Mitochondrial diseases are a group of genetic disorders that affect the mitochondria, the cellular structures responsible for producing energy in the form of ATP (adenosine triphosphate). These diseases are caused by mutations in mitochondrial DNA or in nuclear genes that encode proteins related to mitochondrial function. Because mitochondria are crucial to cells' energy metabolism, mitochondrial disorders can affect multiple systems in the body, including the brain, nervous system, muscles, heart, and other organs.
Characteristics or peculiarities of mitochondrial diseases.
| Nuclear DNA | mtDNA | |
| Location | Core | Mitochondrial matrix |
| Size | 3200 MB | 16.6kb |
| Structure | Double linear antiparallel helix | Double circular helix |
| Introns | Presents | Missing |
| Non-coding sequences | 98% | 7% |
| Transcription | Monogenic. Individual transcripts for each gene. | Multigenic. Block transcription of the entire transcript. |
| Number of copies | 1 set per cell | From hundreds to thousands per cell |
| Associated proteins | Histones | No associated proteins |
| Coding genes | 30.000 | 37 |
| Codon | Universal genetic code | Mitochondrial genetic code |
- Heteroplasmy. Heteroplasmy refers to the presence of different types of mitochondrial DNA in a cell or individual. Mitochondria multiply by dividing independently of the cell cycle, and in the copying process errors can occur that accumulate over time. This variation in mitochondrial DNA is known as heteroplasmy.
- Mitochondrial inheritance. Mitochondria are inherited primarily through the mother, and therefore, mitochondrial DNA (mtDNA) is inherited exclusively from the mother, unlike nuclear DNA, which is inherited from both parents. Mutations or variants in mitochondrial DNA are passed from mother to children, but only daughters can pass these mutations on to their offspring. Male children do not pass on their mitochondrial DNA to their offspring.
- Mitochondrial genetic code. The mitochondrial genetic code is the set of rules that determines how the information contained in mitochondrial DNA (mtDNA) is translated into proteins within the mitochondria, and is similar but not identical to the universal genetic code used in the rest of the cell, which is found in nuclear DNA. In the mitochondrial genetic code, some of the amino acid codings are different, meaning that certain codons in the mRNA translate into different amino acids compared to the nuclear genetic code. Some of the most notable differences in the mitochondrial genetic code are:
- The AGA codon in the nuclear code codes for the amino acid arginine, while in the mitochondrial code it codes for serine.
- The AGG codon in the nuclear code codes for the amino acid arginine, while in the mitochondrial code it also codes for serine.
- The UGA codon in the nuclear code is usually a stop codon (termination codon), but in the mitochondrial code it codes for the amino acid tryptophan.

- Mitochondrial chromosome. The term "mitochondrial chromosome" refers to the genetic material contained in mitochondria, but it is important to note that mitochondria do not have chromosome structures similar to chromosomes in the nucleus. Here are some key features of mitochondrial DNA:
- Shape and Structure: Mitochondrial DNA usually appears in the shape of a closed circle, in contrast to the linear chromosomes in the nucleus.
- Genes: Mitochondrial DNA contains a total of 37 genes.
- Transcription and Translation: Mitochondria are capable of transcribing and translating their own DNA, which allows them to synthesize the proteins necessary for their function. However, most proteins required for mitochondrial function are encoded by the nucleus and then imported into the mitochondria.

Genes encoded in mtDNA
The 37 genes of the Cambridge Reference Sequence for human mitochondrial DNA and their locations[30]
| Gene | Type | Product | Positions in the mitogenome | Strand |
| MT-ATP8 | protein coding | ATP synthase, Fo subunit 8 (complex V) | 08.366–08.572 (overlap with MT-ATP6) | H |
| MT-ATP6 | protein coding | ATP synthase, Fo subunit 6 (complex V) | 08,527–09,207 (overlap with MT-ATP8) | H |
| MT-CO1 | protein coding | Cytochrome c oxidase, subunit 1 (complex IV) | 05,904–07,445 | H |
| MT-CO2 | protein coding | Cytochrome c oxidase, subunit 2 (complex IV) | 07,586–08,269 | H |
| MT-CO3 | protein coding | Cytochrome c oxidase, subunit 3 (complex IV) | 09,207–09,990 | H |
| MT-CYB | protein coding | Cytochrome b (complex III) | 14,747–15,887 | H |
| MT-ND1 | protein coding | NADH dehydrogenase, subunit 1 (complex I) | 03,307–04,262 | H |
| MT-ND2 | protein coding | NADH dehydrogenase, subunit 2 (complex I) | 04,470–05,511 | H |
| MT-ND3 | protein coding | NADH dehydrogenase, subunit 3 (complex I) | 10,059–10,404 | H |
| MT-ND4L | protein coding | NADH dehydrogenase, subunit 4L (complex I) | 10,470–10,766 (overlap with MT-ND4) | H |
| MT-ND4 | protein coding | NADH dehydrogenase, subunit 4 (complex I) | 10,760–12,137 (overlap with MT-ND4L) | H |
| MT-ND5 | protein coding | NADH dehydrogenase, subunit 5 (complex I) | 12,337–14,148 | H |
| MT-ND6 | protein coding | NADH dehydrogenase, subunit 6 (complex I) | 14,149–14,673 | L |
| MT-RNR2 | protein coding | Humanin | — | — |
| MT-TA | transfer RNA | tRNA-Alanine (Ala or A) | 05,587–05,655 | L |
| MT-TR | transfer RNA | tRNA-Arginine (Arg or R) | 10,405–10,469 | H |
| MT-TN | transfer RNA | tRNA-Asparagine (Asn or N) | 05,657–05,729 | L |
| MT-TD | transfer RNA | tRNA-Aspartic acid (Asp or D) | 07,518–07,585 | H |
| MT-TC | transfer RNA | tRNA-Cysteine (Cys or C) | 05,761–05,826 | L |
| MT-TE | transfer RNA | tRNA-glutamic acid (Glu or E) | 14,674–14,742 | L |
| MT-TQ | transfer RNA | tRNA-Glutamine (Gln or Q) | 04,329–04,400 | L |
| MT-TG | transfer RNA | tRNA-Glycine (Gly or G) | 09,991–10,058 | H |
| MT-TH | transfer RNA | tRNA-Histidine (His or H) | 12,138–12,206 | H |
| MT-TI | transfer RNA | tRNA-Isoleucine (Ile or I) | 04,263–04,331 | H |
| MT-TL1 | transfer RNA | tRNA-Leucine (Leu-UUR or L) | 03,230–03,304 | H |
| MT-TL2 | transfer RNA | tRNA-Leucine (Leu-CUN or L) | 12,266–12,336 | H |
| MT-TK | transfer RNA | tRNA-Lysine (Lys or K) | 08,295–08,364 | H |
| MT-TM | transfer RNA | tRNA-Methionine (Met or M) | 04,402–04,469 | H |
| MT-TF | transfer RNA | tRNA-Phenylalanine (Phe or F) | 00.577–00.647 | H |
| MT-TP | transfer RNA | tRNA-Proline (Pro or P) | 15,956–16,023 | L |
| MT-TS1 | transfer RNA | tRNA-Serine (Ser-UCN or S) | 07,446–07,514 | L |
| MT-TS2 | transfer RNA | tRNA-Serine (Ser-AGY or S) | 12,207–12,265 | H |
| MT-TT | transfer RNA | tRNA-Threonine (Thr or T) | 15,888–15,953 | H |
| MT-TW | transfer RNA | tRNA-Tryptophan (Trp or W) | 05,512–05,579 | H |
| MT-TY | transfer RNA | tRNA-Tyrosine (Tyr or Y) | 05,826–05,891 | L |
| MT-TV | transfer RNA | tRNA-Valine (Value or V) | 01,602–01,670 | H |
| MT-RNR1 | ribosomal RNA | Small subunit: SSU (12S) | 00,648–01,601 | H |
| MT-RNR2 | ribosomal RNA | Large subunit: LSU (16S) | 01,671–03,229 | H |
Diagnostic criteria for mitochondrial disease. When to suspect the presence of a mitochondrial disease.

When to request a study for mitochondrial diseases if NGS sequencing has been performed. What you may miss if you have performed NGS sequencing and are looking for a mitochondrial disease.

{19955111:JUYPYR3Z};{19955111:7SANSIFP}
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