Abstract

Rett syndrome (RTT) is an autism spectrum disorder mainly caused by mutations in the X-linked MECP2 gene and affecting roughly 1 out of 10.000 born girls. Symptoms range in severity and include stereotypical movement, lack of spoken language, seizures, ataxia and severe intellectual disability. Notably, muscle tone is generally abnormal in RTT girls and women and the Mecp2-null mouse model constitutively reflects this disease feature. We hypothesized that MeCP2 in muscle might physiologically contribute to its development and/or homeostasis, and conversely its defects in RTT might alter the tissue integrity or function. We show here that a disorganized architecture, with hypotrophic fibres and tissue fibrosis, characterizes skeletal muscles retrieved from Mecp2-null mice. Alterations of the IGF-1/Akt/mTOR pathway accompany the muscle phenotype. A conditional mouse model selectively depleted of Mecp2 in skeletal muscles is characterized by healthy muscles that are morphologically and molecularly indistinguishable from those of wild-type mice raising the possibility that hypotonia in RTT is mainly, if not exclusively, mediated by non-cell autonomous effects. Our results suggest that defects in paracrine/endocrine signaling and, in particular, in the GH/IGF axis appear as the major cause of the observed muscular defects. Remarkably, this is the first study describing the selective deletion of Mecp2 outside the brain. Similar future studies will permit to unambiguously define the direct impact of MeCP2 on tissue dysfunctions.

Highlights

  • Rett syndrome (RTT; MIM 312750) is a genetic disorder that because of its prevalence is considered one of the most frequent causes of intellectual disability in females worldwide [1]

  • No conditional mouse models inactivating Mecp2 in organs different from brain have yet been generated, a role for MeCP2 in the development of heart and skeleton has been proposed [9]. In light of these considerations and of the severe hypotonia affecting RTT patients and mice, we investigated whether MeCP2 expression is required for the development and homeostasis of the skeletal muscle using two mouse models

  • RTT patients are characterized by a significant hypotonia; concordantly, the Mecp2-null mouse model is characterized by a decreased growth and severe hypotonia

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Summary

Introduction

Rett syndrome (RTT; MIM 312750) is a genetic disorder that because of its prevalence (roughly 1/10.000 born girls) is considered one of the most frequent causes of intellectual disability in females worldwide [1]. Typical RTT patients appear to develop normally throughout the first 6–18 months of life, when neurological development arrests and a regression phase occurs, leading to the loss of previously acquired skills. During and after the regression phase, patients develop typical symptoms including continuous stereotypic hand movements with a decline of purposeful hand use, loss of language skills, the appearance of autistic features, gait abnormalities, breathing irregularities, seizures, scoliosis and autonomic dysfunctions [2]. Mild generalized hypotonia is frequently observed in the first months of life of RTT patients, when symptoms are not yet overt. An abnormal muscle tone is generally observed at later times [3]. Abnormal muscle tone is a supportive criterion for the clinical diagnosis of atypical RTT [3]

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