Loss-of-function mutations of SURF-1 are specifically associated with Leigh syndrome with cytochrome c oxidase deficiency

Ann Neurol. 1999 Aug;46(2):161-6. doi: 10.1002/1531-8249(199908)46:2<161::aid-ana4>3.0.co;2-o.


Mutations of SURF-1, a gene located on chromosome 9q34, have recently been identified in patients affected by Leigh syndrome (LS), associated with deficiency of cytochrome c oxidase (COX), the terminal component of the mitochondrial respiratory chain. To investigate to what extent SURF-1 is responsible for human disorders because of COX deficiency, we undertook sequence analysis of the SURF-1 gene in 46 unrelated patients. We analyzed 24 COX-defective patients classified as having typical Leigh syndrome (LS(COX)), 6 patients classified as Leigh-like (LL(COX)) cases, and 16 patients classified as non-LS(COX) cases. Frameshift, stop, and splice mutations of SURF-1 were detected in 18 of 24 (75%) of the LS(COX) cases. No mutations were found in the LL(COX) and non-LS(COX) group of patients. Rescue of the COX phenotype was observed in transfected cells from patients harboring SURF-1 mutations, but not in transfected cell lines from 2 patients in whom no mutations were detected by sequence analysis. Loss of function of SURF-1 protein is specifically associated with LS(COX), although a proportion of LS(COX) cases must be the result of abnormalities in genes other than SURF-1. SURF-1 is the first nuclear gene to be consistently mutated in a major category of respiratory chain defects. DNA analysis can now be used to accurately diagnose LS(COX), a common subtype of Leigh syndrome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child, Preschool
  • Cytochrome-c Oxidase Deficiency*
  • Electron Transport Complex IV / metabolism
  • Female
  • Fibroblasts / metabolism
  • Humans
  • Infant
  • Infant, Newborn
  • Leigh Disease / genetics*
  • Male
  • Membrane Proteins
  • Mitochondrial Proteins
  • Muscles / metabolism
  • Mutation / genetics*
  • Proteins / genetics*
  • Syndrome


  • Membrane Proteins
  • Mitochondrial Proteins
  • Proteins
  • Surf-1 protein
  • Electron Transport Complex IV