A role for metabolism in Rett syndrome pathogenesis: New clinical findings and potential treatment targets
Open accessAbstract
Rett syndrome (RTT), an X-linked neurological disorder caused by mutations in MECP2, may have a metabolic component. We reported a genetic suppressor screen in a Mecp2-null mouse model to identify pathways for therapeutic improvement of RTT symptoms. Of note, one suppressor mutation implied that cholesterol homeostasis was perturbed in Mecp2 null mice; indeed, cholesterol synthesis was elevated in the brain and body system. Remarkably, the genetic effect of downregulating the cholesterol pathway could be mimicked chemically by statin drugs, improving motor symptoms, and increasing longevity in the mouse. Our work linked cholesterol metabolism to RTT pathology for the first time. Both neurological and systemic effects of perturbed cholesterol homeostasis overlap with many RTT symptoms. Here we show in patients that peripheral cholesterol, triglycerides, and/or LDLs may be elevated early in RTT disease onset, providing a biomarker for patients that could be aided by therapeutic interventions that modulate lipid metabolism.
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Both RTT patients and Mecp2 mutant mice present with metabolic syndrome, oxidative stress, cardiac defects, decreased bone density and urological dysfunction.
“Additionally, both RTT patients and Mecp2 mutant mice present with metabolic syndrome [15,180], oxidative stress [27,29], cardiac defects [211,212], decreased bone density [174,213] and urological dysfunction [214,215].”
From Rett syndrome: a neurological disorder with metabolic components (2018) · cites this paper as [15]
For the metabolic-syndrome portion of the sentence, “Considerations for Other Therapies that May Affect Metabolism in RTT Patients” explicitly describes metabolic-syndrome phenotypes in Mecp2-null mice. “A Subset of Rett Patients Display Dyslipidemia” reports elevated lipids in some RTT patients, but does not establish that RTT patients present with metabolic syndrome. No page numbers are provided in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA number of RTT patients present with dyslipidaemia.
“A number of patients present with dyslipidaemia [15,16], elevated plasma leptin and adiponectin [17,18], elevated ammonia [1] and inflammation of the gallbladder, an organ which stores bile for fat digestion [19].”
From Rett syndrome: a neurological disorder with metabolic components (2018) · cites this paper as [15]
Metabolic complications are common in RTT.
“Metabolic complications are also common in RTT.”
From Rett syndrome: a neurological disorder with metabolic components (2018) · cites this paper as [15]
Humans with RTT have a wide range in body mass index.
“Interestingly, heterozygous female mice on all genetic backgrounds, as well as female rats, become significantly overweight as they age [115,117,125], although humans with RTT have a wide range in body mass index [15].”
From Rett syndrome: a neurological disorder with metabolic components (2018) · cites this paper as [15]
Only a subset of RTT patients exhibit increased serum cholesterol and/or triglycerides.
“Consistently, only a subset of RTT patients exhibit increased serum cholesterol and/or triglycerides [15,16,173].”
From Rett syndrome: a neurological disorder with metabolic components (2018) · cites this paper as [15]
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Kabdesh, I. M., Rizvanov, A. A., & Mukhamedshina, Y. O. (2026) · Non-Coding RNA · doi:10.3390/ncrna12040025
Mapping Trofinetide Polypharmacology in Rett Syndrome: A Multi‐Stage Computational Analysis
Hernández‐Ayala, L. F., Guzmán‐López, E. G., & Galano, A. (2026) · Journal of Computational Chemistry · doi:10.1002/jcc.70468
- Authors
- Justice, M. J., Buchovecky, C. M., Kyle, S. M., & Djukic, A.
- Affiliations
- Baylor College of Medicine (US)
- Albert Einstein College of Medicine (US)
- Corresponding author
- Justice, Monica J
- Venue
- Rare Diseases
- Publisher
- Informa UK Limited
- Published
- 2013-01
- Volume
- 1
- Issue
- 1
- Pages
- e27265
- ISSN
- 2167-549X (ISSN-L)
- 2167-5511
- PMC
- PMC3978897
- OpenAlex
- W1964269471
- Cited by
- 61
- References
- 30
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 7 · 2023: 6 · 2022: 2 · 2021: 10 · 2020: 3 · 2019: 8 · 2018: 6 · 2017: 4 · 2016: 6 · 2015: 2
- FWCI
- 1.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Rare Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- International Rett Syndrome Foundation
- Rett Syndrome Research Trust
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Genetic Neurodegenerative Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Keywords
- Rett syndrome, MeCP2, cholesterol homeostasis, cholesterol biosynthesis, statins, Mecp2-null mice, lipid metabolism, biomarkers, motor symptoms, longevity
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