Laranjeira, MateusOliveira, Jorge MiguelSantorelli, Filippo MariaMarchese, MariaNogueira, Célia2026-01-262026-01-262025-10-11Neuromolecular Med. 2025 Oct 11;27(1):69. doi: 10.1007/s12017-025-088901535-1084http://hdl.handle.net/10400.18/10763Mitochondrial diseases (MDs) are heterogeneous multisystemic disorders often caused by genetic defects in either nuclear or mitochondrial DNA. Although next-generation sequencing technologies have dramatically expanded the number of variants associated with these diseases, many remain variants of unknown significance (VUS). This review explores the utility of zebrafish (Danio rerio) as a vertebrate model system for studying mitochondrial dysfunction, with a focused analysis on the application of morpholino oligonucleotides (MOs) to functionally characterize and interpret VUS. MO-induced knockdown produces a transient suppression of target genes during zebrafish early development, recapitulating key MD phenotypes. Furthermore, rescue experiments involving co-injection of MO and either wild-type or mutant mRNA have proven useful to functionally assess the pathogenicity of specific variants. Specifically, while wild-type mRNA rescues the morphant phenotype, failure of mutant mRNA to do so confirms the variant’s pathogenic effect. This approach has successfully linked previously uncharacterized genes to MD and helped reclassify ambiguous variants. The use of MO-based strategies in zebrafish remains a valuable tool for variant interpretation and functional validation, bridging the gap between genomic data and clinical action, and ultimately reducing the diagnostic odyssey. Overall, this review places MO knockdown and rescue assays in zebrafish as a robust and versatile platform to address functional genomics in MD research.engMitochondrial DiseasesMorpholino OligonucleotidesZebrafishVariants of Unknown SignificanceRescue ExperimentsDoenças Genéticasjournal article10.1007/s12017-025-08890-w1559-117441075035