The oxidative phosphorylation (OXPHOS) system in mitochondria is responsible for the generation of the majority of cellular energy in the form of ATP. Patients with genetic OXPHOS disorders form the largest group of inborn errors of metabolism. Unfortunately, there is still a lack of efficient therapies for these disorders other than management of symptoms. Developing therapies has been complicated because, although the total group of OXPHOS patients is relatively large, there is enormous clinical and genetic heterogeneity within this patient population. Thus there has been a lot of interest in generating relevant mouse models for the different kinds of OXPHOS disorders. The most common treatment strategies tested in these mouse models have aimed to up-regulate mitochondrial biogenesis, in order to increase the residual OXPHOS activity present in affected animals and thereby to ameliorate the energy deficiency. Drugs such as bezafibrate, resveratrol and AICAR target the master regulator of mitochondrial biogenesis PGC-1α either directly or indirectly to manipulate mitochondrial metabolism. This review will summarize the outcome of preclinical treatment trials with these drugs in mouse models of OXPHOS disorders and discuss similar treatments in a number of mouse models of common diseases in which pathology is closely linked to mitochondrial dysfunction. In the majority of these studies the pharmacological activation of the PGC-1α axis shows true potential as therapy; however, other effects besides mitochondrial biogenesis may be contributing to this as well.
LINKED ARTICLESThis article is part of a themed issue on Mitochondrial Pharmacology: Energy, Injury & Beyond. To view the other articles in this issue visit http://dx.doi. org/10.1111/bph.2014.171.issue-8 Abbreviations AD, Alzheimer's disease; ALS, amyotrophic lateral sclerosis; AMPK, AMP-activated kinase; BAT, brown adipose tissue; CI-V, complex I-V; DMD, Duchenne muscular dystrophy; FAO, fatty acid oxidation; HD, Huntington's disease; MPTP, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine; mtDNA, mitochondrial DNA; nDNA, nuclear DNA; NRF, nuclear respiratory factor; OXPHOS, oxidative phosphorylation; PD, Parkinson's disease; PGC-1, PPAR-γ coactivator 1; POLG, polymerase γ; SIRT1, silent information regulator two (Sir2) protein 1, sirtuin 1
Mitochondria as the powerhouse and mitochondrial diseaseMitochondria are involved in numerous processes but they are best known for their role as the powerhouse of the cell. The oxidative phosphorylation (OXPHOS) system located in the mitochondrial inner membrane integrates the production of cellular energy in the form of ATP, with all the major catabolic pathways including fatty acid oxidation (FAO), the tricarboxylic acid cycle and amino acid oxidation. The OXPHOS system consists of five multimeric protein complexes, complex I-V (CI-V). Although critical OXPHOS subunits are encoded by the circular DNA molecules residing inside mitochondria (mtDNA), the majority of the subunits, together with all the proteins required fo...