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Updated: Dec 20, 2025

Author Spotlight: Unveiling Mitochondrial Contact Sites and Architectural Insights
Published on: June 16, 2023
Mutation in the MICOS subunit gene APOO (MIC26) associated with an X-linked recessive mitochondrial myopathy, lactic
Cristiane Benincá1,2, Vanessa Zanette2, Michele Brischigliaro3
1Medical Research Council, Mitochondrial Biology Unit, Cambridge, Cambridgeshire, UK.
Background:
Mitochondria provide ATP through the process of oxidative phosphorylation, physically located in the inner mitochondrial membrane (IMM). The mitochondrial contact site and organising system (MICOS) complex is known as the 'mitoskeleton' due to its role in maintaining IMM architecture. APOO encodes MIC26, a component of MICOS, whose exact function in its maintenance or assembly has still not been completely elucidated.
Methods:
We have studied a family in which the most affected subject presented progressive developmental delay, lactic acidosis, muscle weakness, hypotonia, weight loss, gastrointestinal and body temperature dysautonomia, repetitive infections, cognitive impairment and autistic behaviour. Other family members showed variable phenotype presentation. Whole exome sequencing was used to screen for pathological variants. Patient-derived skin fibroblasts were used to confirm the pathogenicity of the variant found in APOO. Knockout models in Drosophila melanogaster and Saccharomyces cerevisiae were employed to validate MIC26 involvement in MICOS assembly and mitochondrial function.
Results:
A likely pathogenic c.350T>C transition was found in APOO predicting an I117T substitution in MIC26. The mutation caused impaired processing of the protein during import and faulty insertion into the IMM. This was associated with altered MICOS assembly and cristae junction disruption. The corresponding mutation in MIC26 or complete loss was associated with mitochondrial structural and functional deficiencies in yeast and D. melanogaster models.
Conclusion:
This is the first case of pathogenic mutation in APOO, causing altered MICOS assembly and neuromuscular impairment. MIC26 is involved in the assembly or stability of MICOS in humans, yeast and flies.
Insights
A mutation in the APOO gene disrupts MIC26 protein, impairing mitochondrial structure and function, leading to severe neuromuscular and developmental disorders in a human family and model organisms.
Area of Science:
- Mitochondrial biology
- Genetics
- Neuroscience
Background:
- Mitochondria generate ATP via oxidative phosphorylation in the inner mitochondrial membrane (IMM).
- The mitochondrial contact site and organising system (MICOS) complex maintains IMM architecture.
- APOO encodes MIC26, a MICOS component with an incompletely understood role in assembly and maintenance.
Purpose of the Study:
- Investigate the function of MIC26 in mitochondrial maintenance.
- Identify genetic variants in APOO associated with severe developmental disorders.
- Elucidate the molecular mechanisms linking APOO mutations to mitochondrial dysfunction.
Main Methods:
- Whole exome sequencing in a family with affected members.
- Analysis of patient-derived skin fibroblasts.
- Creation and analysis of knockout models in yeast and Drosophila melanogaster.
Main Results:
- A pathogenic c.350T>C variant in APOO, causing an I117T substitution in MIC26, was identified.
- The mutation led to impaired MIC26 processing, faulty IMM insertion, altered MICOS assembly, and cristae junction disruption.
- MIC26 dysfunction caused mitochondrial structural and functional deficits in yeast and Drosophila models.
Conclusions:
- This study reports the first pathogenic mutation in APOO, linking it to altered MICOS assembly and neuromuscular impairment.
- MIC26 is crucial for MICOS assembly and stability in humans, yeast, and flies.
- APOO mutations represent a novel cause of mitochondrial disease.
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