Hypoxia and intra-complex genetic suppressors rescue complex I mutants by a shared mechanism

The electron transport chain (ETC) of mitochondria, bacteria, and archaea couples electron flow to proton pumping and is adapted to diverse oxygen environments. Remarkably, in mice, neurological disease due to ETC complex I dysfunction is rescued by hypoxia through unknown mechanisms. Here, we show that hypoxia rescue and hyperoxia sensitivity of complex I deficiency are evolutionarily conserved to C. elegans and are specific to mutants that compromise the electron-conducting matrix arm. We show that hypoxia rescue does not involve the hypoxia-inducible factor pathway or attenuation of reactive oxygen species. To discover the mechanism, we use C. elegans genetic screens to identify suppressor mutations in the complex I accessory subunit NDUFA6/nuo-3 that phenocopy hypoxia rescue. We show that NDUFA6/nuo-3(G60D) or hypoxia directly restores complex I forward activity, with downstream rescue of ETC flux and, in some cases, complex I levels. Additional screens identify residues within the ubiquinone binding pocket as being required for the rescue by NDUFA6/nuo-3(G60D) or hypoxia. This reveals oxygen-sensitive coupling between an accessory subunit and the quinone binding pocket of complex I that can restore forward activity in the same manner as hypoxia. [Display omitted] •Hypoxia rescue and hyperoxia sensitivity of complex I mutants are conserved in C. elegans•Hypoxia rescue is independent of HIF activation or attenuation of ROS toxicity•NDUFA6/nuo-3(G60D) mimics acute hypoxia in restoring complex I forward activity•Residues in the CoQ binding pocket are required for rescue by nuo-3(G60D) or hypoxia C. elegans mutants harboring a defective mitochondrial complex I are rescued by hypoxia or intra-complex genetic suppressor mutation, achieved by increasing forward flow of electrons through complex I and dependent on residues surrounding the CoQ binding pocket.