Incomplete penetrance in mitochondrial optic neuropathies. 2017

Leonardo Caporali, and Alessandra Maresca, and Mariantonietta Capristo, and Valentina Del Dotto, and Francesca Tagliavini, and Maria Lucia Valentino, and Chiara La Morgia, and Valerio Carelli
IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy.

Incomplete penetrance characterizes the two most frequent inherited optic neuropathies, Leber's Hereditary Optic Neuropathy (LHON) and dominant optic atrophy (DOA), due to genetic errors in the mitochondrial DNA (mtDNA) and the nuclear DNA (nDNA), respectively. For LHON, compelling evidence has accumulated on the complex interplay of mtDNA haplogroups and environmental interacting factors, whereas the nDNA remains essentially non informative. However, a compensatory mechanism of activated mitochondrial biogenesis and increased mtDNA copy number, possibly driven by a permissive nDNA background, is documented in LHON; when successful it maintains unaffected the mutation carriers, but in some individuals it might be hampered by tobacco smoking or other environmental factors, resulting in disease onset. In females, mitochondrial biogenesis is promoted and maintained within the compensatory range by estrogens, partially explaining the gender bias in LHON. Concerning DOA, none of the above mechanisms has been fully explored, thus mtDNA haplogroups, environmental factors such as tobacco and alcohol, and further nDNA variants may all participate as protective factors or, on the contrary, favor disease expression and severity. Next generation sequencing, complemented by transcriptomics and proteomics, may provide some answers in the next future, even if the multifactorial model that seems to apply to incomplete penetrance in mitochondrial optic neuropathies remains problematic, and careful stratification of patients will play a key role for data interpretation. The deep understanding of which factors impinge on incomplete penetrance may shed light on the pathogenic mechanisms leading to optic nerve atrophy, on their possible compensation and, thus, on development of therapeutic strategies.

UI MeSH Term Description Entries
D008928 Mitochondria Semiautonomous, self-reproducing organelles that occur in the cytoplasm of all cells of most, but not all, eukaryotes. Each mitochondrion is surrounded by a double limiting membrane. The inner membrane is highly invaginated, and its projections are called cristae. Mitochondria are the sites of the reactions of oxidative phosphorylation, which result in the formation of ATP. They contain distinctive RIBOSOMES, transfer RNAs (RNA, TRANSFER); AMINO ACYL T RNA SYNTHETASES; and elongation and termination factors. Mitochondria depend upon genes within the nucleus of the cells in which they reside for many essential messenger RNAs (RNA, MESSENGER). Mitochondria are believed to have arisen from aerobic bacteria that established a symbiotic relationship with primitive protoeukaryotes. (King & Stansfield, A Dictionary of Genetics, 4th ed) Mitochondrial Contraction,Mitochondrion,Contraction, Mitochondrial,Contractions, Mitochondrial,Mitochondrial Contractions
D009901 Optic Nerve Diseases Conditions which produce injury or dysfunction of the second cranial or optic nerve, which is generally considered a component of the central nervous system. Damage to optic nerve fibers may occur at or near their origin in the retina, at the optic disk, or in the nerve, optic chiasm, optic tract, or lateral geniculate nuclei. Clinical manifestations may include decreased visual acuity and contrast sensitivity, impaired color vision, and an afferent pupillary defect. Cranial Nerve II Diseases,Foster-Kennedy Syndrome,Optic Disc Disorders,Optic Disk Disorders,Optic Neuropathy,Second Cranial Nerve Diseases,Cranial Nerve II Disorder,Neural-Optical Lesion,Disc Disorder, Optic,Disk Disorder, Optic,Disorder, Optic Disc,Foster Kennedy Syndrome,Lesion, Neural-Optical,Neural Optical Lesion,Neural-Optical Lesions,Neuropathy, Optic,Optic Disc Disorder,Optic Disk Disorder,Optic Nerve Disease,Optic Neuropathies,Syndrome, Foster-Kennedy
D004272 DNA, Mitochondrial Double-stranded DNA of MITOCHONDRIA. In eukaryotes, the mitochondrial GENOME is circular and codes for ribosomal RNAs, transfer RNAs, and about 10 proteins. Mitochondrial DNA,mtDNA
D004781 Environmental Exposure The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. Exposure, Environmental,Environmental Exposures,Exposures, Environmental
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D019683 Penetrance The percent frequency with which a dominant or homozygous recessive gene or gene combination manifests itself in the phenotype of the carriers. (From Glossary of Genetics, 5th ed)
D029241 Optic Atrophy, Autosomal Dominant Dominant optic atrophy is a hereditary optic neuropathy causing decreased visual acuity, color vision deficits, a centrocecal scotoma, and optic nerve pallor (Hum. Genet. 1998; 102: 79-86). Mutations leading to this condition have been mapped to the OPA1 gene at chromosome 3q28-q29. OPA1 codes for a dynamin-related GTPase that localizes to mitochondria. Dominant Optic Atrophy,Optic Atrophy, Hereditary, Autosomal Dominant,Autosomal Dominant Optic Atrophy,Autosomal Dominant Optic Atrophy Kjer Type,Kjer Type Optic Atrophy,Kjer's Optic Atrophy,Kjer-Type Optic Atrophy,Optic Atrophy 1,Optic Atrophy Type 1,Optic Atrophy, Juvenile,Optic Atrophy, Kjer Type,Atrophies, Juvenile Optic,Atrophies, Kjer-Type Optic,Atrophy, Juvenile Optic,Atrophy, Kjer's Optic,Atrophy, Kjer-Type Optic,Dominant Optic Atrophies,Juvenile Optic Atrophies,Juvenile Optic Atrophy,Kjer Optic Atrophy,Kjer-Type Optic Atrophies,Kjers Optic Atrophy,Optic Atrophies, Dominant,Optic Atrophies, Juvenile,Optic Atrophies, Kjer-Type,Optic Atrophy 1s,Optic Atrophy, Dominant,Optic Atrophy, Kjer's,Optic Atrophy, Kjer-Type
D029242 Optic Atrophy, Hereditary, Leber A maternally linked genetic disorder that presents in mid-life as acute or subacute central vision loss leading to central scotoma and blindness. The disease has been associated with missense mutations in the mtDNA, in genes for Complex I, III, and IV polypeptides, that can act autonomously or in association with each other to cause the disease. (from Online Mendelian Inheritance in Man, http://www.ncbi.nlm.nih.gov/Omim/, MIM#535000 (April 17, 2001)) Leber Hereditary Optic Atrophy,Hereditary Optic Neuroretinopathy,Leber Hereditary Optic Neuropathy,Leber Optic Atrophy,Leber Optic Atrophy and Dystonia,Leber's Disease,Leber's Hereditary Optic Atrophy,Leber's Hereditary Optic Neuropathy,Leber's Optic Atrophy,Leber's Optic Neuropathy,Optic Atrophy, Leber Type,Optic Atrophy, Leber, Hereditary,Disease, Leber's,Diseases, Leber's,Hereditary Optic Neuroretinopathies,Leber Disease,Leber Optic Neuropathy,Leber's Diseases,Lebers Disease,Lebers Optic Neuropathy,Neuropathy, Leber's Optic,Neuroretinopathies, Hereditary Optic,Neuroretinopathy, Hereditary Optic,Optic Atrophy, Leber,Optic Neuropathy, Leber's,Optic Neuroretinopathies, Hereditary,Optic Neuroretinopathy, Hereditary

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