Cataldo Luis Rodrigo, Olmos Pablo, Valerie Smalley Susan, Díez Alberto, Parada Alejandra, Gejman Roger, Fadic Ricardo, Santos José Luis
Departamento de Nutrición, Diabetes y Metabolismo, Pontificia Universidad Católica de Chile, Chile.
Rev Med Chil. 2013 Mar;141(3):305-12. doi: 10.4067/S0034-98872013000300004.
Maternally Inherited Diabetes and Deafness (MIDD) is caused by mutations in mitochondrial DNA (mtDNA), mainly m.3243A>G. Severity, onset and clinical phenotype of MIDD patients are partially determined by the proportion of mutant mitochondrial DNA copies in each cell and tissue (heteroplasmy). The identification of MIDD allows a corred treatment with insulin avoiding drugs that may interfere with mitochondrial electrón chain transpon. We estimated the degree of heteroplasmy of the mutation m.3243A>G from blood, saliva, hair root and a muscle biopsy using quantitative PCR (qPCR) in a femóle adult patient. For this purpose, PCR producís were inserted in a vector creating plasmids with 3243A or G. Mutant and wild-type vectors were mixed in different proportions to créate a calibration curve used to interpólate heteroplasmy percentages with qPCR threshold cycles. The proportions of m.3243A>G heteroplasmy were 62% (muscle), 14% (saliva), 6% (blood leukocytes) and 3% in hair root. Quantitative analysis of heteroplasmy showed marked variations in different tissues (highest in muscle and lowest in blood). Given the relatively high heteroplasmy found in saliva, this type of biológical sample may represent an adequate non-invasive way for assessing the presence of m.3243A>G mutations in epidemiologic studies.
母系遗传糖尿病和耳聋(MIDD)由线粒体DNA(mtDNA)突变引起,主要是m.3243A>G。MIDD患者的严重程度、发病情况和临床表型部分由每个细胞和组织中突变型线粒体DNA拷贝的比例(异质性)决定。MIDD的确诊有助于采用胰岛素进行正确治疗,避免使用可能干扰线粒体电子传递链的药物。我们使用定量PCR(qPCR)对一名成年女性患者的血液、唾液、发根和肌肉活检组织进行检测,估算了m.3243A>G突变的异质性程度。为此,将PCR产物插入载体中构建含有3243A或G的质粒。将突变型和野生型载体按不同比例混合,绘制校准曲线,用于根据qPCR阈值循环推断异质性百分比。m.3243A>G的异质性比例在肌肉中为62%,在唾液中为14%,在血液白细胞中为6%,在发根中为3%。异质性的定量分析显示不同组织间存在显著差异(肌肉中最高,血液中最低)。鉴于在唾液中发现相对较高的异质性,在流行病学研究中,这种生物样本可能是评估m.3243A>G突变存在情况的一种合适的非侵入性方法。