Implication of a rare variant in OPA1 in Cardiac Pathophysiology: From Cristae Remodelling to Contractile Dysfunction

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Abstract Optic Atrophy 1 (OPA1), an important inner mitochondrial membrane GTPase, regulates mitochondrial fusion, maintains cristae structure, calcium buffering, cellular bioenergetics, preserves mtDNA and controls apoptosis. Here we examined the role of OPA1 variants in DCM using whole-exome sequencing (WES) of 5 familial and 10 sporadic DCM cases. A rare de novo OPA1 variant, c.563C>T (p.Pro188Leu), was identified in a DCM patient, which is absent in 100 healthy controls as well as in the 1000 Genomes, IndiGenomes and GenomeAsia 100k databases while it showed very low MAF (0.000069) in GnomAD. Structural modelling predicted the variant to be highly deleterious and revealed marked conformational distortion of the mutant protein (RMSD = 3.5Å). Molecular docking further demonstrated enhanced accessibility of mutant OPA1 to mitochondrial protease OMA1, suggesting increased OPA1 proteolytic processing and a consequent increase in mitochondrial fragmentation. Functional analysis in stable H9C2 cardiomyoblast cells, demonstrated significantly reduced OPA1 protein expression, extensive mitochondrial fragmentation in mutant-OPA1 expressing cells. The mutant protein caused significant reduction in mitochondrial membrane potential, ATP generation, and oxygen consumption rate (OCR), together with elevated cytosolic Ca² and reactive oxygen species (ROS) levels. qRT-PCR analysis further revealed depletion in mtDNA copy number and increased in expression of intrinsic apoptotic markers Caspase3, 9 and Bax/Bcl-2 ratio. The above findings collectively highlighted the significant impact of the OPA1 mutation on mitochondrial dynamics and cellular health, suggesting a significant correlation with the pathogenesis of DCM. Collectively, these findings suggest that OPA1-mediated mitochondrial dysfunction represents a potential therapeutic avenue for the management of DCM.

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