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Deep sequencing of mitochondrial DNA and characterization of a novel POLG mutation in a patient with arPEO.

Journal article
Authors Carola Oldfors Hedberg
Bertil Macao
Swaraj Basu
Christopher Lindberg
Bradley Peter
Jay Uhler
Erik Larsson
Maria Falkenberg
Anders Oldfors
Published in Neurology. Genetics
Volume 6
Issue 1
ISSN 2376-7839
Publication year 2020
Published at Department of Laboratory Medicine
Institute of Medicine
Institute of Biomedicine, Department of Medical Biochemistry and Cell Biology
Language en
Subject categories Genetics


To determine the pathogenicity of a novel POLG mutation in a man with late-onset autosomal recessive progressive external ophthalmoplegia using clinical, molecular, and biochemical analyses.A multipronged approach with detailed neurologic examinations, muscle biopsy analyses, molecular genetic studies, and in vitro biochemical characterization.The patient had slowly progressive bilateral ptosis and severely reduced horizontal and vertical gaze. Muscle biopsy showed slight variability in muscle fiber size, scattered ragged red fibers, and partial cytochrome c oxidase deficiency. Biallelic mutations were identified in the POLG gene encoding the catalytic A subunit of POLγ. One allele carried a novel mutation in the exonuclease domain (c.590T>C; p.F197S), and the other had a previously characterized null mutation in the polymerase domain (c.2740A>C; p.T914P). Biochemical characterization revealed that the novel F197S mutant protein had reduced exonuclease and DNA polymerase activities and confirmed that T914P was inactive. By deep sequencing of mitochondrial DNA (mtDNA) extracted from muscle, multiple large-scale rearrangements were mapped and quantified.The patient's phenotype was caused by biallelic POLG mutations, resulting in one inactive POLγA protein (T914P) and one with decreased polymerase and exonuclease activity (F197S). The reduction in polymerase activity explains the presence of multiple pathogenic large-scale deletions in the patient's mtDNA.

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