Cited by 221Genetics and Neurodevelopmental DisordersGenomics and Rare DiseasesNeuroscience and Neuropharmacology Research

MECP2 disorders: from the clinic to mice and back

Open access
Lombardi, Laura Marie, Baker, Steven Andrew, Zoghbi, Huda Yahya·2015·Journal of Clinical Investigation

Abstract

Two severe, progressive neurological disorders characterized by intellectual disability, autism, and developmental regression, Rett syndrome and MECP2 duplication syndrome, result from loss and gain of function, respectively, of the same critical gene, methyl-CpG-binding protein 2 (MECP2). Neurons acutely require the appropriate dose of MECP2 to function properly but do not die in its absence or overexpression. Instead, neuronal dysfunction can be reversed in a Rett syndrome mouse model if MeCP2 function is restored. Thus, MECP2 disorders provide a unique window into the delicate balance of neuronal health, the power of mouse models, and the importance of chromatin regulation in mature neurons. In this Review, we will discuss the clinical profiles of MECP2 disorders, the knowledge acquired from mouse models of the syndromes, and how that knowledge is informing current and future clinical studies.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1172/jci78167

Cites

0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Rett syndrome is a pervasive neurodevelopmental disorder caused in most cases by loss-of-function mutations in the X-linked gene MECP2.

    “This is now also the case with Rett syndrome, a pervasive neurodevelopmental disorder caused in most cases by loss-of-function mutations in the X-linked gene, methyl-CpG-binding protein 2 (MECP2) (Lombardi et al., 2015; Lyst and Bird, 2015).”
  • The consequences of MeCP2 dysfunction on neuronal networks have been extensively explored in mice lacking MeCP2 and those with a conditional hemizygous deletion, but the results vary considerably possibly due to differences in the age of the mice in the analysis and the specific characteristics of each cortical area.

    “The consequences of MeCP2 dysfunction on neuronal networks have been extensively explored in mice lacking MeCP2 and those with a conditional hemizygous deletion, but the results vary considerably possibly due to differences in the age of the mice in the analysis (juvenile, young adults and adults) and the specific characteristics of each cortical area 123,124 .”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Part of this paper’s reference list could not be split into single entries.

Flagged first, then by citations

Research works printed but not linked: 88

  1. Rett A. [On a unusual brain atrophy syndrome in hyperammonemia in childhood]. Wien Med Wochenschr. 1966;116(37):723-726.
  2. Hagberg B, Aicardi J, Dias K, Ramos O. A pro- gressive syndrome of autism, dementia, ataxia, and loss of purposeful hand use in girls: Rett's syndrome: report of 35 cases. Ann Neurol. 1983;14(4):471-479.
  3. Trappe R, et al. MECP2 mutations in sporadic cases of Rett syndrome are almost exclu- sively of paternal origin. Am J Hum Genet. 2001;68(5):1093-1101.
  4. Amir RE, Van den Veyver IB, Wan M, Tran CQ, Francke U, Zoghbi HY. Rett syndrome is caused by mutations in X-linked MECP2, encoding methyl-CpG-binding protein 2. Nat Genet. 1999;23(2):185-188.
  5. Van Esch H, et al. Duplication of the MECP2 region is a frequent cause of severe mental retar- dation and progressive neurological symptoms in males. Am J Hum Genet. 2005;77(3):442-453.
  6. Hagberg B, Witt-Engerström I. Rett syndrome: a suggested staging system for describing impair- ment profile with increasing age towards adoles- cence. Am J Med Genet Suppl. 1986;1:47-59.
  7. Hagberg B. Rett syndrome: long-term clinical follow-up experiences over four decades. J Child Neurol. 2005;20(9):722-727.
  8. Roze E, et al. Rett syndrome: an overlooked diagnosis in women with stereotypic hand move- ments, psychomotor retardation, Parkinsonism, and dystonia? Mov Disord. 2007;22(3):387-389.
  9. Armstrong DD. Neuropathology of Rett syn- drome. J Child Neurol. 2005;20(9):747-753.
  10. Salomao Schwartzman J, et al. Rett syndrome in a boy with a 47,XXY karyotype. Am J Hum Genet. 1999;64(6):1781-1785.
  11. Tariverdian G, Kantner G, Vogel F. A monozy- gotic twin pair with Rett syndrome. Hum Genet. 1987;75(1):88-90.
  12. Partington MW. Rett syndrome in monozygotic twins. Am J Med Genet. 1988;29(3):633-637.
  13. Villard L, Kpebe A, Cardoso C, Chelly PJ, Tardieu PM, Fontes M. Two affected boys in a Rett syn- drome family: clinical and molecular findings. Neurology. 2000;55(8):1188-1193.
  14. Zoghbi HY, Percy AK, Schultz RJ, Fill C. Patterns of X chromosome inactivation in the Rett syn- drome. Brain Dev. 1990;12(1):131-135.
  15. Sirianni N, Naidu S, Pereira J, Pillotto RF, Hoffman EP. Rett syndrome: confirmation of X-linked dominant inheritance, and local- ization of the gene to Xq28. Am J Hum Genet. 1998;63(5):1552-1558.
  16. Chahrour M, Zoghbi HY. The story of Rett syn- drome: from clinic to neurobiology. Neuron. 2007;56(3):422-437.
  17. Wan M, et al. Rett syndrome and beyond: recurrent spontaneous and familial MECP2 mutations at CpG hotspots. Am J Hum Genet. 1999;65(6):1520-1529.
  18. Zeev BB, et al. Rett syndrome: clinical manifes- tations in males with MECP2 mutations. J Child Neurol. 2002;17(1):20-24.
  19. Klauck SM, Lindsay S, Beyer KS, Splitt M, Burn J, Poustka A. A mutation hot spot for nonspecific X-linked mental retardation in the MECP2 gene causes the PPM-X syndrome. Am J Hum Genet. 2002;70(4):1034-1037.
  20. Cohen D, et al. MECP2 mutation in a boy with language disorder and schizophrenia. Am J Psy- chiatry. 2002;159(1):148-149.
  21. Adegbola AA, Gonzales ML, Chess A, LaSalle JM, Cox GF. A novel hypomorphic MECP2 point mutation is associated with a neuropsychiatric phenotype. Hum Genet. 2009;124(6):615-623.
  22. Venkateswaran S, McMillan HJ, Doja A, Hum- phreys P. Adolescent onset cognitive regression and neuropsychiatric symptoms associated with the A140V MECP2 mutation. Dev Med Child Neurol. 2014;56(1):91-94.
  23. Carney RM, et al. Identification of MeCP2 muta- tions in a series of females with autistic disorder. Pediatr Neurol. 2003;28(3):205-211.
  24. Campos M, et al. A MECP2 missense mutation within the MBD domain in a Brazilian male with autistic disorder. Brain Dev. 2011;33(10):807-809.
  25. Li H, Yamagata T, Mori M, Yasuhara A, Momoi MY. Mutation analysis of methyl-CpG binding protein family genes in autistic patients. Brain Dev. 2005;27(5):321-325.
  26. Wulffaert J, Van Berckelaer-Onnes IA, Scholte EM. Autistic disorder symptoms in Rett syn- drome. Autism. 2009;13(6):567-581.
  27. Gillberg C. Autistic symptoms in Rett syndrome: the first two years according to mother reports. Brain Dev. 1987;9(5):499-501.
  28. Olsson B. Autistic traits in the Rett syndrome. Brain Dev. 1987;9(5):491-498.
  29. Zappella M. Rett syndrome: a significant propor- tion of girls affected by autistic behavior. Brain Dev. 1985;7(3):307-312.
  30. Neul JL. The relationship of Rett syndrome and MECP2 disorders to autism. Dialogues Clin Neu- rosci. 2012;14(3):253-262.
  31. Meins M, et al. Submicroscopic duplication in Xq28 causes increased expression of the MECP2 gene in a boy with severe mental retardation and features of Rett syndrome. J Med Genet. 2005;42(2):e12.
  32. Bauters M, et al. Nonrecurrent MECP2 duplica- tions mediated by genomic architecture-driven DNA breaks and break-induced replication repair. Genome Res. 2008;18(6):847-858.
  33. Carvalho CM, et al. Complex rearrangements in patients with duplications of MECP2 can occur by fork stalling and template switching. Hum Mol Genet. 2009;18(12):2188-2203.
  34. Lugtenberg D, et al. Structural variation in Xq28: MECP2 duplications in 1% of patients with unexplained XLMR and in 2% of male patients with severe encephalopathy. Eur J Hum Genet. 2009;17(4):444-453.
  35. Friez MJ, et al. Recurrent infections, hypotonia, and mental retardation caused by duplication of MECP2 and adjacent region in Xq28. Pediatrics. 2006;118(6):e1687-e1695.
  36. Ramocki MB, et al. Autism and other neuropsy- chiatric symptoms are prevalent in individuals with MeCP2 duplication syndrome. Ann Neurol. 2009;66(6):771-782.
  37. Clayton-Smith J, et al. Xq28 duplication present- ing with intestinal and bladder dysfunction and a distinctive facial appearance. Eur J Hum Genet. 2009;17(4):434-443.
  38. Yang T, et al. Overexpression of methyl-CpG binding protein 2 impairs T(H)1 responses. Sci Transl Med. 2012;4(163):163ra158.
  39. Van Esch H. MECP2 duplication syndrome. Mol Syndromol. 2012;2(3):128-136.
  40. Reardon W, et al. Progressive cerebellar degenerative changes in the severe mental retardation syndrome caused by duplication of MECP2 and adjacent loci on Xq28. Eur J Pediatr. 2010;169(8):941-949.
  41. Guy J, Hendrich B, Holmes M, Martin JE, Bird A. A mouse Mecp2-null mutation causes neurolog- ical symptoms that mimic Rett syndrome. Nat Genet. 2001;27(3):322-326.
  42. Marchetto MC, et al. A model for neural devel- opment and treatment of Rett syndrome using human induced pluripotent stem cells. Cell. 2010;143(4):527-539.
  43. Li Y, et al. Global transcriptional and translational repression in human-embryonic-stem-cell- derived Rett syndrome neurons. Cell Stem Cell. 2013;13(4):446-458.
  44. Armstrong D, Dunn JK, Antalffy B, Trivedi R. Selective dendritic alterations in the cortex of Rett syndrome. J Neuropathol Exp Neurol. 1995;54(2):195-201.
  45. Fukuda T, Itoh M, Ichikawa T, Washiyama K, Goto Y. Delayed maturation of neuronal archi- tecture and synaptogenesis in cerebral cortex of Mecp2-deficient mice. J Neuropathol Exp Neurol. 2005;64(6):537-544.
  46. Kishi N, Macklis JD. MECP2 is progressively expressed in post-migratory neurons and is involved in neuronal maturation rather than cell fate decisions. Mol Cell Neurosci. 2004;27(3):306-321.
  47. Schüle B, Armstrong DD, Vogel H, Oviedo A, Francke U. Severe congenital encephalopathy caused by MECP2 null mutations in males: central hypoxia and reduced neuronal dendritic structure. Clin Genet. 2008;74(2):116-126.
  48. Chapleau CA, et al. Dendritic spine pathologies in hippocampal pyramidal neurons from Rett syndrome brain and after expression of Rett-as- sociated MECP2 mutations. Neurobiol Dis. 2009;35(2):219-233.
  49. Asaka Y, Jugloff DG, Zhang L, Eubanks JH, Fitzsi- monds RM. Hippocampal synaptic plasticity is impaired in the Mecp2-null mouse model of Rett syndrome. Neurobiol Dis. 2006;21(1):217-227.
  50. Moretti P, et al. Learning and memory and syn- aptic plasticity are impaired in a mouse model of Rett syndrome. J Neurosci. 2006;26(1):319-327.
  51. Guy J, Gan J, Selfridge J, Cobb S, Bird A. Reversal of neurological defects in a mouse model of Rett syndrome. Science. 2007;315(5815):1143-1147.
  52. El-Khoury R, Panayotis N, Matagne V, Ghata A, Villard L, Roux JC. GABA and glutamate path- ways are spatially and developmentally affected in the brain of Mecp2-deficient mice. PLoS One. 2014;9(3):e92169.
  53. Ide S, Itoh M, Goto Y. Defect in normal develop- mental increase of the brain biogenic amine con- centrations in the mecp2-null mouse. Neurosci Lett. 2005;386(1):14-17.
  54. Santos M, et al. Monoamine deficits in the brain of methyl-CpG binding protein 2 null mice suggest the involvement of the cerebral cortex in early stages of Rett syndrome. Neuroscience. 2010;170(2):453-467.
  55. Zoghbi HY, et al. Cerebrospinal fluid biogenic amines and biopterin in Rett syndrome. Ann Neu- rol. 1989;25(1):56-60.
  56. Samaco RC, et al. Loss of MeCP2 in aminergic neurons causes cell-autonomous defects in neurotransmitter synthesis and specific behav- ioral abnormalities. Proc Natl Acad Sci U S A. 2009;106(51):21966-21971.
  57. Ramaekers VT, et al. Reduced folate transport to the CNS in female Rett patients. Neurology. 2003;61(4):506-515.
  58. Fyffe SL, et al. Deletion of Mecp2 in Sim1- expressing neurons reveals a critical role for MeCP2 in feeding behavior, aggression, and the response to stress. Neuron. 2008;59(6):947-958.
  59. Lioy DT, et al. A role for glia in the progression of Rett's syndrome. Nature. 2011;475(7357):497-500.
  60. Cronk JC, et al. Methyl-CpG binding protein 2 regulates microglia and macrophage gene expression in response to inflammatory stimuli. Immunity. 2015;42(4):679-691.
  61. Luikenhuis S, Giacometti E, Beard CF, Jaenisch R. Expression of MeCP2 in postmitotic neurons rescues Rett syndrome in mice. Proc Natl Acad Sci U S A. 2004;101(16):6033-6038.
  62. Giacometti E, Luikenhuis S, Beard C, Jaenisch R. Partial rescue of MeCP2 deficiency by postnatal activation of MeCP2. Proc Natl Acad Sci U S A. 2007;104(6):1931-1936.
  63. McGraw CM, Samaco RC, Zoghbi HY. Adult neural function requires MeCP2. Science. 2011;333(6039):186.
  64. Collins AL, et al. Mild overexpression of MeCP2 causes a progressive neurological disorder in mice. Hum Mol Genet. 2004;13(21):2679-2689.
  65. Samaco RC, Mandel-Brehm C, McGraw CM, Shaw CA, McGill BE, Zoghbi HY. Crh and Oprm1 mediate anxiety-related behavior and social approach in a mouse model of MECP2 duplica- tion syndrome. Nat Genet. 2012;44(2):206-211.
  66. del Gaudio D, et al. Increased MECP2 gene copy number as the result of genomic duplication in neurodevelopmentally delayed males. Genet Med. 2006;8(12):784-792.
  67. Chao HT, Zoghbi HY, Rosenmund C. MeCP2 controls excitatory synaptic strength by regu- lating glutamatergic synapse number. Neuron. 2007;56(1):58-65.
  68. Lewis JD, et al. Purification, sequence, and cellular localization of a novel chromosomal protein that binds to methylated DNA. Cell. 1992;69(6):905-914.
  69. Nan X, Meehan RR, Bird A. Dissection of the methyl-CpG binding domain from the chro- mosomal protein MeCP2. Nucleic Acids Res. 1993;21(21):4886-4892.
  70. Guo JU, et al. Distribution, recognition and regu- lation of non-CpG methylation in the adult mam- malian brain. Nat Neurosci. 2014;17(2):215-222.
  71. Smith ZD, Meissner A. DNA methylation: roles in mammalian development. Nat Rev Genet. 2013;14(3):204-220.
  72. Schubeler D. Function and information content of DNA methylation. Nature. 2015;517(7534):321-326.
  73. Jones PA. Functions of DNA methylation: islands, start sites, gene bodies and beyond. Nat Rev Genet. 2012;13(7):484-492.
  74. Lister R, et al. Global epigenomic reconfiguration during mammalian brain development. Science. 2013;341(6146):1237905.
  75. Skene PJ, et al. Neuronal MeCP2 is expressed at near histone-octamer levels and globally alters the chromatin state. Mol Cell. 2010;37(4):457-468.
  76. Shahbazian MD, Antalffy B, Armstrong DL, Zoghbi HY. Insight into Rett syndrome: MeCP2 levels display tissue-and cell-specific differences and correlate with neuronal maturation. Hum Mol Genet. 2002;11(2):115-124.
  77. Nan X, Campoy FJ, Bird A. MeCP2 is a transcrip- tional repressor with abundant binding sites in genomic chromatin. Cell. 1997;88(4):471-481.
  78. Ben-Shachar S, Chahrour M, Thaller C, Shaw CA, Zoghbi HY. Mouse models of MeCP2 dis- orders share gene expression changes in the cerebellum and hypothalamus. Hum Mol Genet. 2009;18(13):2431-2442.
  79. Yazdani M, Deogracias R, Guy J, Poot RA, Bird A, Barde YA. Disease modeling using embry- onic stem cells: MeCP2 regulates nuclear size and RNA synthesis in neurons. Stem Cells. 2012;30(10):2128-2139.
  80. Adams VH, McBryant SJ, Wade PA, Wood- cock CL, Hansen JC. Intrinsic disorder and autonomous domain function in the multifunc- tional nuclear protein, MeCP2. J Biol Chem. 2007;282(20):15057-15064.
  81. Wakefield RI, et al. The solution structure of the domain from MeCP2 that binds to methylated DNA. J Mol Biol. 1999;291(5):1055-1065.
  82. Ho KL, McNae IW, Schmiedeberg L, Klose RJ, Bird AP, Walkinshaw MD. MeCP2 binding to DNA depends upon hydration at methyl-CpG. Mol Cell. 2008;29(4):525-531.
  83. Ghosh RP, et al. Unique physical properties and interactions of the domains of methy- lated DNA binding protein 2. Biochemistry. 2010;49(20):4395-4410.
  84. Baker SA, Chen L, Wilkins AD, Yu P, Lichtarge O, Zoghbi HY. An AT-hook domain in MeCP2 deter- mines the clinical course of Rett syndrome and related disorders. Cell. 2013;152(5):984-996.
  85. Reeves R, Beckerbauer L. HMGI/Y proteins: flexi- ble regulators of transcription and chromatin struc- ture. Biochim Biophys Acta. 2001;1519(1):13-29.
  86. Yasui DH, et al. Integrated epigenomic analyses of neuronal MeCP2 reveal a role for long-range interaction with active genes. Proc Natl Acad Sci U S A. 2007;104(49):19416-19421.
  87. Cohen S, et al. Genome-wide activity-depen- dent MeCP2 phosphorylation regulates nervous system development and function. Neuron. 2011;72(1):72-85. 100. Lyst MJ, et al. Rett syndrome mutations abolish the interaction of MeCP2 with the NCoR/SMRT co-repressor. Nat Neurosci. 2013;16(7):898-902. 101. Heckman LD, Chahrour MH, Zoghbi HY. Rett- causing mutations reveal two domains critical for MeCP2 function and for toxicity in MECP2 dupli- cation syndrome mice. Elife. 2014;3:e02676. 102. Schanen C, et al. Phenotypic manifesta- tions of MECP2 mutations in classical and atypical Rett syndrome. Am J Med Genet A. 2004;126A(2):129-140. 103.
  88. Voituron N, Zanella S, Menuet C, Dutschmann M, Hilaire G. Early breathing defects after moderate hypoxia or hypercapnia in a mouse model of Rett syndrome. Respir Physiol Neurobiol. 2009;168(1):109-118. 147. Bissonnette JM, Knopp SJ. Effect of inspired oxy- gen on periodic breathing in methy-CpG-binding protein 2 (Mecp2) deficient mice. J Appl Physiol. 2008;104(1):198-204. 148. Lang M, et al. Rescue of behavioral and EEG def- icits in male and female Mecp2-deficient mice by delayed Mecp2 gene reactivation. Hum Mol Genet. 2014;23(2):303-318. 149. D'Cruz JA, Wu C, Zahid T, El-Hayek Y, Zhang L, Eubanks JH. Alterations of cortical and hippo- campal EEG activity in MeCP2-deficient mice. Neurobiol Dis. 2010;38(1):8-16. 150. Christodoulou J, Grimm A, Maher T, Bennetts B. RettBASE: The IRSA MECP2 variation data- base-a new mutation database in evolution. Hum Mutat. 2003;21(5):466-472.

Cited by

Sorted by citations

Authors
Lombardi, L. M., Baker, S. A., & Zoghbi, H. Y.
Affiliations
  • Howard Hughes Medical Institute (US)
  • Baylor College of Medicine (US)
Corresponding author
Zoghbi, Huda Yahya
Venue
Journal of Clinical Investigation
Published
2015-08-03
Volume
125
Issue
8
Pages
2914-2923
ISSN
0021-9738 (ISSN-L)
OpenAlex
W2108328933
Cited by
221
References
0
Citations by year
2026: 10 · 2025: 15 · 2024: 17 · 2023: 6 · 2022: 14 · 2021: 26 · 2020: 23 · 2019: 16 · 2018: 26 · 2017: 37 · 2016: 29 · 2015: 1
FWCI
3.93
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Investigation (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Howard Hughes Medical Institute
  • International Rett Syndrome Foundation
  • Rett Syndrome Research Trust
  • National Institute of Neurological Disorders and Stroke (NS057819, R01NS057819)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neuropharmacology Research
Keywords
MeCP2, Rett syndrome, MECP2 duplication syndrome, intellectual disability, autism spectrum disorder, developmental regression, mouse model, neuronal dysfunction, chromatin regulation
MeSH terms
Animals, Disease Models, Animal, Humans, Neurons, Rett Syndrome, Cell Death, Mental Retardation, X-Linked, X-Linked Intellectual Disability, Chromatin Assembly and Disassembly, Mice, Methyl-CpG-Binding Protein 2

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review