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Mitochondrial Disease: Advances in Clinical Diagnosis, Management, Therapeutic Development, and Preventative Strategies

  • Genetic Counseling and Clinical Testing (B LeRoy and N Callanan, Section Editors)
  • Published:
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Abstract

Purpose of Review

Primary mitochondrial disease encompasses an impressive range of inherited energy deficiency disorders having highly variable molecular etiologies as well as clinical onset, severity, progression, and response to therapies of diverse multi-system manifestations. Significant progress has been made in primary mitochondrial disease diagnostic approaches, clinical management, therapeutic options, and preventative strategies that are tailored to major mitochondrial disease phenotypes and subclasses.

Recent Findings

The extensive phenotypic pleiotropy of individual mitochondrial diseases from an organ-based perspective is reviewed. Improved consensus on standards for mitochondrial disease patient care are being complemented by emerging therapies that target specific molecular subtypes of mitochondrial disease. Reproductive counseling options now include pre-implantation genetic diagnosis at the time of in vitro fertilization for familial mutations in nuclear genes and some mtDNA disorders. Mitochondrial replacement technologies have promise for some mtDNA disorders, although practical and societal challenges remain to allow their further research evaluation and clinical utilization.

Summary

A dramatic improvement has occurred in recent years in the recognition, understanding, treatment options, and preventative strategies for primary mitochondrial disease.

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Authors and Affiliations

  1. Mitochondrial Medicine Frontier Program, Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA, 19104, USA

    Colleen C. Muraresku, Elizabeth M. McCormick & Marni J. Falk

  2. Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA

    Marni J. Falk

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  1. Colleen C. Muraresku
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  2. Elizabeth M. McCormick
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  3. Marni J. Falk
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Correspondence to Marni J. Falk.

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Conflict of Interest

Marni J. Falk reports other from REATA Pharmaceuticals, grants, personal fees and other from Stealth Pharmaceuticals, other from United Mitochondrial Disease Foundation, other from GENESIS, grants and other from Raptor Pharmaceuticals, outside the submitted work. The other authors declare that they have no conflict of interest.

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Muraresku, C.C., McCormick, E.M. & Falk, M.J. Mitochondrial Disease: Advances in Clinical Diagnosis, Management, Therapeutic Development, and Preventative Strategies. Curr Genet Med Rep 6, 62–72 (2018). https://doi.org/10.1007/s40142-018-0138-9

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