{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:33:33Z","timestamp":1792787613711,"version":"4.5.0"},"reference-count":75,"publisher":"American Society for Clinical Investigation","issue":"19","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":30,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Natural Science Foundation of China","award":["U25A20134,32500514"],"award-info":[{"award-number":["U25A20134,32500514"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,8]]},"abstract":"<jats:p>\n                    Mutations in mitochondrial DNA (mtDNA) cause various mitochondrial diseases that are currently incurable. Allotopic expression of nucleus-recoded mitochondrial genes represents a promising therapeutic strategy, given its demonstrated capacity to restore mitochondrial function in human cell models harboring mtDNA mutations. However, the in vivo evaluation of allotopic gene therapy has been hindered by optimization challenges and the lack of appropriate animal models. Here, we overcome these limitations by utilizing an optimized AAV2-ND6 construct with codon optimization and mitochondrial targeting sequence in a mouse model bearing the homoplasmic ND6\n                    <jats:sup>P25L<\/jats:sup>\n                    mutation, which recapitulates Leber hereditary optic neuropathy (LHON). High-dose administration of the AAV2-ND6 construct resulted in robust, sustained expression within the retina and optic nerve without apparent systemic toxicity. Strikingly, we compared the therapeutic efficacy in mutant mice at different ages and presymptomatic intervention with AAV2-ND6 effectively attenuated disease progression, mitigated retinal cellular deficiencies and optic nerve damage, and restored visual function in ND6\n                    <jats:sup>P25L<\/jats:sup>\n                    mice. Mechanistically, allotopic ND6 expression markedly rescued the mitochondrial dysfunction, corrected dysregulated retinol metabolism and phototransduction pathways, and suppressed apoptotic processes in the mutant retina. Our study validates the safety and therapeutic potential of allotopic expression in vivo and provides critical mechanistic insights into its role in treating LHON and other mitochondrial diseases.\n                  <\/jats:p>","DOI":"10.1172\/jci.insight.209108","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:00:30Z","timestamp":1788883230000},"source":"Crossref","is-referenced-by-count":0,"title":["Allotopic expression of ND6 restores vision in a mitochondrial disease model"],"prefix":"10.1172","volume":"11","author":[{"given":"Cheng","family":"Ai","sequence":"first","affiliation":[{"name":"Center for Mitochondrial Biomedicine and Department of Ophthalmology, the Fourth Affiliated Hospital of School of Medicine, Yiwu, Zhejiang, China."},{"name":"Center for Genetic Medicine, International School of Medicine and International Institute of Medicine, and"},{"name":"Institute of Genetics, Zhejiang University, Hangzhou, Zhejiang, 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