Alterations in ATP metabolism have been proposed to be involved in the pathogenesis of cystinosis, the most common form of inherited Fanconi syndrome. A recent study showed normal activity of respiratory chain complexes I-IV with decreased ATP levels in cystinotic fibroblasts. Here, we show normal complex V expression and activity in mitochondria of cystinotic fibroblasts. This indicates that alterations in mitochondrial oxidative phosphorylation enzymes are not responsible for ATP decrease in cystinotic fibroblasts. T he autosomal recessive disorder cystinosis is caused by mutations in the CTNS gene (17p13.3), resulting in the defective lysosomal cystine transporter cystinosin (1). The consequential elevated cystine levels in the lysosomes lead to renal tubular dysfunction by mechanisms that are still elusive. Based on results of studies in cells loaded with cystine dimethyl ester, it was hypothesized that defects in mitochondrial ATP generating capacity are involved, resulting in decreased Na, K-ATPase activity (2,3). This ATP-driven proton pump generates a transmembrane Na ϩ gradient, required for tubular reabsorption of essential solutes such as amino acids, phosphate, and glucose in proximal tubules of the kidney. From this perspective, mitochondrial dysfunction is a possible cause of renal Fanconi syndrome in cystinosis (3). Recently our group extensively studied ATP metabolism in cystinotic fibroblasts and demonstrated slightly decreased intracellular ATP levels, but an intact Na, K-ATPase activity, hormone stimulated mitochondrial ATP production and normal activity of respiratory chain complexes I-IV (4). The activity of mitochondrial enzyme complex V, the ATP synthase complex of the oxidative phosphorylation system, could not be measured at the time of these studies, because lack of sensitivity of the assay. At present, we complete this study in cystinotic fibroblasts by measuring complex V activity using an enzymatic assay. In addition, we examined the expression and assembly status of complex V by Western blot analysis in a blue native gel.
MATERIALS AND METHODSFibroblast culture. Patient (n ϭ 8) and control (n ϭ 9) fibroblasts were obtained after informed consent and subsequently cultured as described previously (4). The study was approved by the Institutional Review Board of Radboud University Medical Centre. All patients were diagnosed with cystinosis by measuring elevated cystine levels in isolated polymorphonuclear cells (Ͼ0.5 nmol cystine/mg protein) by high performance liquid chromatography (HPLC) and confirmed by molecular analysis. Previous data showed elevated levels of cystine in cystinotic fibroblasts compared with controls (4.3 Ϯ 1.1 versus 0.2 Ϯ 0.1 nmol/mg protein) and decreased ATP levels in cystinotic fibroblasts (mean 35.9 (Ϯ16.7) versus 51.7 (Ϯ4.5) nmol/mg protein) (4). Approximately 10 ϫ 10 6 cells were harvested using trypsin and divided in two samples for protein expression analysis and enzyme activity assay, respectively.Expression of complex V. A mitochondrial enriche...