Cytochrome Oxidase Deficiency Research Articles

Stroke‐like episodes in autosomal recessive cytochrome oxidase deficiency

Stroke‐like episodes in autosomal recessive cytochrome oxidase deficiency

Does Overexpression of βAPP in Aging Muscle Have a Pathogenic Role and a Relevance to Alzheimer's Disease?: Clues from Inclusion Body Myositis, Cultured Human Muscle, and Transgenic Mice

In Alzheimer’s disease (AD) pathogenesis, an underlying βAPP/Aβ dysmetabolism leading to neuronal toxicity is considered the essential abnormality by most investigators. 1-4 Hyperphosphorylation and filamentogenesis of tau into paired helical filaments (PHFs) is also thought to be important 5,6 and apolipoprotein E4 genotype is considered an aggravating factor. 7 The various hypotheses for sporadic AD (s-AD) acknowledge the milieu of aging brain cells but usually omit consideration of an initial sparking event. For several years it was presumed that βAPP/Aβ and tau abnormalities occur only in the brain (and its blood vessels in regard to βAPP/Aβ), until βAPP, Aβ, and PHFs containing hyperphosphorylated tau were shown to accumulate pathologically within abnormal muscle fibers of two closely related, progressively disabling muscle diseases, sporadic inclusion-body myositis (s-IBM) and hereditary inclusion-body myopathy (h-IBM). 8-10 s-IBM is a disease of aging muscle with clinical onset nearly always at age 50 or older; h-IBM begins clinically at ages 15–30 in young adult muscle. 11 The autosomal-recessive form of h-IBM is caused by a yet-undetermined gene on chromosome 9 p1-q1, 12,13 not a defect of the βAPP gene on chromosome 21; in two families with the autosomal-dominant form of h-IBM, no defect of the βAPP-gene was demonstrable. 14 s-IBM is the most common muscle disease in older patients. h-IBM is rather rare, but probably more common than hereditary AD (h-AD). In s-IBM and h-IBM it was shown that βAPP-mRNA was overexpressed in muscle fibers 15 (but not exclusively; cellular prion protein and its mRNA were also overexpressed). 16 Several other “Alzheimer characteristic” proteins, including presenilin-1 and proteins related to oxidative stress, also accumulated within abnormal muscle fibers of s-IBM and h-IBM. 11,17,18 Intracellular congophilic amyloid deposits are another characteristic and consistent feature of s-IBM muscle fibers. 8,19 In h-IBM they are very rare in younger patients, but their occurrence, especially in autosomal-dominant forms, increases in older patients. 11 The intracellular amyloid of the IBMs is of two structural-chemical types: collections of 15- to 21-nm PHFs containing immunoreactive tau (and other components, but not Aβ), and collections (“microplaquettes”) containing 6- to 10-nm filaments immunoreactive for Aβ. 11 Because the same proteins accumulate within s- and h-IBM muscle fibers as accumulate in the brains of patients with sporadic and hereditary forms of AD, the muscle and brain diseases might share certain pathogenic steps and knowledge of one disease might help elucidate the other. Cellular aging and evidence of oxidative stress are associated with the IBMs and the ADs. The IBMs and the ADs are both multifactorial and polygenetic. The respective cascades of events leading to the specific form of AD-like IBM muscle fiber degeneration and the similar specific features in AD brain are not understood. Within both the IBM and the AD categories, the pathological phenotypes of sporadic and hereditary forms are very similar, despite the different direct causes being mainly nongenetic versus mainly genetic. Therefore, in each disease category it has been proposed, by our group for the IBMs 20,21 and by others for the ADs, 22,23 that different etiologies including different genetic defects in the hereditary forms lead to the same upstream step, which then promotes the final common downstream pathogenic cascade of events resulting in the specific cellular deterioration. Moreover, the intracellular pathogenic cascades of the IBMs and the ADs might have strong similarities following determination by yet-unknown factors of the initial tissue selectivity in each category, muscle versus brain. In both s-IBM and h-IBM, it is of particular interest that individual muscle fibers accumulate N- and C-terminal βAPP and Aβ, and βAPP-mRNA, before other abnormalities are evident. 8-11 We hypothesized that overexpression of βAPP might be upstream to other cellular abnormalities, including oxidative stress and mitochondrial abnormalities (Figure 1) ▶ . 21 To test this hypothesis, wild-type full-length 751 βAPP was overexpressed long-term in cultured normal human muscle. It produced within muscle fibers several aspects of the IBM cellular phenotype, including vacuolization, congophilic amyloid inclusions (as microplaquettes) in a small percentage of muscle fibers, cytoplasmic 6- to 10-nm amyloid-like filaments, nuclear PHFs, mitochondrial cytochrome oxidase deficiency, and mitochondrial morphological abnormalities. 24,25 Figure 1. Genetic defects in h-IBM and various factors (including a putative virus) in s-IBM lead to presently unknown mechanisms [“?” box in diagram]. These up-regulate βAPP transcription, resulting in βAPP overexpression. ...

Mitochondrial dysfunction in neurodegenerative diseases

A potential pivotal role for mitochondrial dysfunction in neurodegenerative diseases is gaining increasing acceptance. Mitochondrial dysfunction leads to a number of deleterious consequences including impaired calcium buffering, generation of free radicals, activation of the mitochondrial permeability transition and secondary excitotoxicity. Neurodegenerative diseases of widely disparate genetic etiologies may share mitochondrial dysfunction as a final common pathway. Recent studies using cybrid cell lines suggest that sporadic Alzheimer’s disease is associated with a deficiency of cytochrome oxidase. Friedreich’s ataxia is caused by an expanded GAA repeat resulting in dysfunction of frataxin, a nuclear encoded mitochondrial protein involved in mitochondrial iron transport. This results in increased mitochondrial iron and oxidative damage. Familial amyotrophic lateral sclerosis is associated with point mutations in superoxide dismutase, which may lead to increased generation of free radicals and thereby contribute to mitochondrial dysfunction. Huntington’s disease (HD) is caused by an expanded CAG repeat in an unknown protein termed huntingtin. The means by which this leads to energy impairment is unclear, however studies in both HD patients and a transgenic mouse model show evidence of bioenergetic defects. Mitochondrial dysfunction leads to oxidative damage which is well documented in several neurodegenerative diseases. Therapeutic approaches include methods to buffer intracellular ATP and to scavenge free radicals.

A High Rate (20%–30%) of Parental Consanguinity in Cytochrome-Oxidase Deficiency

By studying a large series of 157 patients, we found that complex I (33%), complex IV (28%), and complex I+IV (28%) deficiencies were the most common causes of respiratory chain (RC) defects in childhood. Truncal hypotonia (36%), antenatal (20%) and postnatal (31%) growth retardation, cardiomyopathy (24%), encephalopathy (20%), and liver failure (20%) were the main clinical features in our series. No correlation between the type of RC defect and the clinical presentation was noted, but complex I and complex I+IV deficiencies were significantly more frequent in cases of cardiomyopathy (P<.01) and hepatic failure (P<.05), respectively. The sex ratio (male/female) in our entire series was mostly balanced but was skewed toward males being affected with complex I deficiency (sex ratio R=1.68). Interestingly, a high rate of parental consanguinity was observed in complex IV (20%) and complex I+IV (28%) deficiencies. When parental consanguinity was related to geographic origin, an even higher rate of inbreeding was observed in North African families (76%, P<.01). This study gives strong support to the view that an autosomal recessive mode of inheritance is involved in most cases of mitochondrial disorders in childhood, a feature that is particularly relevant to genetic counseling for this devastating condition.

Saguenay Lac Saint Jean cytochrome oxidase deficiency: sequence analysis of nuclear encoded COX subunits, chromosomal localization and a sequence anomaly in subunit VIc

A biochemically distinct form of cytochrome oxidase (COX) deficiency found in the Saguenay region of Quebec is an autosomal recessive trait. The cDNA sequences of all 10 nuclear-encoded subunits from a patient's fibroblasts showed normal coding sequence. Sequences for subunit VIc in two atypical patients showed a heterozygous base substitution. Subunit VIc was localized to chromosome 18.

COX15 codes for a mitochondrial protein essential for the assembly of yeast cytochrome oxidase.

The respiratory defect of Saccharomyces cerevisiae mutants assigned to complementation group G4 of a pet strain collection stems from their failure to synthesize cytochrome oxidase. The mutations do not affect expression of either the mitochondrially or nuclearly encoded subunits of the enzyme. The cytochrome oxidase deficiency also does not appear to be related to mitochondrial copper metabolism or heme a biosynthesis. These data suggest that the mutants are likely to be impaired in assembly of the enzyme. A gene designated COX15 has been cloned by transformation of mutants from complementation group G4. This gene is identical to reading frame YER141w on chromosome 5. To facilitate further studies, Cox15p has been expressed as a biotinylated protein. Biotinylated Cox15p fully restores cytochrome oxidase in cox15 mutants, indicating that the carboxyl-terminal sequence with biotin does not affect its function. Cox15p is a constituent of the mitochondrial inner membrane and, because of its resistance to proteolysis, probably is largely embedded in the phospholipid bilayer of the membrane. The present studies further emphasize the complexity of cytochrome oxidase assembly and report a new constituent of mitochondria involved in this process. The existence of COX15 homologs in Schizosaccharomyces pombe and Caenorhabditis elegans suggests that it may be widely distributed in eucaryotic organisms.

Isolation of a cDNA encoding the human homolog of COX17, a yeast gene essential for mitochondrial copper recruitment.

The COX17 gene of Saccharomyces cerevisiae codes for a cytoplasmic protein essential for the expression of functional cytochrome oxidase. This protein has been implicated in targeting copper to mitochondria. To determine if Cox17p is present in mammalian cells, a yeast strain carrying a null mutation in COX17 was transformed with a human cDNA expression library. All the respiratory competent clones obtained from the transformations carried a common cDNA sequence with a reading frame predicting a product homologous to yeast Cox17p. The cloning of a mammalian COX17 homolog suggests that the encoded product is likely to function in copper recruitment in eucaryotic cells in general. Its presence in humans provides a possible target for genetically inherited deficiencies in cytochrome oxidase.

No mitochondrial cytochrome oxidase (COX) gene mutations in 18 cases of COX deficiency.

Cytochrome c oxidase (COX) deficiency causes a variety of neuromuscular and non-neuromuscular disorders in childhood and adulthood and can theoretically undergo either a nuclear or a mitochondrial (mt) mode of inheritance, making genetic counseling in COX deficiency particularly hazardous. In an attempt to determine the respective roles of mtDNA and nuclear DNA mutations in COX deficiency, we sequenced the three mitochondrially encoded COX subunits (COXI-III) in a series of 18 patients with isolated COX deficiency, especially as COXI-III code for the catalytic site of the enzyme. We failed to detect any deleterious mutations in this series. Moreover, no mtDNA deletion was observed and sequencing of the flanking tRNA genes involved in the maturation of the COX transcripts failed to detect deleterious mutations as well. The present study supports the view that the disease-causing mutations do not lie in the mt genome but, rather, in the nuclear genes encoding either the COX subunits or the proteins involved in assembly of the complex and suggests a recurrent risk of 25% rather than other modes of inheritance in COX deficiencies.

Mitochondrial Morphology and Intracellular Calcium Homeostasis in Cytochrome Oxidase-Deficient Human Fibroblasts

Mitochondrial encephalomyopathies arise from mutations in the mitochondrial or nuclear genome and result in defective energy metabolism. Investigation of cellular pathophysiology in these disorders has been limited to nonneuronal explant cultures such as fibroblasts and myoblasts. While investigating mitochondrial structure and function in fibroblasts obtained from control and cytochrome oxidase-deficient (COX) patients, we observed possible abnormalities by vital dye confocal microscopy. Most notable were swelling, reticulation (e.g., intricate fusion of mitochondria), and proliferation of mitochondria. However, a detailed quantitative comparison of mitochondrial morphology in age-, sex-, and passage-matched cultures revealed no significant differences between control and cytochrome oxidase-deficient fibroblasts, nor any differences with passage. In addition, COX fibroblasts exhibited no obvious impairment of intracellular calcium handling, measured by fura-2. These results indicate that cytochrome oxidase deficiency, at the level in these cultures, does not produce structural or ionic concentration alterations in fibroblasts. Future investigation of the pathophysiology of this respiratory chain disorder may require excitable tissue.

Congenital hypomyelinating neuropathy: A reversible case

A boy was born at 39 weeks gestation with severe weakness and hypotonia, fractured femurs, poor suck and swallow, and absent deep tendon reflexes. Electrodiagnostic studies revealed marked slowing of motor nerve conduction velocities and normal muscle electrical activity with no evidence of acute denervation. Muscle biopsy showed mild type 2 fiber predominance, and sural nerve biopsy revealed large axons without myelin, and axons with insufficient amount of myelin for their diameter. There was no evidence of inflammation or demyelination. Gradual clinical improvement in tone and strength occurred in a cephalocaudal direction. By 4 months, motor nerve conduction velocities and clinical examination were normal apart from absent deep tendon reflexes. On review at 19 months, motor development and neurological examination were completely normal. Pathogenesis of this reversible pathologically documented case of congenital hypomyelinating neuropathy is unclear. No evidence was found for an inflammatory, toxic, metabolic, or demyelinating cause. Abnormal expression of a developmental gene, as in reversible cytochrome oxidase deficiency, may be a cause of this neuropathy.

Combined aerobic training and dichloroacetate improve exercise capacity and indices of aerobic metabolism in muscle cytochrome oxidase deficiency.

There is no generally effective therapy for mitochondrial myopathies. In this study, we measured responses to combined aerobic training and oral dichloroacetate (DCA) therapy in a 25-year-old woman with a mitochondrial myopathy caused by cytochrome oxidase deficiency. The patient trained for 14 weeks, and DCA therapy was begun after 8 weeks. Independent indices of aerobic capacity and oxidative metabolism showed substantial improvement. Venous lactate concentrations at rest, and after a constant amount of work, decreased by approximately 50% after 8 weeks of aerobic training, and by more than 70% with the combination of training and DCA treatment. Heart rate at rest and after a constant amount of submaximal work decreased progressively. Aerobic capacity on a graded submaximal exercise test improved by 71% from baseline by the end of the treatment period. 31P magnetic resonance spectroscopy measurements of rate constants for recovery of muscle phosphocreatine increased 1.7-fold and metabolically active adenine diphosphate increased 2.8-fold after 8 weeks of training alone, and 4.5-fold and 23.0-fold after 14 weeks of training plus DCA treatment. Responses to the SF-36 Health Survey suggested a marked reduction in handicap. Thus, in this open study of a patient with cytochrome oxidase deficiency, a combination of aerobic training and DCA treatment resulted in substantial improvements in biochemical indices, exercise performance, and handicap. We conclude that exercise limitation in patients with mitochondrial myopathy may arise from effects of chronic deconditioning in addition to the effects of primary mitochondrial dysfunction and may be partially reversed by training and administration of DCA.

Complementation analysis of systemic cytochrome oxidase deficiency presenting as Leigh syndrome.

Systemic cytochrome oxidase deficiency presenting as Leigh syndrome is a well-defined biochemical entity. Although the enzyme defect is demonstrable in all tissues, clinical abnormalities are restricted to the central nervous system. Biochemical studies comparing rates of synthesis of cytochrome oxidase subunits with the steady-state levels of immunoreactive protein in the mitochondrial inner membrane suggest a defect in assembly or stability of the complex. Family studies suggest that the disease is inherited as an autosomal recessive and somatic cell genetic studies directly implicate nuclear genes. As there are likely to be a number of different nuclear genes involved in the synthesis, assembly and stability of the cytochrome oxidase complex, we have fused patient fibroblasts and analysed the heterokaryons for complementation of the enzyme defect in an attempt to define the extent of genetic heterogeneity in this condition. So far, three complementation groups have been defined, although the majority of patients fall into a single group.

Functional mtDNA replication defect in a fibroblast line from a patient with mtDNA depletion.

Mitochondrial DNA (mtDNA) depletion causes infantile cytochrome oxidase deficiency in a number of cases (Moraes et al 1991 ; Trischler et al 1992 ; Poulton et al 1994). Diagnosis is based on a quantitative reduction in the level of qualitatively normal mtDNA relative to nuclear DNA. Where there is a family history, inheritance appears to be autosomal recessive or dominant, suggesting that depletion of mtDNA is secondary to a nuclear defect rather than a mitochondrial gene defect which would be maternally inherited. mtDNA depletion could be caused by a defect in mitochondrial biogenesis such as mtDNA replication, decreased mtDNA stability or increased DNA damage. Unfortunately, few potential candidate genes for causing mtDNA depletion have been identified. One candidate is mitochondrial transcription factor A (mtTFA) which may be an important regulator of both replication and transcription of mtDNA (Parisi and Clayton 1991). Earlier work (Poulton et al 1994) indicated that reduced mtTFA levels correlated with mtDNA depletion and in some cases reduced mtTFA expression. Studies of mtDNA depletion in vitro are difficult owing to the tissue-specific nature of mtDNA depletion. Fibroblasts from mtDNA depletion patients are not always depleted of mtDNA (Poulton et al 1994). In this study we used an artificial depletion method to determine whether cell lines from mtDNA depletion patients have a functional defect in mtDNA replication. The method allows gene expression to be studied during depletion and during the recovery phase where mtDNA levels increase. mtDNA-depleted fibroblasts from one patient were unable to recover mtDNA levels following dideoxycytidine (ddC) treatment.

Variation in mitochondrial DNA levels in muscle from normal controls. Is depletion of mtDNA in patients with mitochondrial myopathy a distinct clinical syndrome.

Recent studies have identified a group of patients with cytochrome oxidase (COX) deficiency presenting in infancy associated with a deficiency of mtDNA in muscle or other affected tissue (Moraes et al 1991). We used a novel approach to compare the level of mitochondrial (mtDNA) compared to nuclear DNA in skeletal muscle from a group of patients and controls, based on dot blots that were hybridized with a mtDNA probe labelled with 35S[dCTP] and a reference nuclear DNA probe labelled with [32P]dCTP. The ratio of mtDNA to nuclear DNA varied in samples from different muscles of the same individual. Secondly, fetal muscle had very low levels of mtDNA compared to nuclear DNA, and data from older controls (cross-sectional rather than sequential) suggest that this increases rapidly over the first 3 months after birth and thereafter more slowly. Four patients with COX deficiency had levels of mtDNA that were below the age-specific range defined by 'normal' quadriceps muscle. The clinical features to two of these patients were similar to earlier case reports of mtDNA depletion. In three patients the clinical course was relatively benign compared to cases that have previously been described. Levels of mtDNA in skeletal muscle from some patients with other forms of muscle disease were also found to be low, suggesting that mtDNA depletion, possibly related to depletion of mitochondria, may be a relatively non-specific response of muscle to various pathological processes. However, there does appear to be a distinctive group of young patients with reduced cytochrome oxidase activity in muscle, in whom marked mtDNA depletion reflects the primary defect.

Mitochondrial myopathy: correlation between oxidative defect and mitochondrial DNA deletions at single fiber level.

In situ hybridization combined with immunohistochemical techniques has been applied to study patients affected by mitochondrial myopathies with large mitochondrial (mt)DNA deletions. All patients' muscle biopsies showed ragged red fibers (RRFs) and cytochrome oxidase (COX) deficiency. Two digoxigenin-labeled, polymerase chain reaction (PCR)-amplified DNAs were used as probes. One probe was designed to hybridize only with wild-type mtDNAs, while the other recognized both wild-type and deleted mtDNAs. Concomitant immunocytochemical analysis using antibodies against subunits II, III, (encoded by mtDNA) and IV (encoded by nuclear DNA) of COX was carried out. In our patients deleted mtDNAs are overexpressed in COX-negative RRFs, while wild-type mtDNAs are decreased in the same fibers. Immunohistochemistry studies show that COX IV is overexpressed in RRFs and that COX II and COX III subunits are still present. Deleted mtDNAs are spatially segregated in muscle fibers, where they interfere with the local population of normal mitochondrial genomes, causing a regional deficiency of the mitochondrial respiratory activity.

Petite mutants of sophorolipid‐producing Candida yeasts

Treatment of both Candida apicola IMET 43747 and Candida bombicola ATCC 22214 with N-methyl-N'-nitro-N-nitroso guanidine resulted in formation of auxotrophic mutants and cytochrome oxidase negative mutants. The deficiency of intact cytochrome oxidase did not affect the ability to produce sophorose lipid. This indicates that intact mitochondrial energy supplying system is not necessary for the production of the extracellular sophorose lipids by both Candida yeasts.

Mitochondrial DNA mutation underlying Leigh's syndrome: Clinical, pathological, biochemical, and genetic studies of a patient presenting with progressive myoclonic epilepsy

An 18-year-old male patient presented with clinical and radiological evidence of Leigh's syndrome (LS), having developed progressive myoclonic epilepsy and ataxia 11 years previously. Muscle biopsy showed cytochrome oxidase deficiency but no ragged red fibres. Autopsy confirmed the diagnosis of LS; there was additional degenerative change in the cerebellum and dentate and olivary nuclei, and an axonal peripheral neuropathy. Biochemical studies showed reduced activity of complexes I and IV of the respiratory chain in mitochondria from heart, liver and kidney. The mutation of mitochondrial DNA (mtDNA) at position 8344, commonly associated with the syndrome of myoclonic epilepsy and ragged red fibres, was detected in the patient's blood and was present in muscle, brain, liver, heart, and kidney in uniformly high amounts. It is clear that LS is genetically heterogeneous and represents one of the most severe phenotypes of a number of different mtDNA defects.

Nonviability of cells with oxidative defects in galactose medium: a screening test for affected patient fibroblasts.

Diagnosis of respiratory chain defects in cultured skin fibroblasts is a difficult diagnostic procedure. We investigated the feasibility of using survival of skin fibroblasts in culture medium with galactose as the major carbon source as a method of quickly diagnosing cell lines that were compromised in oxidative metabolism. We found that cells from patients with most forms of cytochrome oxidase deficiency, cells with complex I deficiency, cells with multiple respiratory chain defects and cells with severe pyruvate dehydrogenase (PDH) complex deficiency failed to survive when subcultured into galactose (5 mM) medium. Cells from patients with Lebers hereditary optic neuropathy (LHON), Kearns-Sayre syndrome (KSS), myoclonus-epilepsy-lactic acidosis-stroke (MELAS), the hepatic form of cytochrome oxidase deficiency, and mild PDH complex deficiency survived well in galactose (5 mM)-containing medium. This could be used as a rapid screening test for skin fibroblasts with major oxidative defects.

Evoked potentials in children with oxidative metabolic defects leading to Leigh syndrome

We studied evoked potentials in 15 children (age range: 2 wks to 4 yrs; mean: 10 mos) with metabolic disturbances that led to Leigh syndrome. These disturbances included deficiencies of pyruvate dehydrogenase (N = 5), complex 1 (N = 7), complex 4 or cytochrome oxidase (N = 2), and complex 5 (N = 1) deficiencies. Subsequent studies were performed in 11 children. All of the children with pyruvate dehydrogenase deficiency had abnormal brainstem auditory evoked potentials (BAEPs) due to poor morphology and reproducibility of the waveforms; central conduction time was normal in 4 of 5 initial studies. The patients with complex 4 or cytochrome oxidase deficiency had abnormal BAEPs, due to increased interpeak latencies and low amplitude or absent waves IV/V. Six of 7 of the children with complex 1 deficiency had normal BAEPs. The remaining patient (the youngest, age 6 wks) had only waves I and II bilaterally and suffered from the rapidly progressive form of complex 1 deficiency; the other 6 with complex 1 deficiency had the slowly progressive form. The one patient with complex 5 deficiency had normal BAEPs when first tested at 4 mos; abnormal BAEPs with loss of later waves were observed 10 weeks later. The visual evoked potentials and somatosensory evoked potentials usually were abnormal in these patients, but the findings were not specific to the patient subgroups. In all but one patient, subsequent studies disclosed a lack of normal maturational changes and/or deterioration across all 3 modalities. The BAEPs appeared to covary with the specific metabolic findings in these patients and with the patient's clinical course, but no BAEP could be considered characteristic of Leigh syndrome.

Evidence for intramitochondrial complementation between deleted and normal mitochondrial DNA in some patients with mitochondrial myopathy

Twenty-three patients with mitochondrial myopathies and mitochondrial DNA deletions in muscle were studied by means of deletion mapping and sequencing, histochemistry and polarography. Histochemistry showed significantly less focal cytochrome oxidase deficiency relative to number of ragged red fibres when the deletion did not involve reading frames for cytochrome oxidase subunits. Polarography in such patients showed defects exclusively involving complex I, in contrast to the others with larger deletions who generally had more diffuse respiratory chain defects. Analysis of other published histochemical data showed similar findings to our own. It is concluded that translation of a proportion of deleted mitochondrial DNAs occurs in at least some patients with mitochondrial DNA deletions, implying that deleted and normal mitochondrial genomes share transfer RNAs within mitochondria in such cases.