Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Reduction of mtDNA heteroplasmy in mitochondrial replacement therapy by inducing forced mitophagy

Abstract

Mitochondrial replacement therapy (MRT) has been used to prevent maternal transmission of disease-causing mutations in mitochondrial DNA (mtDNA). However, because MRT requires nuclear transfer, it carries the risk of mtDNA carryover and hence of the reversion of mtDNA to pathogenic levels owing to selective replication and genetic drift. Here we show in HeLa cells, mouse embryos and human embryos that mtDNA heteroplasmy can be reduced by pre-labelling the mitochondrial outer membrane of a donor zygote via microinjection with an mRNA coding for a transmembrane peptide fused to an autophagy receptor, to induce the degradation of the labelled mitochondria via forced mitophagy. Forced mitophagy reduced mtDNA carryover in newly reconstructed embryos after MRT, and had negligible effects on the growth curve, reproduction, exercise capacity and other behavioural characteristics of the offspring mice. The induction of forced mitophagy to degrade undesired donor mtDNA may increase the clinical feasibility of MRT and could be extended to other nuclear transfer techniques.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Design of forced mitophagy.
Fig. 2: CISD1-Binding induces forced mitophagy in HeLa cells.
Fig. 3: Forced mitophagy degrades C57/6j mtDNA in BALB/c embryos.
Fig. 4: Forced mitophagy is efficient for clearing mtDNA carryover in pronuclear transfer for MRT in mice.
Fig. 5: CISD1-Binding-mediated MRT has little effect on the reproduction, growth curves and behaviour of offspring.
Fig. 6: Forced mitophagy is efficient and safe for the elimination of external mtDNA in human embryos.

Similar content being viewed by others

Data availability

The main data supporting the results in this study are available within the paper and its Supplementary Information. Source data for the figures are provided with this paper. Other raw data generated during the study are available from the corresponding authors on reasonable request. Source data are provided with this paper.

References

  1. Elliott, H. R., Samuels, D. C., Eden, J. A., Relton, C. L. & Chinnery, P. F. Pathogenic mitochondrial DNA mutations are common in the general population. Am. J. Hum. Genet. 83, 254–260 (2008).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Gorman, G. S. et al. Prevalence of nuclear and mitochondrial DNA mutations related to adult mitochondrial disease. Ann. Neurol. 77, 753–759 (2015).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Lightowlers, R. N., Taylor, R. W. & Turnbull, D. M. Mutations causing mitochondrial disease: what is new and what challenges remain? Science 349, 1494–1499 (2015).

    Article  CAS  PubMed  Google Scholar 

  4. DeLuca, S. Z. & O’Farrell, P. H. Barriers to male transmission of mitochondrial DNA in sperm development. Dev. Cell 22, 660–668 (2012).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Luo, S. M., Schatten, H. & Sun, Q. Y. Sperm mitochondria in reproduction: good or bad and where do they go? J. Genet. Genomics 40, 549–556 (2013).

    Article  CAS  PubMed  Google Scholar 

  6. Wallace, D. C. Mitochondrial genetic medicine. Nat. Genet. 50, 1642–1649 (2018).

    Article  CAS  PubMed  Google Scholar 

  7. Ou, X. H. & Sun, Q. Y. Mitochondrial replacement techniques or therapies (MRTs) to improve embryo development and to prevent mitochondrial disease transmission. J. Genet. Genomics 44, 371–374 (2017).

    Article  PubMed  Google Scholar 

  8. Stewart, J. B. & Chinnery, P. F. The dynamics of mitochondrial DNA heteroplasmy: implications for human health and disease. Nat. Rev. Genet. 16, 530–542 (2015).

    Article  CAS  PubMed  Google Scholar 

  9. Bacman, S. R. et al. MitoTALEN reduces mutant mtDNA load and restores tRNA(Ala) levels in a mouse model of heteroplasmic mtDNA mutation. Nat. Med. 24, 1696–1700 (2018).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Gammage, P. A. et al. Genome editing in mitochondria corrects a pathogenic mtDNA mutation in vivo. Nat. Med. 24, 1691–1695 (2018).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Mok, B. Y. et al. A bacterial cytidine deaminase toxin enables CRISPR-free mitochondrial base editing. Nature https://www.nature.com/articles/s41586-020-2477-4 (2020).

  12. Greenfield, A. et al. Assisted reproductive technologies to prevent human mitochondrial disease transmission. Nat. Biotechnol. 35, 1059–1068 (2017).

    Article  CAS  PubMed  Google Scholar 

  13. Craven, L. et al. Pronuclear transfer in human embryos to prevent transmission of mitochondrial DNA disease. Nature 465, 82–85 (2010).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Hyslop, L. A. et al. Towards clinical application of pronuclear transfer to prevent mitochondrial DNA disease. Nature 534, 383–386 (2016).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Kang, E. et al. Mitochondrial replacement in human oocytes carrying pathogenic mitochondrial DNA mutations. Nature 540, 270–275 (2016).

    Article  CAS  PubMed  Google Scholar 

  16. Paull, D. et al. Nuclear genome transfer in human oocytes eliminates mitochondrial DNA variants. Nature 493, 632–637 (2013).

    Article  CAS  PubMed  Google Scholar 

  17. Tachibana, M. et al. Towards germline gene therapy of inherited mitochondrial diseases. Nature 493, 627–631 (2013).

    Article  CAS  PubMed  Google Scholar 

  18. Tachibana, M. et al. Mitochondrial gene replacement in primate offspring and embryonic stem cells. Nature 461, 367–372 (2009).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Wang, T. et al. Polar body genome transfer for preventing the transmission of inherited mitochondrial diseases. Cell 157, 1591–1604 (2014).

    Article  CAS  PubMed  Google Scholar 

  20. Wu, K. et al. Polar bodies are efficient donors for reconstruction of human embryos for potential mitochondrial replacement therapy. Cell Res. 27, 1069–1072 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  21. Wang, Z. et al. Mitochondrial replacement in macaque monkey offspring by first polar body transfer. Cell Res. 31, 233–236 (2021).

    Article  PubMed  Google Scholar 

  22. Hudson, G., Takeda, Y. & Herbert, M. Reversion after replacement of mitochondrial DNA. Nature 574, E8–E11 (2019).

    Article  CAS  PubMed  Google Scholar 

  23. Yamada, M. et al. Genetic drift can compromise mitochondrial replacement by nuclear transfer in human oocytes. Cell Stem Cell 18, 749–754 (2016).

    Article  CAS  PubMed  Google Scholar 

  24. Craven, L., Tang, M. X., Gorman, G. S., De Sutter, P. & Heindryckx, B. Novel reproductive technologies to prevent mitochondrial disease. Hum. Reprod. Update 23, 501–519 (2017).

    Article  CAS  PubMed  Google Scholar 

  25. Youle, R. J. & Narendra, D. P. Mechanisms of mitophagy. Nat. Rev. Mol. Cell Biol. 12, 9–14 (2011).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Kerr, J. S. et al. Mitophagy and Alzheimer’s disease: cellular and molecular mechanisms. Trends Neurosci. 40, 151–166 (2017).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Sandoval, H. et al. Essential role for Nix in autophagic maturation of erythroid cells. Nature 454, 232–235 (2008).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Birgisdottir, A. B., Lamark, T. & Johansen, T. The LIR motif - crucial for selective autophagy. J. Cell Sci. 126, 3237–3247 (2013).

    Article  CAS  PubMed  Google Scholar 

  29. Wu, K. et al. Mitochondrial replacement by pre-pronuclear transfer in human embryos. Cell Res. 27, 834–837 (2017).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Tsukamoto, S. et al. Functional analysis of lysosomes during mouse preimplantation embryo development. J. Reprod. Dev. 59, 33–39 (2013).

    Article  CAS  PubMed  Google Scholar 

  31. Luo, S. M. et al. Unique insights into maternal mitochondrial inheritance in mice. Proc. Natl Acad. Sci. USA 110, 13038–13043 (2013).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Bavister, B. D. & Squirrell, J. M. Mitochondrial distribution and function in oocytes and early embryos. Hum. Reprod. 15, 189–198 (2000).

    Article  PubMed  Google Scholar 

  33. Wai, T. et al. The role of mitochondrial DNA copy number in mammalian fertility. Biol. Reprod. 83, 52–62 (2010).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Cao, L. et al. The mitochondrial bottleneck occurs without reduction of mtDNA content in female mouse germ cells. Nat. Genet. 39, 386–390 (2007).

    Article  CAS  PubMed  Google Scholar 

  35. Cree, L. M. et al. A reduction of mitochondrial DNA molecules during embryogenesis explains the rapid segregation of genotypes. Nat. Genet. 40, 249–254 (2008).

    Article  CAS  PubMed  Google Scholar 

  36. Khrapko, K. Two ways to make an mtDNA bottleneck. Nat. Genet. 40, 134–135 (2008).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Lieber, T., Jeedigunta, S. P., Palozzi, J. M., Lehmann, R. & Hurd, T. R. Mitochondrial fragmentation drives selective removal of deleterious mtDNA in the germline. Nature 570, 380–384 (2019).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Wai, T., Teoli, D. & Shoubridge, E. A. The mitochondrial DNA genetic bottleneck results from replication of a subpopulation of genomes. Nat. Genet. 40, 1484–1488 (2008).

    Article  CAS  PubMed  Google Scholar 

  39. Ma, H. et al. Functional human oocytes generated by transfer of polar body genomes. Cell Stem Cell 20, 112–119 (2017).

    Article  CAS  PubMed  Google Scholar 

  40. Bredenoord, A. L. & Appleby, J. B. Mitochondrial replacement techniques: remaining ethical challenges. Cell Stem Cell 21, 301–304 (2017).

    Article  CAS  PubMed  Google Scholar 

  41. Zhang, J. et al. Live birth derived from oocyte spindle transfer to prevent mitochondrial disease. Reprod. Biomed. Online 34, 361–368 (2017).

    Article  PubMed  Google Scholar 

  42. Reichmann, J. et al. Dual-spindle formation in zygotes keeps parental genomes apart in early mammalian embryos. Science 361, 189–193 (2018).

    Article  CAS  PubMed  Google Scholar 

  43. Xu, X., Li, L., Zhang, C. & Meng, L. Observation of two separate bipolar spindles in the human zygote. J. Assist. Reprod. Genet. 36, 601–602 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  44. Tamashiro, K. L. et al. Phenotype of cloned mice: development, behavior, and physiology. Exp. Biol. Med. 228, 1193–1200 (2003).

    Article  CAS  Google Scholar 

  45. Rodriguiz, R. M. & Wetsel, W. C. in Animal Models of Cognitive Impairment (eds. Levin, E. D. & Buccafusco, J. J.) Ch. 12 (CRC Press/Taylor & Francis, 2006).

  46. Brown, R. E. Behavioural phenotyping of transgenic mice. Can. J. Exp. Psychol. 61, 328–344 (2007).

    Article  PubMed  Google Scholar 

  47. Barritt, J., Willadsen, S., Brenner, C. & Cohen, J. Cytoplasmic transfer in assisted reproduction. Hum. Reprod. Update 7, 428–435 (2001).

    Article  CAS  PubMed  Google Scholar 

  48. Miao, Y. L., Kikuchi, K., Sun, Q. Y. & Schatten, H. Oocyte aging: cellular and molecular changes, developmental potential and reversal possibility. Hum. Reprod. Update 15, 573–585 (2009).

    Article  PubMed  Google Scholar 

  49. Planchon, T. A. et al. Rapid three-dimensional isotropic imaging of living cells using Bessel beam plane illumination. Nat. Methods 8, 417–423 (2011).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Waterfall, C. M., Eisenthal, R. & Cobb, B. D. Kinetic characterization of primer mismatches in allele-specific PCR: a quantitative assessment. Biochem. Biophys. Res. Commun. 299, 715–722 (2002).

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank those who donated gametes for this study, and R. Chen (South China Normal University, Guangzhou, China) and H. Schatten (University of Missouri-Columbia) for editing and proofreading the manuscript. This study was supported by the National Key Research and Development Program of China (2018YFC1004800), the National Natural Science Foundation of China (82071714, 81971357) and the Key-Area Research and Development Program of Guangdong Province (2019B030335001).

Author information

Authors and Affiliations

Authors

Contributions

S.-M.L. and X.-Y.F. conceived the idea. S.-M.L., X.-H.O., Q.-Y.S., X.-Y.F., L.G., L.-N.C., S.Y., C.H., L.Z., J.-Y.M., S.L., T.J., M.-X.J., W.S., Z.-J.G., Z.-B.W. and M.C. designed experiments and interpreted the results. X.-Y.F., S.-M.L., L.G., J.W., X.-H.S., F.W., C.-F.Z. and X.-H.W. carried out the experiments. S.-M.L., S.Y., X.-Y.F., C.H. and Q.-Y.S. wrote the manuscript.

Corresponding authors

Correspondence to Qing-Yuan Sun, Xiang-Hong Ou or Shi-Ming Luo.

Ethics declarations

Competing interests

The authors declare no competing interests.

Peer review

Peer review information

Nature Biomedical Engineering thanks the anonymous reviewer(s) for their contribution to the peer review of this work. Peer reviewer reports are available.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Extended data

Extended Data Fig. 1 CISD1-RFP-SQSTM1 induces forced mitophagy and reduces the mitochondrial number.

a. HeLa cells were stably transfected with GFP-LC3 (green) and stained with MitoTracker Deep Red FM (grey) to label mitochondria. CISD1-RFP-SQSTM1 (red) was transiently transfected into the HeLa cells. Images were obtained 60 hours after CISD1-RFP-SQSTM1 transfection. The insets indicate that CISD1-RFP-SQSTM1-labeled mitochondria co-localizes with GFP-LC3. b. CISD1-RFP-SQSTM1-labelled mitochondria fuse with lysosomes. HeLa cells were stably transfected with pmEmerald-Mito (grey) to label mitochondria, transiently transfected with CISD1-RFP-SQSTM1 (red), and stained with LysoTracker Blue DND-22 (green) to label lysosomes. Images were obtained 48 hours after CISD1-RFP-SQSTM1 transfection. The insets indicate that CISD1-RFP-SQSTM1-labeled mitochondria fuse with lysosomes. c. The CISD1-RFP-SQSTM1-expressed cells have fewer mitochondria than the unexpressed cells. The stably pmEmerald-Mito (green)-transfected HeLa cells were transiently transfected with CISD1-RFP-SQSTM1 (red) and stained with Hoechst 33342. Images were obtained24 and 48 hours after CISD1-RFP-SQSTM1 transfection. White arrowheads indicate that the CISD1-RFP-SQSTM1-expression cells decrease the pmEmerald-Mito fluorescence signals. In ac, scale bars, 30 μm, and three independently repeated experiments with similar results. d. The fluorescence analysis of mitochondria in the CISD1-RFP-SQSTM1-expressed and control cells at different time points. Data were analyzed by two-tailed unpaired t-test and expressed as average ± SEM, and each point represents one cell from 3 biological replicates. For the 24 hours group, n = 106, the control value is 945 ± 84.97, and the CISD1-RFP-SQSTM1 value is 950.8 ± 90.19. For the 48 hours group, n = 67, the control value is 815.9 ± 51.32, and the CISD1-RFP-SQSTM1 value is 455.7 ± 39.86. e. The mtDNA number decreased after CISD1-RFP-SQSTM1 expression. Forty-eight hours after CISD1-RFP-SQSTM1 transfection, a single cell with or without CISD1-RFP-SQSTM1 expression was picked up, and the mtDNA quantity was analyzed by qPCR. Data were analyzed by two-tailed unpaired t-test and expressed as average ± SEM. n = 27 for control, and n = 30 for CISD1-RFP-Binding from 3 biological replicates. The value of control is 2357 ± 104.3, and the value of CISD1-RFP-Binding is 1274 ± 79.14.

Source data

Extended Data Fig. 2 CISD1-Binding expresses immediately and localizes to mitochondria after its mRNA microinjection in mouse oocytes and Zygotes.

The mRNA encoding CISD1-Binding was microinjected into mouse GV oocytes, MII oocytes, and early pronuclear embryos. Images were obtained 1.5 hours after microinjection. Red indicates CISD1-Binding proteins and Green indicates MitoTracker Deep Red FM. Pearson’s correlation coefficient assessed co-localization between the CISD1-Binding and Mitotracker. Data were analyzed from three independently repeated experiments, and each point represents one cell. n = 10 for GV oocytes; n = 11 for MII oocytes and n = 12 for zygotes. The mean ± SEM values are 0.899 ± 0.01286 (GV), 0.9491 ± 0.00667 (MII) and 0.9467 ± 0.0076 (Zygote). Bar = 30 μm.

Source data

Extended Data Fig. 3

CISD1-Binding recruits GFP-LC3 at different mouse-embryo stages. Mouse zygotes were microinjected with the CISD1-Binding (red) and GFP-LC3 (green) mRNA and cultured to 2-cell, 4-cell and 8-cell stages. The insets indicate that CISD1-Binding recruits GFP-LC3. Bar = 30 μm. Also, see Fig. 3a and c. Four independently repeated biological experiments with similar results.

Extended Data Fig. 4 CISD1-Binding-labelled mitochondria begin to fuse with lysosomes after 4-cell stages.

Mouse embryos were microinjected with the CISD1-Binding mRNA at the zygote stage and stained with Blue DND-22 to label lysosomes at 1-cell, 2-cell and 4-cell stages before imaging. The insets indicate that CISD1-Binding-labeled mitochondria fuse with lysosomes (orange only). Bar = 30 μm. Also, see Fig. 3b and e. Three independently repeated biological experiments with similar results.

Extended Data Fig. 5 CISD1-RFP-Binding(mutation)-labelled mitochondria do not recruit LC3 proteins and fuse with lysosomes in mouse embryos.

a. Mouse zygotes were microinjected with the mRNA encoding CISD1-RFP-Binding(mutation) and GFP-LC3. The insets indicate that the CISD1-RFP-Binding(mutation)-labelled mitochondria do not recruit GFP-LC3 in mouse embryos. b. Mouse zygotes were microinjected with the mRNA encoding CISD1-RFP-Binding(mutation) and stained with Blue DND-22 to label lysosomes before imaging. The insets indicate no fusion between the CISD1-RFP-Binding(mutation)-labelled mitochondria and lysosomes in mouse embryos. In a and b, scale bars, 30 μm, and experiments with similar results were biologically repeated twice.

Extended Data Fig. 6 The capacity of early mouse embryos to degrade CISD1-Binding-labelled mitochondria.

a. Mouse embryos were injected with or without (control) CISD1-Binding mRNA at the zygote stage, cultured to different stages, and then the whole embryos were subjected to absolute quantification of the mtDNA. Data were analyzed by two-tailed unpaired t-test and expressed as average ± SEM. Each point represents one embryo from three biological replicates. For Zygote, n = 14, the values are 2.44 ± 0.1618 (control) and 2.485 ± 0.1586 (CISD1-Binding). For 2-Cell, n = 13, the values are 2.543 ± 0.1016 (control) and 2.642 ± 0.1891 (CISD1-Binding). For 4-Cell, n = 12 (control) and n = 11 (CISD1-Binding), the values are 2.529 ± 0.07611 (control) and 2.405 ± 0.1418 (CISD1-Binding). For 8-Cell, n = 11, the values are 3.109 ± 0.1873 (control) and 2.703 ± 0.1292 (CISD1-Binding). For Morula, n = 12, the values are 3.457 ± 0.2498 (control) and 1.466 ± 0.2157 (CISD1-Binding). For Blastocyst group, n = 12, the values are 2.659 ± 0.1224 (control) and 2.143 ± 0.1093 (CISD1-Binding). b. Morula embryos expressed with or without CISD1-Bindingprotein (red) were stained with Sybgreen I (green) for observing mtDNA. The insets indicate that the embryo with CISD1-Binding protein expression has less mtDNA than in the control embryo. Bar = 40 μm. Three biologically repeated experiments with similar results.

Source data

Supplementary information

Supplementary Information

Supplementary figures and tables, and informed-consent templates.

Reporting Summary

Peer Review File.

Source data

Source Data for Fig. 2

Source data and statistics.

Source Data for Fig. 3

Source data and statistics.

Source Data for Fig. 4

Source data and statistics.

Source Data for Fig. 5

Source data and statistics.

Source Data for Fig. 6

Unprocessed gels.

Source Data for ED Fig. 1

Source data and statistics.

Source Data for ED Fig. 2

Source data and statistics.

Source Data for ED Fig. 6

Source data and statistics.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fan, XY., Guo, L., Chen, LN. et al. Reduction of mtDNA heteroplasmy in mitochondrial replacement therapy by inducing forced mitophagy. Nat. Biomed. Eng 6, 339–350 (2022). https://doi.org/10.1038/s41551-022-00881-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41551-022-00881-7

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing