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Imbalanced mitochondrial function provokes heterotaxy via aberrant ciliogenesis
Martin D. Burkhalter, … , Stephanie M. Ware, Melanie Philipp
Martin D. Burkhalter, … , Stephanie M. Ware, Melanie Philipp
Published May 16, 2019
Citation Information: J Clin Invest. 2019;129(7):2841-2855. https://doi.org/10.1172/JCI98890.
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Research Article Cardiology Development

Imbalanced mitochondrial function provokes heterotaxy via aberrant ciliogenesis

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Abstract

About 1% of all newborns are affected by congenital heart disease (CHD). Recent findings identify aberrantly functioning cilia as a possible source for CHD. Faulty cilia also prevent the development of proper left-right asymmetry and cause heterotaxy, the incorrect placement of visceral organs. Intriguingly, signaling cascades such as mTOR that influence mitochondrial biogenesis also affect ciliogenesis, and can cause heterotaxy-like phenotypes in zebrafish. Here, we identify levels of mitochondrial function as a determinant for ciliogenesis and a cause for heterotaxy. We detected reduced mitochondrial DNA content in biopsies of heterotaxy patients. Manipulation of mitochondrial function revealed a reciprocal influence on ciliogenesis and affected cilia-dependent processes in zebrafish, human fibroblasts and Tetrahymena thermophila. Exome analysis of heterotaxy patients revealed an increased burden of rare damaging variants in mitochondria-associated genes as compared with 1000 Genome controls. Knock down of such candidate genes caused cilia elongation and ciliopathy-like phenotypes in zebrafish, which could not be rescued by RNA encoding damaging rare variants identified in heterotaxy patients. Our findings suggest that ciliogenesis is coupled to the abundance and function of mitochondria. Our data further reveal disturbed mitochondrial function as an underlying cause for heterotaxy-linked CHD and provide a mechanism for unexplained phenotypes of mitochondrial disease.

Authors

Martin D. Burkhalter, Arthi Sridhar, Pedro Sampaio, Raquel Jacinto, Martina S. Burczyk, Cornelia Donow, Max Angenendt, Competence Network for Congenital Heart Defects Investigators, Maja Hempel, Paul Walther, Petra Pennekamp, Heymut Omran, Susana S. Lopes, Stephanie M. Ware, Melanie Philipp

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Figure 5

Cilia length and function defects upon loss-of-function of heterotaxy patient-derived genes.

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Cilia length and function defects upon loss-of-function of heterotaxy pa...
(A) KD of candidate genes reduces cellular ATP. One-way ANOVA with Holm-Sidak comparison, n = 10, all compared with control siRNA (siCTRL): ****P < 0.0001 (TAZ, OSBPL1A, MTRR, PHKA2), ***P < 0.0001 (CA5B), **P = 0.0049 (ACOX1). Red line indicates median. (B, C) KD of candidate genes causes longer cilia. Cartoon illustrates staining for cilia (acTub, red), the basal body (BB, green), and the nucleus (blue). Scale bar: 10 μm. Kruskal-Wallis test with Dunn’s multiple comparison, N = 3, n = 95/99/96/96/98/94/100, all compared with siCTRL: ****P < 0.0001 (CA5B, TAZ, OSBPL1A, MTRR), **P = 0.0049 (ACOX1). Red line indicates median. (D) Representative images of 48 hpf zebrafish embryos, which were either noninjected (NI), control-injected (CTRL MO), or injected with MO targeting splice sites (spMO) in Mtrr, Phka2, and Osbpl1a, respectively. (E) Quantification of pericardial edema and body curvature in embryos. One-way ANOVA with Holm-Sidak comparison; N = 7/7/3/4/4, n = 196/178/52/102/109, all compared with CTRL MO. Pericardial edema: ****P < 0.0001 (Mtrr splMO, Phka2 splMO); *P = 0.0144 (Osbpl1a splMO); curved tail: ****P <0.0001 (Mtrr splMO), ***P =0.0008 (Osbpl1a splMO), **P = 0.0003 (Phka2 splMO). (F) KD of candidate genes increases frequency of aberrant heart looping. Two-sided Fisher’s exact test; N = 9/9/3/6/4; n = 227/200/50/143/104; all compared with CTRL MO: ****P <0.0001 (Mtrr splMO, Phka2 splMO), ***P = 0.0006 (Osbpl1a splMO). (G) KD of candidate genes does not alter the number of cilia per KV. One-way ANOVA with Holm-Sidak comparison, n = 15/12/13/15. (H) KD of candidate genes confers elongation of LRO cilia. Kruskal-Wallis test with Dunn’s multiple comparison test; n = 261/209/268/343; all compared with CTRL MO, ****P < 0.0001. Red line indicates median. Scale bars: 10 μm (B) or 500 μm (D). Shown are mean ± SEM in E and G.
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