Abstract

The study of skeletal muscle continues to support the accurate diagnosis of mitochondrial disease and remains important in delineating molecular disease mechanisms. The heterogeneous expression of oxidative phosphorylation proteins and resulting respiratory deficiency are both characteristic findings in mitochondrial disease, hence the rigorous assessment of these at a single cell level is incredibly powerful. Currently, the number of proteins that can be assessed in individual fibres from a single section by immunohistochemistry is limited but imaging mass cytometry (IMC) enables the quantification of further, discrete proteins in individual cells. We have developed a novel workflow and bespoke analysis for applying IMC in skeletal muscle biopsies from patients with genetically-characterised mitochondrial disease, investigating the distribution of nine mitochondrial proteins in thousands of single muscle fibres. Using a semi-automated analysis pipeline, we demonstrate the accurate quantification of protein levels using IMC, providing an accurate measure of oxidative phosphorylation deficiency for complexes I–V at the single cell level. We demonstrate signatures of oxidative phosphorylation deficiency for common mtDNA variants and nuclear-encoded complex I variants and a compensatory upregulation of unaffected oxidative phosphorylation components. This technique can now be universally applied to evaluate a wide range of skeletal muscle disorders and protein targets.

Highlights

  • The study of skeletal muscle continues to support the accurate diagnosis of mitochondrial disease and remains important in delineating molecular disease mechanisms

  • We demonstrate the use of this assay on ten patients with genetically confirmed mitochondrial disease due to pathogenic variants in either mtDNA or nDNA leading to a range of heterogeneous or homogenous deficiencies of oxidative phosphorylation

  • We have optimised imaging mass cytometry (IMC) for use in frozen skeletal muscle to determine the levels of metal-labelled antibodies targeting proteins of interest in a multiplexed assay at the single cell level

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Summary

Introduction

The study of skeletal muscle continues to support the accurate diagnosis of mitochondrial disease and remains important in delineating molecular disease mechanisms. We demonstrate signatures of oxidative phosphorylation deficiency for common mtDNA variants and nuclear-encoded complex I variants and a compensatory upregulation of unaffected oxidative phosphorylation components This technique can be universally applied to evaluate a wide range of skeletal muscle disorders and protein targets. Investigation and analysis of muscle in ageing and disease is often complicated by the presence of both normal healthy fibres and those affected by pathology within a skeletal muscle biopsy This is true of atrophy, senescence, degeneration, regeneration, inflammatory processes and necrosis among other pathological changes not to mention the heterogeneity of fibre-types[1,2]. The recent development of a high resolution laser ablation laser module has brought tissue imaging modality, at 1 μm per pixel resolution, to cytometry by time of flight mass cytometers (CyTOF) This imaging mass cytometry (IMC) technique utilises antibody-conjugated isotopes of rare earth metals and so is not limited by fluorophore associated spectral overlap. IMC allows for the simultaneous measurement of a greater number of proteins targets in a single section than is possible with standard immunofluorescent t­echniques[12]

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