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Melas with point mutations involving tRNALeu (A3243G) and tRNAGlu(A14693g)

✍ Scribed by Chin-Yuan Tzen; Peterus Thajeb; Tsu-Yen Wu; Shiu-Ching Chen


Publisher
John Wiley and Sons
Year
2003
Tongue
English
Weight
252 KB
Volume
28
Category
Article
ISSN
0148-639X

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✦ Synopsis


Abstract

The syndrome of mitochondrial encephalomyopathy, lactic acidosis, and stroke‐like episode (MELAS) is typically associated with a single point mutation in the mitochondrial genome (mtDNA). Because mtDNA is known to have a higher mutation rate than nuclear DNA, we speculate that some patients with MELAS syndrome may harbor more than one mutation in mtDNA. For this purpose, mtDNA extracted from muscle containing dysmorphic mitochondria from a 32‐year‐old man with MELAS was sequenced in its entirety to identify all possible mutations. The result showed a homoplasmic A14693G and a heteroplasmic A3243G. The A14693G transition was not present in 205 unrelated control individuals, was not seen in 76 species randomly selected from GenBank, and appears to disrupt the base pairing within the T‐loop of mtDNA tRNA^Glu^. His asymptomatic siblings' blood showed wild‐type at these positions, whereas the blood of the patient's oligosymptomatic diabetic mother had a heteroplasmic A14693G and an apparent homoplasmic wild‐type A3243, suggesting an association of A14693G with diabetes mellitus. This case demonstrates the importance of sequencing the mtDNA in its entirety to evaluate the molecular basis of mitochondriopathy. Muscle Nerve 28: 575–581, 2003


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MELAS is a mitochondrial encephalomyopathy characterized clinically by recurrent stroke-like episodes, seizures, sensorineural deafness, dementia, hypertrophic cardiomyopathy, and short stature. The majority of patients are heteroplasmic for a mutation (A3243G) in the tRNA leu(UUR) gene in mitochond