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Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), and myoclonus epilepsy associated with ragged red fibers (MERRF) are major clinical subgroups of mitochondrial diseases caused by pathogenic point mutations in tRNA genes encoded in mtDNA. We previously reported a severe reduction in the frequency of 5-taurinomethyluridine (\u03c4m5U) and its 2-thiouridine derivative (\u03c4m5s2U) in the anticodons of mutant mt-tRNAs isolated from the cells of patients with MELAS and MERRF, respectively. The hypomodified tRNAs fail to decode cognate codons efficiently, resulting in defective translation of respiratory chain proteins in mitochondria. To restore the mitochondrial activity of MELAS patient cells, we overexpressed MTO1, a \u03c4m5U-modifying enzyme, in patient-derived myoblasts. We used a newly developed primer extension method and showed that MTO1 overexpression almost completely restored the \u03c4m5U modification of the MELAS mutant mt-tRNALeu(UUR). An increase in mitochondrial protein synthesis and oxygen consumption rate suggested that the mitochondrial function of MELAS patient cells can be activated by restoring the \u03c4m5U of the mutant tRNA. In addition, we confirmed that MTO1 expression restored the \u03c4m5s2U of the mutant mt-tRNALys in MERRF patient cells. These findings pave the way for epitranscriptomic therapies for mitochondrial diseases.<\/jats:p>","DOI":"10.1093\/nar\/gkad139","type":"journal-article","created":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T13:39:31Z","timestamp":1678282771000},"page":"7563-7579","source":"Crossref","is-referenced-by-count":32,"title":["Restoration of mitochondrial function through activation of hypomodified tRNAs with pathogenic mutations associated with mitochondrial diseases"],"prefix":"10.1093","volume":"51","author":[{"given":"Ena","family":"Tomoda","sequence":"first","affiliation":[{"name":"Department of Chemistry and Biotechnology, Graduate School of Engineering, University of Tokyo , 7-3-1 Hongo , Bunkyo-ku , Tokyo\u00a0113-8656 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asuteka","family":"Nagao","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Biotechnology, Graduate School of Engineering, University of Tokyo , 7-3-1 Hongo , Bunkyo-ku , Tokyo\u00a0113-8656 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Shirai","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Biotechnology, Graduate School of Engineering, University of Tokyo , 7-3-1 Hongo , Bunkyo-ku , Tokyo\u00a0113-8656 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kana","family":"Asano","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Biotechnology, Graduate School of Engineering, University of Tokyo , 7-3-1 Hongo , Bunkyo-ku , Tokyo\u00a0113-8656 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeo","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Biotechnology, Graduate School of Engineering, University of Tokyo , 7-3-1 Hongo , Bunkyo-ku , Tokyo\u00a0113-8656 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8136-2753","authenticated-orcid":false,"given":"Brendan\u00a0J","family":"Battersby","sequence":"additional","affiliation":[{"name":"Institute of Biotechnology, University of Helsinki , Helsinki \u00a000790, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9731-1731","authenticated-orcid":false,"given":"Tsutomu","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Biotechnology, Graduate School of Engineering, University of Tokyo , 7-3-1 Hongo , Bunkyo-ku , Tokyo\u00a0113-8656 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,17]]},"reference":[{"key":"2023081100431351300_B1","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1146\/annurev.genet.39.110304.095751","article-title":"A mitochondrial paradigm of metabolic and degenerative diseases, aging, and cancer: a dawn for evolutionary medicine","volume":"39","author":"Wallace","year":"2005","journal-title":"Annu. 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