB2, and SLC26A4 gene mutations from matrilineal relatives of this family. Mitochondrial functions including mitochondrial membrane potential (MMP), ATP, and ROS were evaluated in polymononuclear leukocytes (PMNs) derived from three deaf patients and three controls from this pedigree.ResultsFour of nine matrilineal relatives developed hearing loss at the variable age of onset. Two putative pathogenic mutations, m.5601C>T in tRNA^Ala and m.12311T>C in tRNA^Leu(CUN), were identified via PCR‐Sanger sequencing, as well as 34 variants that belonged to mtDNA haplogroup G2b2. Intriguingly, m.5601C>T mutation resided at very conserved nucleotide in the TψC loop of tRNA^Ala (position 59), while the T‐to‐C substitution at position 12311 located at position 48 in the variable stem of tRNA^Leu(CUN) and was believed to alter the aminoacylation and the steady‐state level of tRNA. Biochemical analysis revealed the impairment of mitochondrial functions including the significant reductions of ATP and MMP, whereas markedly increased ROS levels were found in PMNs derived from NSHL patients with m.5601C>T and m.12311T>C mutations. However, we did not detect any mutations in GJB2 and SLC26A4 genes.ConclusionOur data indicated that mt‐tRNA^Ala m.5601C>T and tRNA^Leu(CUN) 12311T>C mutations were associated with NSHL.     

Molecular identification and phylogeny of parasitic wasp species (Hymenoptera: Trichogrammatidae) by mitochondrial DNA RFLP and RAPD markers

Mitochondrial DNA (mtDNA) restriction fragment length polymorphism (RFLP) and random amplified polymorphic DNA (RAPD) were tested for their ability to discriminate between seven species of minute parasitic wasps belonging to the genus Trichogramma. They proved to be reliable species-diagnostic molecular markers. Pairwise comparisons of the mtDNA restriction maps revealed considerable differentiation among the seven species. Percentage of common restriction sites ranged from 30% to 83%. Phylogenetic analyses performed either on the mtDNA nucleotide distance matrix or on the matrix of the restriction site-state generated a tree congruent with those based on allozymes and morphology.
RAPD procedures also revealed species-specific banding patterns and seem promising for a rapid and easy identification of Trichogramma species. Moreover, for some Trichogramma species, RAPD banding patterns might be informative of the phylogenetic related ness.     

Abundant nuclear copies of mitochondrial origin (NUMTs) in the Aedes aegypti genome

A portion of the Aedes aegypti mitochondrial NADH dehydrogenase subunit 4 gene (ND4) was amplified using PCR with a 42 °C annealing temperature. Amplified fragments from individual mosquitoes were similar to ND4 but contained multiple segregating sites. We suspected that nuclear copies of mitochondrial origin (NUMTs) exist in the Ae. aegypti genome. A BlastN search in VectorBase with the entire Ae. aegypti mitochondrial genome identified 233 NUMTs comprising 110 178 bp in 145 supercontigs. At a density of 0.080 bp/kb, this represents the second highest density of NUMTs in an insect genome and the highest in Diptera. Analyses of flanking sequences suggested that Ae. aegypti NUMTs arise through mtDNA leakage from damaged mitochondria followed by breakage and nonhomologous recombination, rather than through duplicative processes such as transposition or molecular drive.     

湖北汉族人群2型糖尿病患者线粒体基因突变检测及临床意义

目的研究线粒体DNA(mtDNA)16S rRNA基因(T3200C、C3206T)和ND1基因(A4136G、A4164G和T4216C)突变在湖北汉族2型糖尿病人群中的发生率及临床意义。方法采用等位基因特异性PCR(AS-PCR)、PCR-限制性酶切片段长度多态性(PCR-RFLP)分析及PCR产物直接测序,对175例2型糖尿病患者和200例正常对照的线粒体基因突变进行检测,并用Primer、Antherprot和Mfold软件对检出的突变位点进行分析,对RNA突变后最小自由能下的二级结构变化和ND1基因突变后蛋白质的二级结构改变进行预测。结果2型糖尿病组检出3200(T→C)突变2例(1．14％),3206(C→T)突变11例(6．28％),4216(T→C)突变3例(1．71％),4136位点未发现突变。发现2个未曾报道的新突变位点4164(A→G)7例(4．00％),4200(A→T)1例(0．57％)。对照组中检出3206(C→T)突变8例(3．92％),4164(A→G)突变5例(2．45％),两位点突变率在两组中比较差异无显著性(P>0．05)。RNA二级结构预测显示3200(T→C)突变引起16S rRNA基因最小自由能和二级结构的改变,可能引起疾病。4164(A→G)和4200(A→T)突变分别为Met和Leu的无义突变,4216(T→C)突变可使线粒体呼吸链中一个中性酪氨酸被亲水性组氨酸取代,蛋白质二级结构预测显示该突变可引起NDl蛋白质二级结构改变。研究还显示线粒体基因突变率在≥40岁个体呈上升趋势。结论mtDNA 3200(T→C)和4216(T→C)突变可能增加糖尿病的易感性;3206(C→T)和4164(A→G)为基因多态性改变;4136位点未发现突变。以上结果提示糖尿病的发生在线粒体基因突变上存在一定的异质性。     

线粒体动力学在临床常见机体高能量代谢系统病变中作用的研究进展

线粒体作为机体内主要的能量提供细胞器，自身主要通过线粒体动力学，即融合和分裂过程以及线粒体自噬来维持平衡，功能异常的线粒体堆积会导致细胞凋亡和对能量代谢高度需求的组织器官损害。本文主要阐述线粒体动力学及其改变对于临床常见能量代谢相关疾病的影响。     

Phylogenetic relationships among muscoidea (Diptera: calyptratae) based on mitochondrial DNA sequences

The utility of a mitochondrial DNA (mtDNA) fragment of about 1100 bp (including partial COI and COII sequences and tRNALeu) for evolutionary studies in Muscoidea is discussed. The species investigated are Scathophaga stercoraria, Microprosopa pallidicauda and Trichopalpus fraterna (family Scathophagidae), Musca domestica (Muscidae), Lasiomma seminitidum (Anthomyiidae) and Fannia armata (Fanniidae). Comparisons were made with published mtDNA sequences of Drosophila, Anopheles and three Calliphoridae species. The molecular phylogeny obtained here matches the classical morphological taxonomy reasonably well. This varies considerably, however, at different taxonomical levels. At a high taxonomic level, there is a clear separation between the Nematocera and the Brachycera, but the Calyptratae-Acalyptratae division is not always supported. At a lower taxonomic level, all species belonging to the same family are well grouped, but at an intermediate level, within the Calyptratae, it is impossible to clearly separate the Muscoidea and Calliphoridae, preventing a firm conclusion on the phylogenetic relationships among Muscoidea families. The entire COI sequence of S. stercoraria, as well as other mtDNA sequences (including the proximal portions of the COI gene, tRNATrp, tRNACys and tRNATyr genes) in Muscoidea species, are also presented and discussed.     

2型糖尿病患者线粒体ATP6基因变异分析

目的 研究2型糖尿病(T2DM)患者线粒体DNA(mitocho-ndrial DNA,mtDNA)ATP6基因变异与T2DM及其慢性并发症的相关性.方法 选取浙江籍汉族人群中临床诊断为T2DM的无血缘关系患者254例,同时收集165名年龄匹配的健康体检者作为健康对照组.提取所有受试者全血基因组DNA,采用PCR扩增线粒体ATP6基因,直接测序后与线粒体基因组剑桥参考序列(rCRS)进行比对.借助生物信息学和统计学方法分析ATP6基冈变异.结果 所有变异位点的发生率在T2DM组和健康对照组间差异无统计学意义(P>0.05).其中有部分位点仅在T2DM组中以低频率出现,多数为错义变异,其改变了线粒体ATP合酶6亚基(ATPase6)跨膜螺旋上高度保守的氨基酸.这些变异位点未见相关报道,同时在合并高血压且为非肥胖患者中检测到,包括G8557A、A8563G、T8594C、C8609T、A8689G、G8998A和G9139A.结论 线粒体ATP6基因存在大量变异,多数为多态性位点,但不能排除变异位点A8689G、T8825C、G8920A、G8998A、G9139A提高了T2DM易感性和微效致病性的可能.变异位点G8557A、A8563G、T8594C、C8609T、A8689G、G8998A和G9139A可能与糖尿病、高血压等生物能学疾病的发生有关.     

The calculated versus the measured glycosylated haemoglobin (HbA1c) levels in patients with type 2 diabetes mellitus

BackgroundDiabetes mellitus (DM) is a chronic metabolic disorder that is increasing globally. It is associated with chronic complications that are more common among patients with poor glycaemic control. Glycosylated haemoglobin (HbA_1c) is the gold standard for monitoring glycaemic control. Measurements of HbA_1c are relatively expensive and not available in some remote areas of developing countries.MethodsWe conducted a cross‐sectional study to evaluate the agreement between the calculated and measured HbA_1c levels. The equation to compute the calculated HbA_1c also incorporated the fasting blood glucose (FBG) level and was as follows: HbA_1c = 2.6 + 0.03 × FBG (mg/dl).ResultWe enrolled 290 patients with type 2 DM in this study. Of these, 204 (70.3%) were females and the mean (SD) age was 54.9 (12.8) years. The mean (SD) diabetes duration was 6.8 (5.5) years. There were 211 (72.8%) patients using oral hypoglycaemic agents, 62 (21.4%) were using insulin and 17 (5.9%) were using both insulin and oral hypoglycaemic agents. There was a borderline difference between the mean (SD) calculated and measured HbA_1c levels (p = 0.054). There was a significant correlation between the calculated and measured HbA_1c (r = 0.595, p < 0.001). However, there was no agreement between the calculated and measured HbA_1c. The bias ±SD (limits of agreement) for calculated versus measured HbA_1c was −1.008 ± 2.02% (−5.05, 2.032).ConclusionDespite the presence of a significant correlation between the calculated and measured HbA_1c, the calculated level has shown an unacceptable agreement with the measured HbA_1c.     

The mitochondrial genome of the Korean hairstreak, Coreana raphaelis (Lepidoptera: Lycaenidae)

We determined the complete nucleotide sequences of the mitochondrial genome (mitogenome) of the Korean hairstreak, Coreana raphaelis (Lepidoptera: Lycaenidae). The entire mitochondrial DNA (mtDNA) molecule was 15,314 bp long. The C. raphaelis genes were in the same order and orientation as the completely sequenced mitogenomes of other lepidopteran species, except for the presence of an extra copy of tRNA(Ser)(AGN). High similarity in primary sequence and secondary structure between the two tandemly located copies of the tRNA(Ser)(AGN) suggest a recent duplication of an original single tRNA(Ser)(AGN). The DHU arm of the two copies of tRNA(Ser)(AGN) formed a simple loop as seen in many other metazoan mt tRNA(Ser)(AGN). The putative initiation codon for the C. raphaelis COI gene appears to be a tetranucleotide, TTAG, found commonly in the sequenced lepidopterans. ATPase8, ATPase6, ND4L and ND6 genes, which are next to another protein-coding gene at their 3' end all had the sequences potential to form a hairpin structure, suggesting the importance of such a structure for precise cleavage of the mature protein-coding genes.     

Molecular mechanisms accounting for fibrinogen deficiency: from large deletions to intracellular retention of misfolded proteins

Summary.  Fibrinogen, the soluble precursor of fibrin, which is the main protein constituent of the blood clot, is synthesized in hepatocytes in the form of a hexamer composed of two sets of three polypeptides (Aα, Bβ, and γ). Each polypeptide is encoded by a distinct gene, FGA, FGB and FGG , all three clustered in a region of 50 kb on 4q32. Congenital afibrinogenemia is characterized by the complete absence of fibrinogen. The first causative mutation for this disease was identified in Geneva in a non-consanguineous Swiss family in 1999: the four patients were homozygous for a large deletion in the fibrinogen cluster, which eliminated almost the entire FGA genomic sequence. Mutations in the fibrinogen genes may lead to deficiency of fibrinogen by several mechanisms: acting at the DNA level, at the RNA level by affecting mRNA splicing or stability, or at the protein level by affecting protein synthesis, assembly or secretion. Recent reviews have provided helpful updates for the rapidly growing number of causative mutations identified in patients with fibrinogen deficiencies, either afibrinogenemia or hypofibrinogenemia. The aim of this review is to highlight specifically the subset of mutations that allow fibrinogen chain synthesis and hexamer assembly but impair secretion. Indeed, functional studies of these mutations have shed light on the specific sequences and structures in the fibrinogen molecule involved in the quality control of fibrinogen secretion.     

Latent autoimmune diabetes of adulthood (LADA): An often misdiagnosed type of diabetes mellitus

Purpose: The purpose of this article is to raise awareness about a frequently misdiagnosed form of diabetes, latent autoimmune diabetes of adulthood (LADA), to describe its clinical and epidemiological characteristics, and to compare them to those of the more common and widely known types of diabetes, type 1 diabetes mellitus (DM) and type 2 DM.
Data sources: A review of the pertinent literature describing the features of LADA from 2000–2007 is summarized.
Conclusions: LADA is a rather common and often underrecognized form of diabetes whose clinical presentation falls somewhere between that of type 1 DM and type 2 DM. From a pathophysiological perspective, it is more closely related to type 1 DM, and some have even used the term type 1.5 diabetes to refer to it; however, it is most often misdiagnosed and treated as type 2 DM.
Implications for practice: Nurse practitioners (NPs) should always consider alternate diagnoses when patients with newly or previously identified adult-onset diabetes mellitus do not fit the traditional stereotype of type 2 DM (i.e., overweight with signs of insulin resistance and a significant family history of diabetes). Statistically, strong consideration must be given to the diagnosis of LADA, especially in those who are of normal weight, show little evidence of insulin resistance, and have hardly any family history of diabetes. Knowing the patient's exact diabetes type can give the NP a much greater understanding of the natural history of the patient's disease, the changes that may occur as the patient ages, and how to optimally manage their diabetes to minimize complications. Likewise, when a patient is correctly diagnosed, they can be empowered to manage their diabetes with the appropriate therapies.