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Deoxypyrimidine monophosphate bypass therapy for thymidine kinase 2 deficiency.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Garcia-Diaz, Beatriz 
Emmanuele, Valentina 
Lopez, Luis C 
Tadesse, Saba 

Abstract

Autosomal recessive mutations in the thymidine kinase 2 gene (TK2) cause mitochondrial DNA depletion, multiple deletions, or both due to loss of TK2 enzyme activity and ensuing unbalanced deoxynucleotide triphosphate (dNTP) pools. To bypass Tk2 deficiency, we administered deoxycytidine and deoxythymidine monophosphates (dCMP+dTMP) to the Tk2 H126N (Tk2(-/-)) knock-in mouse model from postnatal day 4, when mutant mice are phenotypically normal, but biochemically affected. Assessment of 13-day-old Tk2(-/-) mice treated with dCMP+dTMP 200 mg/kg/day each (Tk2(-/-200dCMP/) (dTMP)) demonstrated that in mutant animals, the compounds raise dTTP concentrations, increase levels of mtDNA, ameliorate defects of mitochondrial respiratory chain enzymes, and significantly prolong their lifespan (34 days with treatment versus 13 days untreated). A second trial of dCMP+dTMP each at 400 mg/kg/day showed even greater phenotypic and biochemical improvements. In conclusion, dCMP/dTMP supplementation is the first effective pharmacologic treatment for Tk2 deficiency.

Description

Keywords

deoxycytidine monophosphate, deoxythymidine monophosphate, encephalomyopathy, therapy, thymidine kinase, Animals, Deoxycytidine Monophosphate, Gene Knock-In Techniques, Mice, Mitochondrial Diseases, Survival Analysis, Thymidine Kinase, Thymidine Monophosphate, Treatment Outcome

Journal Title

EMBO Mol Med

Conference Name

Journal ISSN

1757-4676
1757-4684

Volume Title

6

Publisher

Springer Science and Business Media LLC