From the Structural and (Dys)function of ATP Synthase to Deficiency in Age-Related Diseases

The ATP synthase is a mitochondrial complex embedded in the inner mitochondrial membrane. The enzyme is under the double genetic control of the mitochondrial DNA (mtDNA) and nuclear DNA (nDNA). Fatal human diseases have been associated with defects in ATP synthase (Complex V) activity linked to mtDNA or nDNA pathogenetic variants in genes encoding structural subunits or assembly factors. Mitochondrial post-translational modifications of key amino acids, reduced/increased subunit expression, or protein to protein ATP synthase interaction, are also some of the mechanisms involved in the age-related disease pathway. All the major neurodegenerative diseases: Parkinson’s, Alzheimer’s and motor neuron diseases such as Amyotrophic Lateral Sclerosis highlight an impaired ATP generation in a mechanism involving the permeability transition pore that triggers a cellular homeostasis failure responsible for different forms of regulated cell death. In this review, we will explore ATP synthase assembly and function in physiological and pathological conditions by referring to the recent cryo-EM studies and by exploring human diseases models.