Tafazzin is a mitochondrial enzyme that exchanges fatty acids between phospholipids by phospholipid-lysophospholipid transacylation. Its most important in vivo substrate is cardiolipin, a mitochondria-specific lipid. This reaction alters lipid molecular species composition and physical properties. Tafazzin is crucial for mitochondrial function, and its mutations cause Barth syndrome [1,2].

A tafazzin knockdown (TAZKD) mouse model, a type of gene knockout model, has been used to study Barth syndrome. In this model, the physiological, biochemical, and ultrastructural abnormalities mirror those in Barth patients. Analyzing the TAZ-KD mouse hearts revealed significant lipid composition differences compared to wild-type, indicating genotype-dependent alterations in many lipid species. These findings offer potential avenues for BTHS diagnosis and treatment. Also, the peroxisome proliferator-activated receptor pan-agonist bezafibrate was suggested as a potential therapy as it ameliorated cardiomyopathy in TAZKD mice, increasing mitochondrial biogenesis [3,4].

In conclusion, Tafazzin is essential for mitochondrial lipid remodeling, especially of cardiolipin. The study of Tafazzin using gene knockout mouse models, like the TAZKD mouse, has provided crucial insights into the pathogenesis of Barth syndrome and potential therapeutic targets, which may also be relevant to understanding pediatric heart failure.