In this episode of PaperCast Base by Base, we explore how de novo heterozygous ATP5F1A missense variants disrupt mitochondrial ATP synthase and manifest as pediatric neurological disorders, revealing a dominant‑negative mechanism and an isolated Complex V defect.
Study Highlights:
The authors describe six probands with developmental delay, dystonia, pyramidal tract signs and failure to thrive, each carrying ATP5F1A variants clustered at the α–β or α–γ interfaces of the F1 sector of ATP synthase. In vivo CRISPR knock‑ins of orthologous variants in C. elegans behaved dominantly, slowed development and locomotion, and activated a mitochondrial stress response that was dose‑dependently suppressed by adding wild‑type gene copies. Patient‑derived cells showed reduced abundance and ATPase activity of Complex V, with increased oxygen consumption but decreased mitochondrial membrane potential and ATP levels, indicating uncoupled oxidative phosphorylation. Structural modeling supported disrupted subunit interactions, and proteomics demonstrated an isolated Complex V deficiency distinct from earlier reports for other ATP5F1A alterations.
Reference:
Fielder SM, Friederich MW, Hock DH, Zhang JR, Valin LM, Rosenfeld JA, Booth KTA, Brown NJ, Rius R, Sharma T, Semcesen LN, Worley KC, Burrage LC, Treat K, Samson T, Govert S, DaCunha S, Yuan W, Chen J, Lesinski J, Hoang H, Morrison SA, Ladha FA, Van Hove R, Michel CR, Reisdorph R, Tycksen E, Baldridge D, Silverman GA, Soler‑Alfonso C, Conboy E, Vetrini F, Emrick L, Craigen WJ, Undiagnosed Diseases Network, Sykes SM, Stroud DA, Van Hove JLK, Schedl T, Pak SC. Dominant negative ATP5F1A variants disrupt oxidative phosphorylation causing neurological disorders. EMBO Molecular Medicine. 2025. https://doi.org/10.1038/s44321-025-00290-8
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