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A novel inborn error of the coenzyme Q10 biosynthesis pathway: cerebellar ataxia and static encephalomyopathy due to COQ5 C‐methyltransferase deficiency
Author(s) -
Malicdan May Christine V.,
Vilboux Thierry,
BenZeev Bruria,
Guo Jennifer,
Eliyahu Aviva,
PodeShakked Ben,
Dori Amir,
Kakani Sravan,
Chandrasekharappa Settara C.,
Ferreira Carlos R.,
Shelestovich Natalia,
MarekYagel Dina,
PriChen Hadass,
Blatt Ilan,
Niederhuber John E.,
He Langping,
Toro Camilo,
Taylor Robert W.,
Deeken John,
Yardeni Tal,
Wallace Douglas C.,
Gahl William A.,
Anikster Yair
Publication year - 2018
Publication title -
human mutation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.981
H-Index - 162
eISSN - 1098-1004
pISSN - 1059-7794
DOI - 10.1002/humu.23345
Subject(s) - biology , coenzyme q10 , ataxia , genetics , exome sequencing , cerebellar ataxia , proband , mitochondrial encephalomyopathy , mitochondrial myopathy , phenotype , bioinformatics , gene , mutation , endocrinology , neuroscience , mitochondrial dna
Primary coenzyme Q10 (CoQ 10 ; MIM# 607426) deficiencies are an emerging group of inherited mitochondrial disorders with heterogonous clinical phenotypes. Over a dozen genes are involved in the biosynthesis of CoQ 10 , and mutations in several of these are associated with human disease. However, mutations in COQ5 (MIM# 616359), catalyzing the only C‐methylation in the CoQ 10 synthetic pathway, have not been implicated in human disease. Here, we report three female siblings of Iraqi‐Jewish descent, who had varying degrees of cerebellar ataxia, encephalopathy, generalized tonic‐clonic seizures, and cognitive disability. Whole‐exome and subsequent whole‐genome sequencing identified biallelic duplications in the COQ5 gene, leading to reduced levels of CoQ 10 in peripheral white blood cells of all affected individuals and reduced CoQ 10 levels in the only muscle tissue available from one affected proband. CoQ 10 supplementation led to clinical improvement and increased the concentrations of CoQ 10 in blood. This is the first report of primary CoQ 10 deficiency caused by loss of function of COQ5 , with delineation of the clinical, laboratory, histological, and molecular features, and insights regarding targeted treatment with CoQ 10 supplementation.