C o m m e n t a r y
Methyl-CpG-binding protein 2: linking epigenetics to neuronal functionOver 95% of classic Rett syndrome (RTT) cases are linked to mutations in a single gene that encodes methyl-CpG-binding protein 2 (MECP2) (1, 2), one of six mammalian methyl-CpG-binding proteins identified so far. These proteins specifically bind DNA methylated at the 5′ position of cytosine within cytosine-guanine (CpG) dinucleotide sequences, a process that constitutes an important gene-silencing mechanism in eukaryotes and is essential for viability (3). MECP2 dysfunction results in various neuropsychiatric disorders that include mild mental retardation, learning disabilities, autism spectrum disorders, and complex forms of severe mental retardation (1, 2). In RTT, numerous, mostly spontaneous mutations have been identified in MECP2 that result in a loss of MECP2 function. Several Mecp2-KO mouse models have been generated to investigate RTT pathology and to potentially identify and test new therapies (2). MECP2-deficient mice manifest many of the predominant characteristics of human RTT. The traditionally held belief is that the neurological and psychiatric features caused by RTT-associated failures that occur during brain development are irreversible; however, studies in MECP2-deficient mice suggest that normal brain function can be restored by reinstating MECP2 (4). These results are promising, because they suggest that it may be possible to improve neuronal function in patients with RTT. However, therapeutic approaches aimed at altering MECP2 levels in patients will likely require a more complex strategy, as both loss of MECP2 function and elevated MECP2 levels have deleterious neurological effects. Thus, current basic and clinical research has focused on identification of critical factors downstream of MECP2 that have altered expression or function and may directly cause neuronal defects in RTT. Candidate molecules include brainderived neurotrophic factor (BDNF) and IGF-1, both of which are currently the focus of many investigations (5-8). Approaches that elevate BDNF expression and those using BDNF mimetics have shown promising results in RTT animal models (9-12), while phase I clinical trials of recombinant IGF-1 treatment in patients with RTT have produced encouraging outcomes (13).
PTP1B: linking MECP2 to insulin signalingSeveral lines of evidence suggest that RTT is associated with metabolic disorders. First, lipid metabolism is disturbed in both RTT mouse models, in which cholesterol levels are elevated in the brain (14), and in RTT patients, in whom plasma levels of cholesterol regulatory proteins are altered (15). Second, various studies found typical signs of insulin and leptin resistance as well as obesity in RTT animal models (16,17). Moreover, insulin resistance has also been reported in patients with RTT (18). In this issue, Krishnan and colleagues investigated the metabolic processes associated with RTT (19). The authors examined glucose metabolism and insulin signaling in male Mecp2 -/y and female Mecp2...