Mutation in mitochondrial complex IV subunit COX5A causes pulmonary arterial hypertension, lactic acidemia, and failure to thrive

Fabian Baertling, Fathiya Al-Murshedi, Laura Sánchez-Caballero, Khalfan Al-Senaidi, Niranjan P. Joshi, Hanka Venselaar, Mariël Am van den Brand, Leo Gj Nijtmans, Richard Jt Rodenburg

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

COX5A is a nuclear-encoded subunit of mitochondrial respiratory chain complex IV (cytochrome c oxidase). We present patients with a homozygous pathogenic variant in the COX5A gene. Clinical details of two affected siblings suffering from early-onset pulmonary arterial hypertension, lactic acidemia, failure to thrive, and isolated complex IV deficiency are presented. We show that the variant lies within the evolutionarily conserved COX5A/COX4 interface domain, suggesting that it alters the interaction between these two subunits during complex IV biogenesis. In patient skin fibroblasts, the enzymatic activity and protein levels of complex IV and several of its subunits are reduced. Lentiviral complementation rescues complex IV deficiency. The monomeric COX1 assembly intermediate accumulates demonstrating a function of COX5A in complex IV biogenesis. A potential therapeutic lead is demonstrated by showing that copper supplementation leads to partial rescue of complex IV deficiency in patient fibroblasts.

Original languageEnglish
JournalHuman Mutation
DOIs
Publication statusAccepted/In press - 2017

Fingerprint

Cytochrome-c Oxidase Deficiency
Failure to Thrive
Pulmonary Hypertension
Milk
Mutation
Fibroblasts
Electron Transport Complex IV
Electron Transport
Siblings
Copper
Skin
Genes
Proteins
Therapeutics

Keywords

  • Complex IV
  • COX5A
  • Cytochrome c oxidase
  • OXPHOS
  • Pulmonary arterial hypertension

ASJC Scopus subject areas

  • Genetics
  • Genetics(clinical)

Cite this

Mutation in mitochondrial complex IV subunit COX5A causes pulmonary arterial hypertension, lactic acidemia, and failure to thrive. / Baertling, Fabian; Al-Murshedi, Fathiya; Sánchez-Caballero, Laura; Al-Senaidi, Khalfan; Joshi, Niranjan P.; Venselaar, Hanka; van den Brand, Mariël Am; Nijtmans, Leo Gj; Rodenburg, Richard Jt.

In: Human Mutation, 2017.

Research output: Contribution to journalArticle

Baertling, Fabian ; Al-Murshedi, Fathiya ; Sánchez-Caballero, Laura ; Al-Senaidi, Khalfan ; Joshi, Niranjan P. ; Venselaar, Hanka ; van den Brand, Mariël Am ; Nijtmans, Leo Gj ; Rodenburg, Richard Jt. / Mutation in mitochondrial complex IV subunit COX5A causes pulmonary arterial hypertension, lactic acidemia, and failure to thrive. In: Human Mutation. 2017.
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AU - Baertling, Fabian

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AU - Sánchez-Caballero, Laura

AU - Al-Senaidi, Khalfan

AU - Joshi, Niranjan P.

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AU - van den Brand, Mariël Am

AU - Nijtmans, Leo Gj

AU - Rodenburg, Richard Jt

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AB - COX5A is a nuclear-encoded subunit of mitochondrial respiratory chain complex IV (cytochrome c oxidase). We present patients with a homozygous pathogenic variant in the COX5A gene. Clinical details of two affected siblings suffering from early-onset pulmonary arterial hypertension, lactic acidemia, failure to thrive, and isolated complex IV deficiency are presented. We show that the variant lies within the evolutionarily conserved COX5A/COX4 interface domain, suggesting that it alters the interaction between these two subunits during complex IV biogenesis. In patient skin fibroblasts, the enzymatic activity and protein levels of complex IV and several of its subunits are reduced. Lentiviral complementation rescues complex IV deficiency. The monomeric COX1 assembly intermediate accumulates demonstrating a function of COX5A in complex IV biogenesis. A potential therapeutic lead is demonstrated by showing that copper supplementation leads to partial rescue of complex IV deficiency in patient fibroblasts.

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