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Ban, R. ; Liu, Z.* ; Shimura, M. ; Tong, X.* ; Wang, J.* ; Yang, L.* ; Xu, M.* ; Xiao, J.* ; Murayama, K.* ; Elstner, M.* ; Prokisch, H. ; Fang, F.*

Biallelic COA7-variants leading to developmental regression with progressive spasticity and brain atrophy in a Chinese patient.

Front. Genet. 12:685035 (2021)
Publ. Version/Full Text DOI
Open Access Gold
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Objective: The cytochrome c oxidase assembly factor 7 (COA7) gene encodes a protein localized to mitochondria that is involved in the assembly of mitochondrial respiratory chain complex IV. Here, we report the clinical, genetic and biochemical analysis of a female patient with suspected mitochondrial disorder and novel variants in COA7, that presented with a considerably different phenotype and age of onset than the five COA7 patients reported to date. Methods: We performed trio-exome sequencing in the affected patient and both parents. To verify the pathogenicity of the detected variants in COA7, mitochondrial enzyme activities and oxygen consumption rate were investigated in fibroblasts of the patient and her parents. Results: A Chinese girl was referred at 9 months of age with a history of developmental delay and regression since 3 months of age. In the following months, she lost previously acquired skills and developed progressive spasticity of the lower extremities. Trio-exome sequencing revealed compound heterzygous variants in COA7 (c.511G > A/p.Ala171Thr and c.566A > G/p.Asn189Ser). Functional validation experiments revealed isolated complex IV deficiency and a significantly reduced mitochondrial respiration rate in patient-derived fibroblasts. Interpretation: Hitherto, characteristic features of COA7 patients were described as slowly progressing neuropathy and spinocerebellar ataxia, starting at the toddler age and progressing into adulthood. In contrast, our patient was reported to show developmental delay from 3 months of age, which was found to be due to a rapidly progressive encephalopathy and brain atrophy seen at 9 months of age. Unexpectedly, the genetic investigation revealed a COA7-associated mitochondrial disease, which was confirmed functionally. Thus, this report broadens the genetic and clinical spectrum of this heterogeneous mitochondriopathy and highlights the value of the presented unbiased approach.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Biallelic Variant ; Coa7/resa1 ; Cox Assembly Factor ; Mitochondrial Disease ; Nervous System Disorder; Mitochondrial; Mutations; C1orf163/resa1; Disease
ISSN (print) / ISBN 1664-8021
e-ISSN 1664-8021
Quellenangaben Volume: 12, Issue: , Pages: , Article Number: 685035 Supplement: ,
Publisher Frontiers
Publishing Place Avenue Du Tribunal Federal 34, Lausanne, Ch-1015, Switzerland
Reviewing status Peer reviewed
Grants Horizon 2020 through the ERA PerMed project PerMiM
Practical Research Project for Rare/Intractable Diseases from the Japan Agency for Medical Research and Development, AMED
Chinese Ministry of Human Resources and Social Security through the OCPC-Helmholtz Postdoc Program
European Joint Programme on Rare Diseases project GENOMIT
German BMBF