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      CMT2A Harboring Mitofusin 2 Mutation with Optic Nerve Atrophy and Normal Visual Acuity

      case-report

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          Abstract

          Charcot-Marie-Tooth (CMT) constitutes a group of heterogeneous hereditary motor and sensor neuropathies. Mutations in mitofusin-2 ( MFN2) cause CMT type 2A by altering mitochondrial fusion and trafficking along with the axonal microtubule system. In literature patients presenting with CMT2A are reported as having a subacute onset of optic atrophy associated with central scotoma and color vision defects. We report on the clinical and genetic findings in a 40 years-old Caucasian woman presenting with CMT type 2A and MFN2 mutation (c.2258duplT/p.Leu753fs) who presented bilateral progressive optic atrophy with bilateral severe concentric narrowing of the visual field but normal visual acuity and color vision. This is the first report that describes such phenotypical manifestation of an MFN2 mutation suggesting that the molecular mechanisms underlying the mitofusin-2 function alteration at optic nerve need to be investigated further.

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          Most cited references11

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          Genetic and clinical aspects of Charcot-Marie-Tooth's disease.

          H Skre (1973)
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            Mitochondrial dynamics: Biological roles, molecular machinery, and related diseases

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              Axonal neuropathy with optic atrophy is caused by mutations in mitofusin 2.

              Charcot-Marie-Tooth (CMT) neuropathy with visual impairment due to optic atrophy has been designated as hereditary motor and sensory neuropathy type VI (HMSN VI). Reports of affected families have indicated autosomal dominant and recessive forms, but the genetic cause of this disease has remained elusive. Here, we describe six HMSN VI families with a subacute onset of optic atrophy and subsequent slow recovery of visual acuity in 60% of the patients. Detailed clinical and genetic studies were performed. In each pedigree, we identified a unique mutation in the gene mitofusin 2 (MFN2). In three families, the MFN2 mutation occurred de novo; in two families the mutation was subsequently transmitted from father to son indicating autosomal dominant inheritance. MFN2 is a mitochondrial membrane protein that was recently reported to cause axonal CMT type 2A. It is intriguing that MFN2 shows functional overlap with optic atrophy 1 (OPA1), the protein underlying the most common form of autosomal dominant optic atrophy, and mitochondrial encoded oxidative phosphorylation components as seen in Leber's hereditary optic atrophy. We conclude that autosomal dominant HMSN VI is caused by mutations in MFN2, emphasizing the important role of mitochondrial function for both optic atrophies and peripheral neuropathies.
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                Author and article information

                Journal
                Int Med Case Rep J
                Int Med Case Rep J
                IMCRJ
                imcrj
                International Medical Case Reports Journal
                Dove
                1179-142X
                20 February 2020
                2020
                : 13
                : 41-45
                Affiliations
                [1 ]Department of Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro , Bari, Italy
                [2 ]Department of Molecular Biology, University of Geneva , Geneva, Switzerland
                Author notes
                Correspondence: Vittoria Petruzzella Dipartimento di Scienze Mediche di Base, Neuroscienze e, Organi di Senso - Università degli Studi Aldo Moro , Piazza G. Cesare, Bari70124, ItalyTel +39 080 5448530Fax +39 080 5448538 Email vittoria.petruzzella@uniba.it
                Author information
                http://orcid.org/0000-0001-8313-4159
                http://orcid.org/0000-0001-8771-6033
                Article
                237620
                10.2147/IMCRJ.S237620
                7039061
                32110117
                69414918-84f0-4148-ae9a-65eee2963d61
                © 2020 Guerriero et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 12 November 2019
                : 17 January 2020
                Page count
                Figures: 2, References: 17, Pages: 5
                Categories
                Case Report

                charcot-marie-tooth type 2a,mitofusin2,optic atrophy,mitochondria,visual field

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