Mitochondrial Disease (or Mito)

12 Jul 2024

Scientists are preparing for a clinical trial to test the safety and effectiveness of mitochondrial donation.

Mitochondrial donation Significance

  • This procedure offers a cure for Mito disease

About Mitochondrial Disease

  • Mitochondrial disease (or Mito) affects the mitochondria’s ability to produce energy for organs, leading to potential organ failure.
  • Types: There are two types of Mito:
    • Nuclear DNA Fault: Caused by faulty genes in nuclear DNA, inherited from either parent.
    • Mitochondrial DNA Fault: Caused by faulty genes in mitochondrial DNA, inherited only from the mother. The severity can vary widely.
  • Commonly Affected Organs: Heart, brain, and muscles, as they require a lot of energy.
  • Childhood Impact: Mito in children often affects multiple organs, progresses quickly, and can be fatal.
  • Prevalence: Around 1 in 5000 people suffer from genetic mitochondrial disease. 
    • Number, type of symptoms and organ systems cause misdiagnosis, leading to underestimation of prevalence of this disease. 

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Mitochondrial Disease

Mitochondrial Donation

Mitochondrial Disease

  • Mitochondrial donation is a new IVF technique that helps people with faulty mitochondrial DNA have children who are genetically related to them without passing on the defective DNA.
  • Process

    • Remove the nuclear DNA from an egg with faulty mitochondrial DNA.
    • Insert the nuclear DNA into a donor egg with healthy mitochondrial DNA.
    • Fertilize the egg with sperm, combining the nuclear DNA of both parents with healthy mitochondria from the donor.
  • Benefits: The child will have genetic material from three people—nuclear DNA from both parents and mitochondrial DNA from the donor.

    • It will reduce or eliminate the risk of mitochondrial disease.
    • Procedure of Mitochondrial Donation
      • Preparation: Both the egg donor and the person with mitochondrial disease receive hormone injections to stimulate the ovaries to produce multiple eggs.
      • Egg Retrieval: Eggs are retrieved using an ultrasound-guided surgical procedure.
  • Challenges: One of the major hurdles in mitochondrial donation is finding suitable eggs. While frozen eggs might work for initial research and training, actual clinical trials require fresh eggs.

    • There are two main challenges in acquiring these eggs:
      • Limited availability: Not everyone opts to freeze their eggs, making readily available frozen eggs scarce.
      • Need for fresh eggs: For the most effective procedures, fresh eggs are irreplaceable.
    • Potential solutions to address this challenge:
      • Egg donation programs: Encouraging people who have already undergone egg retrieval and have unused eggs to donate them. 
      • Volunteer donors: Recruiting individuals willing to undergo egg donation specifically to help those with mitochondrial diseases is another option. 
        • This could involve both those who know someone participating in the trials and those who are simply driven to help others have healthy children.

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Maeve’s Law on Mitochondrial Donation

  • Legislation: The Mitochondrial Donation Law Reform Bill 2021 was passed by the Australian Senate in 2022 after three years of public consultation.
  • Legalization: This law makes mitochondrial donation legal for research and clinical trials in Australia.

Regulations Under Maeve’s Law

  • Permit Requirements: Facilities need a special permit to perform mitochondrial donation.
  • Licensing:
    • Initial licences will be issued for pre-clinical and clinical trial research and training.
    • These licences ensure the safety and effectiveness of mitochondrial donation before it is used in regular clinical practice.

MitoHOPE Program

  • Goals: The mitoHOPE program aims to refine the mitochondrial donation method and conduct a clinical trial to confirm its safety and effectiveness.
  • Training:
    • Embryologists will be trained in real-life clinical conditions.
    • Existing techniques for mitochondrial donation will be improved through a preclinical research and training program.
  • Requirements: A large number of human eggs are needed for this program.

 

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