Cosegregation of the ND4 G11696A mutation with the LHON-associated ND4 G11778A mutation in a four generation Chinese family--Lebers hereditary optic neuropathy in a Chinese family. J. Qu¹, X. Zhou¹, Y. Tong¹, L. Yang¹, F. Zhao¹, C. Lu¹, F. Lu¹, M.X. Guan². 1) Dept Ophthalmology/Optometry, Wenzhou Medical Col, Wenzhou, Zhejiang, China; 2) Division of Human Genetics, Cincinnati Childrens Hospital Medical Center, Cincinnati, Ohio 45229, USA.
   Lebers hereditary optic neuropathy (LHON) is a maternally inherited disorder leading to the rapid, painless, bilateral loss of central vision. Recently, a systematic and extended mutational screening of mtDNA has been initiated in the large clinical population of Ophthalmology Clinic at the Wenzhou Medical College, China We report here the characterization of a four-generation Han Chinese family with LHON. This Chinese family exhibited a variable severity and age-at-onset of visual impairment. Notably, the average-age-at-onset of vision impairment changed from 26 years (generation III) to 14 years (generation IV), with the average of 18 years in this family. In addition, 30% and 50% of matrilineal relatives in generation III and IV of this family developed visual loss with a variability of severity, ranging from blindness to normal vision. Sequence analysis of the complete mitochondrial DNA in this pedigree revealed the presence of the homoplasmic ND4 G11778A mutation and 33 other variants, belonging to the Asian haplogroup D4. Of other variants, the homoplasmic G11696A mutation in the ND4 gene is of special interest as it was implicated to be associated with LHON in a large Dutch family and five Chinese pedigrees with extremely penetrance of visual loss. In fact, the G11696A mutation caused the substitution of an isoleucine for valine at amino acid position 312, located in predicted transmembrane region of ND4. These imply that the G11696A mutation may act in synergy with the primary LHON-associated G11778A mutation in this Chinese pedigree.