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      Diagnosis and treatment of mitochondrial myopathies

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          Abstract

          Mitochondrial disorders are a heterogeneous group of disorders resulting from primary dysfunction of the respiratory chain. Muscle tissue is highly metabolically active, and therefore myopathy is a common element of the clinical presentation of these disorders, although this may be overshadowed by central neurological features. This review is aimed at a general medical and neurologist readership and provides a clinical approach to the recognition, investigation, and treatment of mitochondrial myopathies. Emphasis is placed on practical management considerations while including some recent updates in the field.

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          Animal and human studies with the mitochondria-targeted antioxidant MitoQ.

          As mitochondrial oxidative damage contributes to a wide range of human diseases, antioxidants designed to be accumulated by mitochondria in vivo have been developed. The most extensively studied of these mitochondria-targeted antioxidants is MitoQ, which contains the antioxidant quinone moiety covalently attached to a lipophilic triphenylphosphonium cation. MitoQ has now been used in a range of in vivo studies in rats and mice and in two phase II human trials. Here, we review what has been learned from these animal and human studies with MitoQ.
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            Mitochondrial disease.

            Defects of mitochondrial metabolism cause a wide range of human diseases that include examples from all medical subspecialties. This review updates the topic of mitochondrial diseases by reviewing the most important recent advances in this area. The factors influencing inheritance, maintenance and replication of mtDNA are reviewed and the genotype-phenotype of mtDNA disorders has been expanded, with new insights into epidemiology, pathogenesis and its role in ageing. Recently identified nuclear gene mutations of mitochondrial proteins include mutations of frataxin causing Friedreich's ataxia, PINK1, DJ1 causing Parkinson's disease and POLG causing infantile mtDNA depletion syndrome, ophthalmoplegia, parkinsonism, male subfertility and, in a transgenic mouse model, premature senescence. Mitochondrial defects in neurodegenerative diseases include Parkinson's, Alzheimer's and Huntington's disease. Improved understanding of mtDNA inheritance and mutation penetrance patterns, and novel techniques for mtDNA modification offer significant prospects for more accurate genetic counselling and effective future therapies.
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              Early coenzyme Q10 supplementation in primary coenzyme Q10 deficiency.

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                Author and article information

                Journal
                Ann Med
                Ann. Med
                ANN
                Annals of Medicine
                Informa Healthcare
                0785-3890
                1365-2060
                February 2013
                25 August 2011
                : 45
                : 1
                : 4-16
                Affiliations
                1Institute of Genetic Medicine , Newcastle University, Newcastle, United Kingdom
                2Clinician Investigator Program , University of British Columbia, Vancouver, Canada
                Author notes
                Correspondence: Professor Patrick F. Chinnery, Institute of Genetic Medicine , Central Parkway, Newcastle, NE13BZ, United Kingdom. E-mail: p.f.chinnery@ 123456ncl.ac.uk
                Article
                10.3109/07853890.2011.605389
                3581062
                21867371
                751f1020-e836-4b19-a066-f5749ea23e48
                © 2013 Informa UK, Ltd.

                This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.

                History
                : 01 August 2011
                : 15 August 2011
                Categories
                Review Article

                Medicine
                diagnosis,mitochondrial disorders,mitochondrial myopathy,treatment
                Medicine
                diagnosis, mitochondrial disorders, mitochondrial myopathy, treatment

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