核基因突变导致儿童线粒体心肌病的分子遗传学研究进展

王子威, 王钰琪, 王春莉

中国当代儿科杂志 ›› 2026, Vol. 28 ›› Issue (6) : 772-779.

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中国当代儿科杂志 ›› 2026, Vol. 28 ›› Issue (6) : 772-779. DOI: 10.7499/j.issn.1008-8830.2510107
综述

核基因突变导致儿童线粒体心肌病的分子遗传学研究进展

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Advances in the molecular genetics of nuclear gene mutations causing pediatric mitochondrial cardiomyopathy

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摘要

线粒体心肌病(mitochondrial cardiomyopathy, MCM)是一组由编码氧化磷酸化链的基因缺陷导致心肌结构和/或功能异常的异质性疾病。该文系统综述儿童MCM相关核基因突变的分子遗传学研究进展,重点探讨影响呼吸链复合物亚基及组装因子、辅酶Q10合成、线粒体DNA维持与表达、脂质代谢、铁硫簇代谢、细胞凋亡调控及线粒体动力学等通路的核基因突变。上述核基因突变可通过干扰线粒体能量代谢、膜稳定性及信号传导等关键过程,导致心肌病理改变。该文通过总结核基因突变在儿童MCM发病机制中的作用,为临床精准诊断与潜在分子靶点的研究提供理论依据。

Abstract

Mitochondrial cardiomyopathy (MCM) is a heterogeneous group of disorders characterized by abnormal myocardial structure and/or function caused by defects in genes encoding the oxidative phosphorylation chain. This review systematically summarizes molecular genetic advances regarding nuclear gene mutations associated with pediatric MCM, focusing on mutations affecting pathways including respiratory chain complex subunits and assembly factors, coenzyme Q10 biosynthesis, mitochondrial DNA maintenance and expression, lipid metabolism, iron-sulfur cluster metabolism, apoptosis regulation, and mitochondrial dynamics. These nuclear gene mutations contribute to myocardial pathological changes by disrupting key processes such as mitochondrial energy metabolism, membrane stability, and signal transduction. The review provides a theoretical basis for precise clinical diagnosis and the exploration of potential molecular targets in pediatric MCM.

关键词

线粒体心肌病 / 核基因 / 氧化磷酸化 / 突变 / 儿童

Key words

Mitochondrial cardiomyopathy / Nuclear gene / Oxidative phosphorylation / Mutation / Child

引用本文

导出引用
王子威, 王钰琪, 王春莉. 核基因突变导致儿童线粒体心肌病的分子遗传学研究进展[J]. 中国当代儿科杂志. 2026, 28(6): 772-779 https://doi.org/10.7499/j.issn.1008-8830.2510107
Zi-Wei WANG, Yu-Qi WANG, Chun-Li WANG. Advances in the molecular genetics of nuclear gene mutations causing pediatric mitochondrial cardiomyopathy[J]. Chinese Journal of Contemporary Pediatrics. 2026, 28(6): 772-779 https://doi.org/10.7499/j.issn.1008-8830.2510107

参考文献

[1]
Mazzaccara C, Mirra B, Barretta F, et al. Molecular epidemiology of mitochondrial cardiomyopathy: a search among mitochondrial and nuclear genes[J]. Int J Mol Sci, 2021, 22(11): 5742. PMCID: PMC8197938. DOI: 10.3390/ijms22115742 .
[2]
Palmer CS, Anderson AJ, Stojanovski D. Mitochondrial protein import dysfunction: mitochondrial disease, neurodegenerative disease and cancer[J]. FEBS Lett, 2021, 595(8): 1107-1131. DOI: 10.1002/1873-3468.14022 .
[3]
Fernandez-Vizarra E, Zeviani M. Mitochondrial disorders of the OXPHOS system[J]. FEBS Lett, 2021, 595(8): 1062-1106. DOI: 10.1002/1873-3468.13995 .
[4]
Bozdemir N, Cakir C, Topcu U, et al. A comprehensive review of mitochondrial complex I during mammalian oocyte maturation[J]. Genesis, 2025, 63(3): e70017. PMCID: PMC12127898. DOI: 10.1002/dvg.70017 .
[5]
Alkhaldi HA, Vik SB. Analysis of compound heterozygous and homozygous mutations found in peripheral subunits of human respiratory Complex I, NDUFS1, NDUFS2, NDUFS8 and NDUFV1, by modeling in the E. coli enzyme[J]. Mitochondrion, 2023, 68: 87-104. PMCID: PMC9805526. DOI: 10.1016/j.mito.2022.11.007 .
[6]
Loeffen J, Elpeleg O, Smeitink J, et al. Mutations in the complex I NDUFS2 gene of patients with cardiomyopathy and encephalomyopathy[J]. Ann Neurol, 2001, 49(2): 195-201. DOI: 10.1002/1531-8249(20010201)49:2<195::aid-ana39>3.0.co;2-m .
[7]
Liu HY, Liao PC, Chuang KT, et al. Mitochondrial targeting of human NADH dehydrogenase (ubiquinone) flavoprotein 2 (NDUFV2) and its association with early-onset hypertrophic cardiomyopathy and encephalopathy[J]. J Biomed Sci, 2011, 18(1): 29. PMCID: PMC3117770. DOI: 10.1186/1423-0127-18-29 .
[8]
Kalantari S, Veraldi D, Politano D, et al. Mitochondrial complex I deficiency: unraveling the relevance of NDUFAF1 in pediatric hypertrophic cardiomyopathy[J]. Am J Med Genet A, 2025, 197(5): e63994. DOI: 10.1002/ajmg.a.63994 .
[9]
Abu Hanna F, Zehavi Y, Cohen-Barak E, et al. Lack of mitochondrial complex I assembly factor NDUFAF2 results in a distinctive infantile-onset brainstem neurodegenerative disease with early lethality[J]. Orphanet J Rare Dis, 2024, 19(1): 92. PMCID: PMC10900632. DOI: 10.1186/s13023-024-03094-0 .
[10]
Du Z, Zhou X, Lai Y, et al. Structure of the human respiratory complex II[J]. Proc Natl Acad Sci U S A, 2023, 120(18): e2216713120. PMCID: PMC10161127. DOI: 10.1073/pnas.2216713120 .
[11]
Courage C, Jackson CB, Hahn D, et al. SDHA mutation with dominant transmission results in complex II deficiency with ocular, cardiac, and neurologic involvement[J]. Am J Med Genet A, 2017, 173(1): 225-230. DOI: 10.1002/ajmg.a.37986 .
[12]
Liu C, Zhou D, Yang K, et al. Research progress on the pathogenesis of the SDHB mutation and related diseases[J]. Biomed Pharmacother, 2023, 167: 115500. DOI: 10.1016/j.biopha.2023.115500 .
[13]
Lin S, Fasham J, Al-Hijawi F, et al. Consolidating biallelic SDHD variants as a cause of mitochondrial complex II deficiency[J]. Eur J Hum Genet, 2021, 29(10): 1570-1576. PMCID: PMC8484551. DOI: 10.1038/s41431-021-00887-w .
[14]
Gusic M, Schottmann G, Feichtinger RG, et al. Bi-allelic UQCRFS1 variants are associated with mitochondrial complex III deficiency, cardiomyopathy, and alopecia totalis[J]. Am J Hum Genet, 2020, 106(1): 102-111. PMCID: PMC7042493. DOI: 10.1016/j.ajhg.2019.12.005 .
[15]
Capaci V, Zupin L, Magistrati M, et al. Uncovering a novel pathogenic mechanism of BCS1L in mitochondrial disorders: insights from functional studies on the c.38A>G variant[J]. Int J Mol Sci, 2025, 26(8): 3670. PMCID: PMC12027322. DOI: 10.3390/ijms26083670 .
[16]
Incognito C, Hedley J, Posadas KT, et al. Pathogenic BCS1L mutation resulting in hypertrophic cardiomyopathy: a unique presentation of nuclear mitochondrial disease[J]. Tex Heart Inst J, 2023, 50(2): e217730. PMCID: PMC10178648. DOI: 10.14503/THIJ-21-7730 .
[17]
Dennerlein S, Rehling P, Richter-Dennerlein R. Cytochrome c oxidase biogenesis: from translation to early assembly of the core subunit COX1[J]. FEBS Lett, 2023, 597(12): 1569-1578. DOI: 10.1002/1873-3468.14671 .
[18]
Abdulhag UN, Soiferman D, Schueler-Furman O, et al. Mitochondrial complex IV deficiency, caused by mutated COX6B1, is associated with encephalomyopathy, hydrocephalus and cardiomyopathy[J]. Eur J Hum Genet, 2015, 23(2): 159-164. PMCID: PMC4297913. DOI: 10.1038/ejhg.2014.85 .
[19]
Lee IC, Chiang KL. Clinical diagnosis and treatment of leigh syndrome based on SURF1: genotype and phenotype[J]. Antioxidants (Basel), 2021, 10(12): 1950. PMCID: PMC8750222. DOI: 10.3390/antiox10121950 .
[20]
Kose M, Canda E, Kagnici M, et al. SURF1 related Leigh syndrome: clinical and molecular findings of 16 patients from Turkey[J]. Mol Genet Metab Rep, 2020, 25: 100657. PMCID: PMC7586243. DOI: 10.1016/j.ymgmr.2020.100657 .
[21]
Tang JX, Cabrera-Orefice A, Meisterknecht J, et al. COA5 has an essential role in the early stage of mitochondrial complex IV assembly[J]. Life Sci Alliance, 2025, 8(3): e202403013. PMCID: PMC11711468. DOI: 10.26508/lsa.202403013 .
[22]
Aich A, Boshnakovska A, Witte S, et al. Defective mitochondrial COX1 translation due to loss of COX14 function triggers ROS-induced inflammation in mouse liver[J]. Nat Commun, 2024, 15(1): 6914. PMCID: PMC11319346. DOI: 10.1038/s41467-024-51109-y .
[23]
李溪远, 杨艳玲. 线粒体呼吸链酶复合物Ⅴ缺陷与线粒体病[J]. 中国当代儿科杂志, 2013, 15(7): 596-600. DOI: 10.7499/j.issn.1008-8830.2013.07.022 .
[24]
Tauchmannová K, Pecinová A, Houštěk J, et al. Variability of clinical phenotypes caused by isolated defects of mitochondrial ATP synthase[J]. Physiol Res, 2024, 73(): S243-S278. PMCID: PMC11412354. DOI: 10.33549/physiolres.935407 .
Suppl 1
[25]
Mantle D, Dewsbury M, Hargreaves IP. The ubiquinone-ubiquinol redox cycle and its clinical consequences: an overview[J]. Int J Mol Sci, 2024, 25(12): 6765. PMCID: PMC11203502. DOI: 10.3390/ijms25126765 .
[26]
Wang Y, Lilienfeldt N, Hekimi S. Understanding coenzyme Q[J]. Physiol Rev, 2024, 104(4): 1533-1610. PMCID: PMC11495197. DOI: 10.1152/physrev.00040.2023 .
[27]
Scalais E, Chafai R, Van Coster R, et al. Early myoclonic epilepsy, hypertrophic cardiomyopathy and subsequently a nephrotic syndrome in a patient with CoQ10 deficiency caused by mutations in para-hydroxybenzoate-polyprenyl transferase (COQ2)[J]. Eur J Paediatr Neurol, 2013, 17(6): 625-630. DOI: 10.1016/j.ejpn.2013.05.013 .
[28]
Pettenuzzo I, Carli S, Sánchez-Cuesta A, et al. COQ7 defect causes prenatal onset of mitochondrial CoQ10 deficiency with cardiomyopathy and gastrointestinal obstruction[J]. Eur J Hum Genet, 2024, 32(8): 938-946. PMCID: PMC11291740. DOI: 10.1038/s41431-024-01615-w .
[29]
Donis R, Al Badi M, Alhashmi N, et al. Two cases of neonatal hyperglycemia caused by a homozygous COQ9 stop-gain variant[J]. J Diabetes Investig, 2025, 16(5): 959-963. PMCID: PMC12057368. DOI: 10.1111/jdi.70022 .
[30]
Manicki M, Aydin H, Abriata LA, et al. Structure and functionality of a multimeric human COQ7: COQ9 complex[J]. Mol Cell, 2022, 82(22): 4307-4323.e10. PMCID: PMC10058641. DOI: 10.1016/j.molcel.2022.10.003 .
[31]
Akbari M, Nilsen HL, Montaldo NP. Dynamic features of human mitochondrial DNA maintenance and transcription[J]. Front Cell Dev Biol, 2022, 10: 984245. PMCID: PMC9491825. DOI: 10.3389/fcell.2022.984245 .
[32]
Nicholas Russo S, Shah EG, Copeland WC, et al. A new pathogenic POLG variant[J]. Mol Genet Metab Rep, 2022, 32: 100890. PMCID: PMC9289853. DOI: 10.1016/j.ymgmr.2022.100890 .
[33]
Kornblum C, Nicholls TJ, Haack TB, et al. Loss-of-function mutations in MGME1 impair mtDNA replication and cause multisystemic mitochondrial disease[J]. Nat Genet, 2013, 45(2): 214-219. PMCID: PMC3678843. DOI: 10.1038/ng.2501 .
[34]
吉照明, 杨世伟. GTPBP3基因突变致线粒体功能障碍与肥厚型心肌病的研究进展[J]. 心脏杂志, 2024, 36(4): 437-441. DOI: 10.12125/j.chj.202212029 .
[35]
Zhou C, Wang J, Zhang Q, et al. Clinical and genetic analysis of combined oxidative phosphorylation defificiency-10 caused by MTO1 mutation[J]. Clin Chim Acta, 2022, 526: 74-80. DOI: 10.1016/j.cca.2021.12.025 .
[36]
Rubalcava-Gracia D, Bubb K, Levander F, et al. LRPPRC and SLIRP synergize to maintain sufficient and orderly mammalian mitochondrial translation[J]. Nucleic Acids Res, 2024, 52(18): 11266-11282. PMCID: PMC11472161 . DOI: 10.1093/nar/gkae662 .
[37]
Oláhová M, Hardy SA, Hall J, et al. LRPPRC mutations cause early-onset multisystem mitochondrial disease outside of the French-Canadian population[J]. Brain, 2015, 138(Pt 12): 3503-3519. PMCID: PMC4655343. DOI: 10.1093/brain/awv291 .
[38]
Xue C, Tian J, Chen Y, et al. Structural insights into human ELAC2 as a tRNA 3' processing enzyme[J]. Nucleic Acids Res, 2024, 52(21): 13434-13446. PMCID: PMC11602120 . DOI: 10.1093/nar/gkae1014 .
[39]
Gokalp S, Inci A, Kilic A, et al. A very rare presentation of mitochondrial elongation factor Tu deficiency-TUFM mutation and literature review[J]. J Pediatr Endocrinol Metab, 2024, 37(6): 571-574. DOI: 10.1515/jpem-2023-0569 .
[40]
Baertling F, Haack TB, Rodenburg RJ, et al. MRPS22 mutation causes fatal neonatal lactic acidosis with brain and heart abnormalities[J]. Neurogenetics, 2015, 16(3): 237-240. DOI: 10.1007/s10048-015-0440-6 .
[41]
Beutner G, Huyck HL, Deutsch G, et al. Dysfunctional electron transport chain assembly in COXPD8[J]. J Cardiovasc Dev Dis, 2025, 12(8): 318. PMCID: PMC12386341. DOI: 10.3390/jcdd12080318 .
[42]
Mayr JA. Lipid metabolism in mitochondrial membranes[J]. J Inherit Metab Dis, 2015, 38(1): 137-144. DOI: 10.1007/s10545-014-9748-x .
[43]
Wu CW, Caha M, Smoot L, et al. Sengers syndrome and AGK-related disorders: minireview of phenotypic variability and clinical outcomes in molecularly confirmed cases[J]. Mol Genet Metab, 2023, 139(3): 107626. DOI: 10.1016/j.ymgme.2023.107626 .
[44]
Barbosa-Gouveia S, Vázquez-Mosquera ME, Gonzalez-Vioque E, et al. Characterization of a novel splicing variant in acylglycerol kinase (AGK) associated with fatal sengers syndrome[J]. Int J Mol Sci, 2021, 22(24): 13484. PMCID: PMC8708263. DOI: 10.3390/ijms222413484 .
[45]
Pena LD, van Calcar SC, Hansen J, et al. Outcomes and genotype-phenotype correlations in 52 individuals with VLCAD deficiency diagnosed by NBS and enrolled in the IBEM-IS database[J]. Mol Genet Metab, 2016, 118(4): 272-281. PMCID: PMC4970910. DOI: 10.1016/j.ymgme.2016.05.007 .
[46]
Vieira Neto E, Wang M, Szuminsky AJ, et al. Mitochondrial bioenergetics and cardiolipin remodeling abnormalities in mitochondrial trifunctional protein deficiency[J]. JCI Insight, 2024, 9(17): e176887. PMCID: PMC11385086. DOI: 10.1172/jci.insight.176887 .
[47]
Lim CC, Vockley J, Ujah O, et al. Outcomes and genotype correlations in patients with mitochondrial trifunctional protein or isolated long chain 3-hydroxyacyl-CoA dehydrogenase deficiency enrolled in the IBEM-IS database[J]. Mol Genet Metab Rep, 2022, 32: 100884. PMCID: PMC9167967. DOI: 10.1016/j.ymgmr.2022.100884 .
[48]
Read AD, Bentley RE, Archer SL, et al. Mitochondrial iron-sulfur clusters: Structure, function, and an emerging role in vascular biology[J]. Redox Biol, 2021, 47: 102164. PMCID: PMC8577454. DOI: 10.1016/j.redox.2021.102164 .
[49]
Kollberg G, Tulinius M, Melberg A, et al. Clinical manifestation and a new ISCU mutation in iron-sulphur cluster deficiency myopathy[J]. Brain, 2009, 132(Pt 8): 2170-2179. DOI: 10.1093/brain/awp152 .
[50]
Iijima H, Imai-Okazaki A, Kishita Y, et al. Role of BOLA3 in the mitochondrial Fe-S cluster clarified by metabolomic analysis[J]. Mol Genet Metab, 2025, 145(2): 109113. DOI: 10.1016/j.ymgme.2025.109113 .
[51]
Lebigot E, Schiff M, Golinelli-Cohen MP. A review of multiple mitochondrial dysfunction syndromes, syndromes associated with defective Fe-S protein maturation[J]. Biomedicines, 2021, 9(8): 989. PMCID: PMC8393393. DOI: 10.3390/biomedicines9080989 .
[52]
Schlingmann KP, Jouret F, Shen K, et al. mTOR-Activating mutations in RRAGD are causative for kidney tubulopathy and cardiomyopathy[J]. J Am Soc Nephrol, 2021, 32(11): 2885-2899. PMCID: PMC8806087. DOI: 10.1681/ASN.2021030333 .
[53]
Qiu H, Sun Y, Wang X, et al. Lamin A/C deficiency-mediated ROS elevation contributes to pathogenic phenotypes of dilated cardiomyopathy in iPSC model[J]. Nat Commun, 2024, 15(1): 7000. PMCID: PMC11324749. DOI: 10.1038/s41467-024-51318-5 .
[54]
Tokuyama T, Yanagi S. Role of mitochondrial dynamics in heart diseases[J]. Genes (Basel), 2023, 14(10): 1876. PMCID: PMC10606177. DOI: 10.3390/genes14101876 .
[55]
Franco A, Li J, Kelly DP, et al. A human mitofusin 2 mutation can cause mitophagic cardiomyopathy[J]. Elife, 2023, 12: e84235. PMCID: PMC10619978. DOI: 10.7554/eLife.84235 .
[56]
Chen L, Liu B, Qin Y, et al. Mitochondrial fusion protein Mfn2 and its role in heart failure[J]. Front Mol Biosci, 2021, 8: 681237. PMCID: PMC8138128. DOI: 10.3389/fmolb.2021.681237 .

脚注

所有作者声明不存在利益冲突。

基金

江苏省自然科学基金面上项目(BK20251732)
南京市卫生科技发展项目重点项目(ZKX24038)

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