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Heteroplasmy Shifting as Therapy for Mitochondrial Disorders

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Mitochondria in Health and in Sickness

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1158))

Abstract

Mitochondrial disease can arise due to pathogenic sequence variants in the mitochondrial DNA (mtDNA) that prevent cells from meeting their energy demands. Mitochondrial diseases are often fatal and currently there are no treatments directed towards the underlying cause of disease. Pathogenic variants in mtDNA often exist in a state of heteroplasmy, with coexistence of pathogenic and wild type mtDNA. The load of heteroplasmy, defined as the relative amount of pathogenic mtDNA to wild type mtDNA, corresponds to timing and symptom severity. Thus, changing the heteroplasmy load may lead to a shift in disease onset and symptom severity. Here we review techniques aimed at preventing inheritance of pathogenic mtDNA via mitochondrial replacement therapy (MRT) and strategies geared toward shifting of heteroplasmy in individuals with active mitochondrial disease. MRT strategies seek to create embryos with the nuclear genetic makeup of the intended parents and wild type mtDNA from a donor in order to avoid known maternal pathogenic variants. Heteroplasmy shift approaches in patients are of two categories: nuclease dependent and nuclease independent strategies. Despite initial success in mouse models and patient cells, these techniques have not reached clinical use. Translational attempts in this area are urgently needed to improve therapies for a currently untreatable set of disorders.

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Authors and Affiliations

  1. Institute of Medical Science, The University of Toronto, Toronto, ON, Canada

    Mansur M. Naeem & Neal Sondheimer

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  1. Mansur M. Naeem
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  2. Neal Sondheimer
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Correspondence to Neal Sondheimer .

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Editors and Affiliations

  1. Institute of Biochemistry and Clinical Biochemistry, Università Cattolica del Sacro Cuore, Rome, Italy, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy

    Andrea Urbani

  2. Department of Biochemistry, University of Regina, Regina, SK, Canada

    Mohan Babu

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Naeem, M.M., Sondheimer, N. (2019). Heteroplasmy Shifting as Therapy for Mitochondrial Disorders. In: Urbani, A., Babu, M. (eds) Mitochondria in Health and in Sickness. Advances in Experimental Medicine and Biology, vol 1158. Springer, Singapore. https://doi.org/10.1007/978-981-13-8367-0_14

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