Abstract

Objective Cerebral atrophy is a correlate of clinical progression in multiple sclerosis (MS). Mitochondria are now established to play a part in the pathogenesis of MS. Uniquely, mitochondria harbor their own mitochondrial DNA (mtDNA), essential for maintaining a healthy central nervous system. We explored mitochondrial respiratory chain activity and mtDNA deletions in single neurons from secondary progressive MS (SPMS) cases.Methods Ninety-eight snap-frozen brain blocks from 13 SPMS cases together with complex IV/complex II histochemistry, immunohistochemistry, laser dissection microscopy, long-range and real-time PCR and sequencing were used to identify and analyze respiratory-deficient neurons devoid of complex IV and with complex II activity.Results The density of respiratory-deficient neurons in SPMS was strikingly in excess of aged controls. The majority of respiratory-deficient neurons were located in layer VI and immediate subcortical white matter (WM) irrespective of lesions. Multiple deletions of mtDNA were apparent throughout the gray matter (GM) in MS. The respiratory-deficient neurons harbored high levels of clonally expanded mtDNA deletions at a single-cell level. Furthermore, there were neurons lacking mtDNA-encoded catalytic subunits of complex IV. mtDNA deletions sufficiently explained the biochemical defect in the majority of respiratory-deficient neurons.Interpretation These findings provide evidence that neurons in MS are respiratory-deficient due to mtDNA deletions, which are extensive in GM and may be induced by inflammation. We propose induced multiple deletions of mtDNA as an important contributor to neurodegeneration in MS.

Highlights

  • Interpretation: These findings provide evidence that neurons in multiple sclerosis (MS) are respiratory-deficient due to mitochondrial DNA (mtDNA) deletions, which are extensive in gray matter (GM) and may be induced by inflammation

  • A comprehensive analysis of 13 secondary progressive MS (SPMS) cases with age ranging from 39 to 80 years showed a significantly greater density of respiratory-deficient neurons in MS compared with controls, despite MS cases being significantly younger than controls

  • There were strikingly more neurons lacking complex IV and with complex II activity in SPMS cases compared with aged controls

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Summary

Objective

Cerebral atrophy is a correlate of clinical progression in multiple sclerosis (MS). Mitochondria are established to play a part in the pathogenesis of MS. Besides inherited defects, induced mtDNA mutations (deletions and point mutations) within neurons are well recognized in aging and neurodegenerative disorders.[16,17,18] mtDNA is vulnerable to oxidative damage due to its presence in a highly oxidative environment and lack of protective histones.[19,20] Processes that repair double-stranded breaks have been proposed as an important mechanism for the formation of mtDNA deletions, the predominant type of induced mtDNA mutations in neurodegeneration.[17,18,20,21,22] As a single cell contains many copies of mtDNA, for a biochemical defect to manifest, the ratio between deleted to wild-type or healthy mtDNA (heteroplasmy) needs to exceed a certain threshold.[23] The increase in heteroplasmy level is through a process of clonal expansion whereby 1 mutation becomes dominant within the cell.[12,18,21,24] Interestingly, different mutations expand in different cells in cases with multiple mtDNA deletions.[24] to explore mtDNA it is essential to focus on single cells, when investigating pathogenicity of mtDNA mutations. We propose that bouts of acute inflammation and diffuse chronic inflammation in MS damage mtDNA and, through repair processes and clonal expansion, give rise to high heteroplasmy levels of mtDNA deletions in single cells and respiratorydeficient neurons

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