The role of MECP2 in disease is primarily associated with either a loss of function (under expression) of the
MECP2 gene as in
Rett syndrome or in a gain of function (over expression) as in
MECP2 duplication syndrome. Many mutations have been associated with loss of expression of the MECP2 gene and have been identified in Rett syndrome patients. These mutations include changes in single DNA
base pairs (
SNP), insertions or deletions of DNA in the
MECP2 gene, and changes that affect how the gene information is processed into a protein (
RNA splicing). Mutations in the gene alter the structure of the MeCP2 protein or lead to reduced amounts of the protein. As a result, the protein is unable to bind to DNA or turn other genes on or off. Genes that are normally repressed by MeCP2 remain active when their products are not needed. Other genes that are normally activated by MeCP2 remain inactive leading to a lack of gene product. This defect probably disrupts the normal functioning of nerve cells, leading to the signs and symptoms of Rett syndrome.
Rett syndrome is mainly found in girls with a
prevalence of around 1 in every 10,000; male fetuses with normal karyotypes afflicted with this condition rarely survive to term and if so, usually die shortly after birth. Patients are born with very hard to find signs of a disorder, but after about six months to a year and half, speech and motor function capabilities start to decrease. This is followed by
seizures, growth retardation and cognitive and motor impairment. The MECP2 locus is
X-linked and the disease-causing alleles are
dominant. Due to its prevalence in females, it has been linked to male lethality, or to a predominant transmission with the paternal X chromosome; nevertheless, in rare cases some males can also be affected by Rett syndrome. Males with gene duplications of MECP-2 at the Xq28 locus are also at risk for recurrent infections & meningitis in infancy. Mutations in the
MECP2 gene have also been identified in people with several other disorders affecting the central nervous system. For example,
MECP2 mutations are associated with some cases of moderate to severe X-linked intellectual disability. Mutations in the gene have also been found in males with severe brain dysfunction (
neonatal encephalopathy) who live only into early childhood. In addition, several people with features of both Rett syndrome and
Angelman syndrome (a condition characterized by intellectual disability, problems with movement, and inappropriate laughter and excitability) have mutations in the
MECP2 gene. Lastly,
MECP2 mutations or changes in the gene's activity have been reported in some cases of
autism (a developmental disorder that affects communication and social interaction). More recent studies reported genetic polymorphisms in the MeCP2 gene in patients with
systemic lupus erythematosus (SLE). SLE is a systemic autoimmune disease that can affect multiple organs. MeCP2 polymorphisms have been reported so far in European-derived and Asian lupus patients. The genetic loss of MECP2 has been identified as changing the properties of cells in the
locus ceruleus, the exclusive source of noradrenergic innervation to the
cerebral cortex and
hippocampus. Researchers have concluded that "Because these neurons are a pivotal source of norepinephrine throughout the brainstem and forebrain and are involved in the regulation of diverse functions disrupted in Rett syndrome, such as respiration and cognition, we hypothesize that the locus ceruleus is a critical site at which loss of MECP2 results in CNS dysfunction." == Interactive pathway map ==