TABLE 4.
Clinical and genetic characteristics of patients included in the study sorted according to clinical severity and percentage of variation in mitochondrial protein synthesis in PBMCa
Code | Clinical manifestation(s) | Polymorphism(s) in: |
Haplotype | % change in PBMC mitochondrial protein synthesis | |
---|---|---|---|---|---|
12S rRNA | 16S rRNA | ||||
P1 | Asymptomatic | H* | −75.80 | ||
P2 | Asymptomatic | H* | −67.00 | ||
P3 | Asymptomatic | m.961T→G | H* | −88.48 | |
P4 | Asymptomatic | m.709G→A | H* | −17.74 | |
P5 | Asymptomatic | m.1189T→C | m.1811A→G, m.2706A→G | UK | −90.06 |
P6 | Asymptomatic | m.2706A→G, m.3010G→A | No N | −54.63 | |
P7 | Asymptomatic | m.1598G→A | m.1703C→T, m.1719G→A, m.2706A→G | N* | −58.18 |
P8 | Anemia | H5 | −99.13 | ||
P9 | Hyperlactatemia | H* | −78.08 | ||
P10 | Hyperlactatemia | m.2098G→A | H* | −84.89 | |
P11 | Hyperlactatemia | m.2706A→G, m.3197T→C | U5 | −1.96 | |
P12 | Hyperlactatemia | m.980T→C | m.1811A→G, m.2523C→T, m.2706A→G | U1811/U* | −47.19 |
P13 | Hyperlactatemia, asthenia | m.709G→A | m.1888G→A, m.2706A→G, m.2850T→C | T (JT, no J) | |
P14 | Hyperlactatemia, gastrointestinal discomfort | m.1189T→C | m.1811A→G, m.2706A→G | UK | −54.74 |
P15 | Vomiting, anemia | m.2092C→T | H* | ||
P16 | Sickness and vomiting, asthenia, anemia | m.709G→A, m.930G→A | m.1888G→A, m.2706A→G | T (JT, no J) | −12.29 |
P17 | Hyperlactatemia, anemia, asthenia | m.3010G→A | H1 | −10.60 | |
P18 | Thrombocytopenia | m.1700T→C, m.2706A→G, m.3197T→C | U5 | ||
P19 | Lactic acidosis, gastrointestinal discomfort, sickness and vomiting, anemia, thrombocytopenia | 961insC | m.2706A→G, m.3197T→C | U5 | −50.70 |
In addition to the polymorphisms and mutations depicted here, all the patients presented m.750A→G and m.1438A→G polymorphisms with respect to the mitochondrial DNA Cambridge reference sequence containing these 2 rare variations. Despite identical antibiotic exposures for all the patients, clinical manifestations of linezolid toxicity ranged from asymptomatic individuals to patients presenting as many as 5 secondary effects. None of them showed clinical signs of peripheral neuropathy, which has usually been described upon linezolid treatment for extended periods, longer than the currently approved 28-day period. The distributions of mitochondrial haplogroups and polymorphisms in the cohort of linezolid-treated patients resembled the standard distributions observed in European populations.