Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Pathology of Adult and Paediatric Mitochondrial Myopathies

Version 1 : Received: 12 June 2017 / Approved: 13 June 2017 / Online: 13 June 2017 (06:23:36 CEST)

A peer-reviewed article of this Preprint also exists.

Phadke, R. Myopathology of Adult and Paediatric Mitochondrial Diseases. J. Clin. Med. 2017, 6, 64. Phadke, R. Myopathology of Adult and Paediatric Mitochondrial Diseases. J. Clin. Med. 2017, 6, 64.


Mitochondria are dynamic organelles ubiquitously present in nucleated eukaryotic cells, subserving multiple metabolic functions, including cellular ATP generation by oxidative phosphorylation (OXPHOS). The OXPHOS machinery comprises five transmembrane respiratory chain enzyme complexes (RC). Defective OXPHOS gives rise to mitochondrial diseases (mtD). The incredible phenotypic and genetic diversity of mtD can be attributed at least in part to the RC dual genetic control (nuclear DNA [nDNA] and mitochondrial DNA [mtDNA]) and the complex interaction between the two genomes. Despite the increasing use of next-generation-sequencing (NGS) and various -omics platforms in unraveling novel mtD genes and pathomechanisms, current clinical practice for investigating mtD essentially involves a multipronged approach including clinical assessment, metabolic screening, imaging, pathological, biochemical and functional testing to guide molecular genetic analysis. This review addresses the broad muscle pathology landscape including genotype-phenotype correlations in adult and paediatric mtD, the role of immunodiagnostics in understanding some of the pathomechanisms underpinning the canonical features of mtD, and recent diagnostic advances in the field.


mitochondrial; muscle biopsy; ragged red; COX-negative; subsarcolemmal; immunohistochemistry


Medicine and Pharmacology, Pathology and Pathobiology

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