Quantifying variability of mitochondrial markers in m3243A > G myopathy

Tiago M Bernardino Gomes1,2, Jordan B Childs3, Valeria Di Leo3,4

  • 1Mitochondrial Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK. tiago.gomes@newcastle.ac.uk.

Scientific Reports
|December 19, 2025
PubMed

Insights

Mitochondrial myopathy shows significant spatial variability in muscle fibers. This study quantifies this heterogeneity, providing crucial thresholds for assessing disease progression and therapeutic responses in clinical trials.

Area of Science:

  • Mitochondrial Myopathy Research
  • Skeletal Muscle Physiology
  • Genetic Disease Heterogeneity

Background:

  • Myopathy is a common, debilitating symptom of mitochondrial disease.
  • Skeletal muscle exhibits mitochondrial dysfunction in a mosaic pattern, complicating assessments.
  • Spatial heterogeneity in mitochondrial myopathy is poorly understood, hindering research and clinical trials.

Purpose of the Study:

  • To quantify spatial variability in m.3243A>G-related mitochondrial myopathy.
  • To establish thresholds for meaningful change in mitochondrial dysfunction markers.
  • To provide insights for clinical trial design and patient monitoring.

Main Methods:

  • Analysis of post-mortem muscle biopsies (quadriceps femoris, tibialis anterior) from four patients.
  • Quantification of single-fiber oxidative phosphorylation (OXPHOS) complex I and IV deficiency.
  • Measurement of mitochondrial DNA (mtDNA) copy number and m.3243A>G heteroplasmy using qPCR and pyrosequencing.
  • Application of bootstrapped combinatorial analyses to determine variability thresholds accounting for biopsy distance.

Main Results:

  • Spatial variability in OXPHOS-deficient fibers increased with muscle biopsy distance.
  • Within-muscle thresholds for fiber deficiency were 13.8% (NDUFB8) and 9.8% (MT-CO1).
  • mtDNA copy number variability increased modestly with distance; m.3243A>G heteroplasmy remained stable with thresholds of 1,136 copies/nucleus and 8.2%.

Conclusions:

  • Established assay-specific thresholds for meaningful change in mitochondrial myopathy markers.
  • Findings offer mechanistic insights into spatial heterogeneity of mitochondrial dysfunction.
  • Provides translational value for designing clinical trials, monitoring patients, and detecting disease progression or treatment effects.