Variant Rett syndrome in a girl with a pericentric X-chromosome inversion leading to epigenetic changes and overexpression of the MECP2 gene.
Rett syndrome is a neurodevelopmental disorder caused by mutations in the MECP2 gene. We investigated the genetic basis of disease in a female patient with a Rett-like clinical. Karyotype analysis revealed a pericentric inversion in the X chromosome -46,X,inv(X)(p22.1q28), with breakpoints in the cytobands where the MECP2 and CDKL5 genes are located. FISH analysis revealed that the MECP2 gene is not dislocated by the inversion. However, and in spite of a balanced pattern of X inactivation, this patient displayed hypomethylation and an overexpression of the MECP2 gene at the mRNA level in the lymphocytes (mean fold change: 2.55±0.38) in comparison to a group of control individuals; the expression of the CDKL5 gene was similar to that of controls (mean fold change: 0.98±0.10). No gains or losses were detected in the breakpoint regions encompassing known or suspected transcription regulatory elements. We propose that the de-regulation of MECP2 expression in this patient may be due to alterations in long-range genomic interactions caused by the inversion and hypothesize that this type of epigenetic de-regulation of the MECP2 may be present in other RTT-like patients.
Neurology Department, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, Portugal.
José Pedro
JP
Vieira
Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
Fátima
F
Lopes
Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
Anabela
A
Silva-Fernandes
Neurology Department, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, Portugal.
Maria Vânia
MV
Sousa
Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
Sofia
S
Moura
Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
Susana
S
Sousa
Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
Bruno M
BM
Costa
Department of Genetics and Genomic Sciences, The Mindich Child Health & Development Institute, The Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, NY, USA; Instituto Gulbenkian de Ciência, Oeiras, Portugal.
Mafalda
M
Barbosa
Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.
Bauke
B
Ylstra
Neuropediatrics Department, Centro Hospitalar do Porto, Portugal.
Teresa
T
Temudo
Neurology Department, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, Portugal.
Teresa
T
Lourenço
Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal. Electronic address: pmaciel@ecsaude.uminho.pt.
Patrícia
P
Maciel
D002648:Child; D007446:Chromosome Inversion / Q000235:genetics*; D041321:Chromosomes, Human, X / Q000235:genetics*; D044127:Epigenesis, Genetic; D005260:Female; D006801:Humans; D007621:Karyotyping; D051783:Methyl-CpG-Binding Protein 2 / Q000235:genetics*; D009154:Mutation / Q000235:genetics; D017346:Protein Serine-Threonine Kinases / Q000235:genetics / Q000378:metabolism; D012333:RNA, Messenger; D015518:Rett Syndrome / Q000235:genetics* / Q000378:metabolism / Q000473:pathology
C497392:MECP2 protein, human; D051783:Methyl-CpG-Binding Protein 2; D012333:RNA, Messenger; D017346:Protein Serine-Threonine Kinases; C114482:CDKL5 protein, human
Epigenetics; Epilepsy; Intellectual disability; Neurodevelopment