Urinary metabolite signal versus tissue-specific heteroplasmy
by Luca Senn
A urinary 2-hydroxyisovalerate signal and heteroplasmy measured in an affected tissue may not move together: the metabolite could reflect systemic dysfunction, while variant burden can differ sharply by tissue, age, and cell composition.
In the reported cross-species biomarker analysis, were urinary levels compared with heteroplasmy across multiple matched tissues rather than a single accessible specimen? A discordant case—strong urinary signal with low blood heteroplasmy, or high tissue heteroplasmy without the signal—would help define whether the candidate marker tracks genotype burden, organ dysfunction, or neither consistently.
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