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Mitochondrial diseases are characterized by a high clinical and genetic heterogeneity and a growing number of genes of mitochondrial disease has been identified. Mitochondrial diseases follow any mode of inheritance, due to the twofold genetic origin of RC components (nuclear DNA and mitochondrial DNA). 1 000 to 1 500 nuclear genes encode mitochondrial proteins. Approximately 250 of these genes have been reported as disease causing. These genes not only encode the various subunits of each respiratory chain complex, but also the ancillary proteins involved in the different stages of holoenzyme biogenesis, transcription, translation, chaperoning, addition of prosthetic groups and assembly of proteins, as well as the various enzymes involved in mtDNA maintenance. Some of these genes are associated with well defined syndromes but more and more are specific to one patient or family only, hampering to establish genotype-phenotype correlations. The clinical heterogeneity of these disorders makes the diagnosis difficult especially in the first years of the clinical course and other genetic diseases can present an overlapping phenotype. Therefore only the identification of the disease causing mutation allows to certainly establish the diagnosis of mitochondrial disease.
Dr. Rötig (PhD) is the head of the group working on mitochondrial diseases in Necker Hospital (Paris). This group has initially settled and integrated platform of clinic, biochemistry and molecular analysis to investigate patients with OXPHOS disease. The scientific field of this group is the identification of genes involved in mitochondrial disorders and the investigation of their pathophysiology. They have described the first non-neuromuscular presentation of mitochondrial diseases and characterized the very first mutations in nuclear genes resulting in defects of Krebs’s cycle or the respiratory chain.