The genetic origin of fetal growth restriction and mitochondrial complex I dysregulation

BackgroundMitochondria are organelles required for bioenergetic homeostasis, providing energy in the form of ATP to support cellular function, growth, and proliferation. Mitochondria synthesise ATP using the electron transport chain (ETC) to produce an electrochemical gradient that facilitates the conversion of ADP to ATP by ATP synthase. Mitochondrial function is governed by an intricate bidirectional relationship between the mitochondrial genome encoding 1-2% of proteins and the nuclear genome which encodes 98-99% of mitochondrial proteins. Pregnancy creates a unique environment whereby the mitochondrial genome of the placenta is maternally inherited, while the nuclear genome is comprised of both maternal and paternal contributions. Thus, mitochondrial structure and function are largely dependent on the adaptability of mitochondria to conform to the new mixed nuclear genome. In pregnancy, fetal growth restriction (FGR) is characterised by poor placental development, underlying trophoblast insufficiencies, and is associated with mitochondrial dysfunction within the placenta, although the mechanisms which underpin these changes remain unclear. This study investigated if mitochondrial dysfunction in FGR is programmed by genetic incompatibility arising from single nucleotide polymorphisms (SNPs). Methods and findingsWe performed a targeted meta-analysis of over 100 genome wide association studies within the early growth genetics (EGG) consortium, assessing 289 genes encoding mitochondrial function across the ETC and ATP synthase. This study identified 37 SNPs across 32 genes associated with low birthweight. Sanger sequencing was performed to validate the presence of 10 SNPs of interest located within the nuclear genome in a cohort of fetal growth restricted placentas. Of the 10 SNPs assessed we confirmed the presence of 6 in FGR, and identified an additional previously unidentified SNP, and detected 3 nucleotide deletions across numerous components of the electron transport chain. This analysis identified 5 mutations within genes that encode complex I. Subsequent analysis of the gene and proteins that correspond to complex I mutations was performed using PCR, proteomics, and western blotting. Notably, we identified significant downregulation of NDUFA6 at the gene and protein level in FGR, lower protein levels of NDUFS3 and NDUFS6, and confirmed the largest log2 fold change identified in NDUFS6 by western blot. Subsequent investigation of mitochondrial respiratory capacity identified decreased ATP-linked respiration in FGR using Seahorse XF Analysis. ConclusionOur results identify that there is an inheritable contribution of SNPs within the maternal and paternal nuclear genome in fetal growth restriction. These SNPs alter gene expression and protein abundance of mitochondrial complex I components, impacting structural assembly and subsequent bioenergetic function within the placenta. Collectively these findings suggest that SNPs that affect mitochondrial assembly and function are associated with low birthweight and fetal growth restriction.