La méthylation de l’ADN est une modification majeure du génome des eucaryotes permettant de moduler l’expression génique et contrôler le développement des mammifères. La protéine Mecp2 (Methyl CpG binding protein 2), dont le gène est situé sur le chromosome X, appartient à la famille des protéines de liaison à l’ADN méthylé. Sur la base de sa structure et de ses interactions Mecp2 a été décrit comme un répresseur de l’expression des gènes. A l’heure actuelle, son implication en tant qu’activateur de la transcription et organisateur de la structure chromatinienne lui confère un rôle plus global dans la régulation de l’épigénome. Des mutations de MECP2 conduisent à des troubles neurologiques dont le principal est le syndrome de Rett (RTT). Cette pathologie dominante liée à l’X affecte principalement les jeunes filles (incidence: 1/15000 naissances). Même si les causes précises du phénotype RTT ne sont pas connues, le profil d’expression de Mecp2 est en lien avec la synaptogenèse, la maturation et la maintenance des réseaux neuronaux. A mon arrivée en thèse l’équipe qui m’a accueilli venait d’identifier des déficits neuronaux, affectant notamment les groupes catécholaminergiques bulbaires et périphériques, à l’origine de troubles respiratoires chez un modèle murin de cette pathologie. Mon travail de thèse a permis de caractériser l’évolution postnatale des déficits moteurs et physiologiques affectant la souris Mecp2-déficiente. L’étude de structures catécholaminergiques d’intérêt telles que la Substantia Nigra et le Locus Coeruleus a révélé que les neurones dopaminergiques et noradrénergiques centraux ont un métabolisme affecté. Le nombre de neurones immunomarqués apparait significativement réduit dans ces groupes ce qui résulterait d’une perte progressive du phénotype « catécholaminergique », en l’absence de mort cellulaire. Nos données suggèrent que ces atteintes constituent un corrélat neuropathologique aux troubles comportementaux observés chez les souris Mecp2-déficientes. Ainsi certains troubles moteurs ont pu être améliorés, à l’aide d’un agent pharmacologique pro-dopaminergique, la L-Dopa. En relation avec les déficits en Bdnf (Brain-derived neurotrophic factor) décrits chez les patientes et les souris Mecp2-déficientes, nous avons identifié qu’une modification du dosage de Mecp2 induit une dérégulation de gènes (Htt, Hap1) codant des protéines impliquées dans le transport intracellulaire des vésicules de Bdnf. Nos travaux nous permettent de postuler que chez la souris Mecp2-déficiente, une altération de la dynamique de transport des vésicules chargées en Bdnf pourrait exacerber le déficit d’expression de cette neurotrophine. Notre traitement des souris Mecp2-déficientes par la cystéamine, une molécule capable d’agir sur les contenus, la libération et la sécrétion du Bdnf permet d’augmenter la survie des animaux et de réduire leurs troubles moteurs. Nos résultats montrent que les déficiences en Mecp2 entrainent des déficits de transport axonal du Bdnf qui s’ajoutent aux déficits de production du Bdnf. Par ailleurs, avec l’utilisation d’agents pharmacologiques agissant sur ce transport, nous offrons de nouvelles perspectives thérapeutiques. / DNA methylation is the major modification of eukaryotic genomes and plays an essential role in mammalian development. The protein Mecp2 (Methyl CpG binding protein 2), encoded by a gene located on the X chromosome, belongs to the ‘Methyl Binding domain’ protein family. Based on its structure and its interactions Mecp2 has historically been described as a repressor of expression for many genes. Currently, its involvement as an activator of transcription and its role in chromatin architecture suggests that it could be a global regulator of the epigenome. Mutations in MECP2 lead to neurological disorders, among which Rett syndrome (RTT). This dominant X-linked pathology mainly affects girls (incidence: 1/15000 live births). Although the precise causes of the RTT phenotype are unknown, the pattern of Mecp2 expression is related to synaptogenesis, maturation and neuromaintenance. Before my integration in the ‘Human Neurogenetics’ team, this group identified neural deficits, affecting brainstem and peripheral catecholaminergic cell groups, causing respiratory disturbances in a mouse model of this disease. My thesis work enabled the characterization of the postnatal physiological and motor deficits affecting the Mecp2-deficient mice. The study of catecholaminergic structures of interest such as the substantia nigra pars compacta and the locus coeruleus has revealed that the central noradrenergic and dopaminergic neurons are affected in their metabolism. The number of immunolabelled neurons of these groups appears significantly reduced and would result in a gradual loss of the mature ‘catecholaminergic’ phenotype, in the absence of cell death. Our data suggest that these defects are a neuropathological correlate for behavioral disorders observed in Mecp2-deficient mice. Some motor deficits have been improved, with L-Dopa, a pro-dopaminergic drug. In relation with Bdnf (Brain-derived neurotrophic factor) reduction described in patients and Mecp2-deficient mice, we identified that a change in the dosage of Mecp2 deregulates genes (Htt, Hap1) encoding proteins involved in the intracellular transport of Bdnf. Our work allows to postulate that in the Mecp2-deficient neurons, an altered dynamics of Bdnf vesicles transport could exacerbate the deficit of expression of this neurotrophin. Our treatment of Mecp2-deficient mice with cysteamine, a molecule able to increase Bdnf contents and enhancing its release and secretion, increased the survival of the animals and reduced their motor defects. Our results show that the Mecp2-deficiencies lead to alteration in the axonal transport of Bdnf in addition to deficits in Bdnf production. In addition, by the use of pharmacological agents that affect this transport, we offer new therapeutic perspectives.

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Made available in DSpace on 2016-03-15T19:40:44Z (GMT). No. of bitstreams: 1 Erika Miti Yasui.pdf: 439112 bytes, checksum: 64788c447a4bd122f64e6e366477885f (MD5) Previous issue date: 2006-08-03 / Fundo Mackenzie de Pesquisa / To study the oral manifestations of Rett syndrome and the oral health conditions of female patients with Rett syndrome diagnosis and to evaluate the necessity of specific preventive and therapeutic dental treatment. Clinical evaluation of 21 patients from Associação Brasileira de Síndrome de Rett (ABRE-TE) classified according to the syndrome stage. The collected data came from a questionnaire about general and oral health for the caretakers and clinical and radiographic examination (panoramic radiography). These data were loaded and analysed statiscally in the EPI6 6.04d, 2001 program. The used indexes for the oral health conditions evaluation were: carie experience index (DMFT), simplified hygiene index (IHO-S) and dental treatment needs index (INTO). The diurnal excentric bruxism was observed in 17 patients (80,9%) and it was the main reason for the dental visits. Alterations in shape, size or chronological eruption of the teeth were not detected. Only 7,6% of the dental surfaces were plaque free and 12 patients presented gingival bleeding (57,1%). The person responsible for the oral hygiene of the patients, in most cases was the mother (n=17), who presented high level of education and reported have not been given professional advice to performed it. Although 14 patients did not show dental treatment needs, it increases with age. In the present study clinical and radiographic oral alterations specific to the Rett syndrome were not detected, and the diurnal excentric bruxism was the main oral manifestation. The oral hygiene conditions were not satisfactory and the clinical characteristics presented by the patients with Rett syndrome make the oral hygiene performance by the caretakers difficult. This fact stresses the necessity of the implementation of a preventive and therapeutic dental program as well the education and training of professionals capable to work in a multidisciplinary way and then, to provide dental treatment according to the patients needs. / A síndrome de Rett é uma condição neurobiológica, que afeta quase que exclusivamente o sexo feminino, ocorrendo em uma diversidade de grupos raciais e étnicos no mundo inteiro. Desde que foi descrita pela primeira vez, por Andreas Rett em 1966, grandes avanços das pesquisas sobre diversos aspectos da síndrome foram realizados. Porém, na área odontológica, pouco se conhece a respeito de suas manifestações bucais. Esse desconhecimento dificulta a detecção da necessidade de elaboração de tratamento odontológico preventivo e terapêutico específico. O objetivo desse estudo foi detectar as manifestações bucais da síndrome de Rett e as condições de saúde bucal apresentadas por 21 portadoras da síndrome de Rett e avaliar a necessidade de tratamento odontológico preventivo e terapêutico específico. Foram estudadas 21 pacientes atendidas na Associação Brasileira de Síndrome de Rett de São Paulo, classificadas de acordo com o estágio de evolução da síndrome. A coleta de dados utilizou questionário sobre as condições de saúde geral e bucal das pacientes, dirigido aos responsáveis; avaliação das condições saúde bucal realizada por meio de exame de inspeção com a utilização de espelho clínico, sonda periodontal CPI (OMS) e corante para evidenciação de biofilme dental e exame radiológico (radiografia panorâmica) para detecção de eventuais alterações ósseas e dentárias. Os dados coletados foram armazenados e analisados em banco de dados do programa Epi6, versão 6.04d, 2001. Os índices utilizados para análise das condições de saúde bucal foram: índice de experiência de cárie (CPOD), índice de higiene oral simplificado (IHO-S) e índice de necessidade de tratamento (INTO). O bruxismo excêntrico diurno foi observado em 17 pacientes (80,9%), sendo o principal motivo para consultas odontológicas. Não foram observadas alterações de forma, tamanho ou cronologia de erupção dos dentes ou das estruturas ósseas das pacientes examinadas. Somente 7,6% das superfícies dentárias examinadas apresentavam-se isentas de biofilme dental e 12 pacientes apresentaram sangramento gengival (57,1%). O responsável pela higiene bucal das portadoras de síndrome de Rett é, na maioria dos casos, a mãe (n=17), que apresenta nível de escolaridade elevada e relata não ter recebido orientação profissional para realizar a higiene bucal de sua filha. Apesar de 14 pacientes não apresentarem necessidades de tratamento odontológico (índice INTO=0), essa necessidade aumenta de acordo com a idade das pacientes. Conclui-se que no presente estudo não foram detectadas alterações clínicas ou radiográficas específicas, relacionadas com a síndrome de Rett, sendo o bruxismo excêntrico diurno a principal manifestação bucal observada, devendo sofrer intervenção sempre que possível. As pacientes com síndrome de Rett não apresentaram condições de higiene bucal satisfatórias, independente da idade e estágio de evolução da síndrome. As características clínicas apresentadas por essas pacientes dificultam a realização da higiene bucal por seus responsáveis, evidenciando a necessidade de implementação de programas odontológicos preventivos e terapêuticos para essas pacientes, além da necessidade de formação e treinamento de profissionais capazes de trabalhar de forma multidisciplinar, com uma visão integral de seus pacientes e de suas necessidades odontológicas.

Cette these en cotutelle entre le Laboratoire Peptlab de l’Université de Florence en Italie et le Laboratoire de Pharmacognosie de l’Université de Bourgogne Franche-Comté en France, porte sur l’extraction, la purification et l’élucidation structurale de saponines d’origine végétale en tant que mimétiques d’antigènes impliqués dans une réponse immunitaire. L’étude phytochimique de cinq espèces végétales appartenant à trois familles différentes, Fabaceae : Wisteria frustecens, Wisteria floribunda “macrobotrys”, Wisteria floribunda “rosea”, Caprifoliaceae : Weigela florida “rumba” et Polygalaceae : Polygala acicularis, a conduit à l’isolement de seize glycosides triterpéniques naturels parmi lesquelles six sont de structure nouvelle, une a été isolée sous sa forme native pour la première fois, et neuf déjà répertoriées dans la littérature. Les composés ont été isolés grâce à l’utilisation de différentes méthodes chromatographiques. Leurs structures ont été élucidées en utilisant principalement la RMN 2D et la spectrométrie de masse. Parmis ces seize molécules, six ont été sélectionnées pour être testées en tant que mimétiques d’antigènes impliqués dans une réponse immunitaire. De plus, un flavonoïde glycosylé extrait de Sophora japonica et un acide triterpénique commercial, l’acide ursolique, ont eux aussi été choisis comme mimétiques d’antigènes. Des tests immunochimiques (ELISA) ont été réalisés afin d’évaluer leur potentiel en tant que mimétiques d’antigènes dans le sang de patients atteints de sclérose en plaque ou du syndrome de Rett. Le taux IgM dans le sérum des patients atteints de sclérose en plaque ou du syndrome de Rett a été mesuré et comparé à celui de donneurs sains. Concernant la sclérose en plaque, les résultats sont peu significatifs concernant le potentiel des saponines en tant que mimétiques d’antigènes. Mais dans le cas du syndrome de Rett des résultats intéressants et surprenants ont été obtenus. En effet, l’hypothèse de départ était l’implication de la partie glycosylée dans la reconnaissance d’autoanticorps. Pour le syndrome de Rett, l’acide ursolique, qui est un aglycone, démontre une grande efficacité dans la reconnaissance d’IgM. Par contre, un triterpène glycosylé démontre lui aussi une efficacité semblable. Les résultats obtenus sont donc à analyser afin d’établir des relations structure/activité fiables. / This PhD in co-direction between the Peptlab Laboratory of the University of Firenze (Italy) and the Laboratory of Pharmacognosy of the University of Bourgogne Franche-Comté (France), deals with extraction, purification and structural elucidation of saponins from plants as mimetic antigens involved in an immune response. The phytochemical study of five species from three different families, Wisteria frustecens, Wisteria floribunda “macrobotrys” and Wisteria floribunda “rosea” from Fabaceae, Weigela florida “rumba” from Caprifoliaceae, and Polygala acicularis from Polygalaceae, allowed us to isolate sixteen natural glycosides: six with new structures, one analyzed for the first time in its native form, and nine which have been already described in the literature. These compounds were isolated using various chromatographic methods, and their structures were elucidated using mainly 2D NMR and mass spectrometry. From the isolated glycosides, six were selected and tested as mimetics of native antigens involved in the immune response. Moreover, one flavonoid glycoside extracted from Sophora japonica, and one commercial triterpenic acid, ursolic acid, were also chosen as mimetics of native antigens. Immunoenzymatic assays (ELISA) were performed for each compound to evaluate their potential as mimetics of native antigens of multiple sclerosis and Rett syndrome. The IgM levels in sera of patients affected by multiple sclerosis and Rett syndrome were measured and compared to normal blood donors. Concerning multiple sclerosis, no significant results were obtained for saponins, but in the case of Rett syndrome, interesting and surprising results were obtained. Indeed, the first hypothesis was that the glycosyl part of the molecule could be relevant for antibody recognition. In the case of Rett syndrome ursolic acid, an aglycone without any glycosidic part, demonstrated a good efficiency in IgM recognition. On the other hand, one triterpenic glycoside showed similar results. These results were discussed to define possible structure/activity relationships.

Thesis advisor: Thomas N. Seyfried / Epilepsy is a prevalent disabling chronic and socially isolating neurological disorder that involves recurrent abnormal discharges of neurons. Despite seizures afflicting about 10% of people worldwide, antiepileptic drugs (AEDs) are largely unable to manage seizures in many persons with epilepsy. As an alternative to AEDs, dietary therapies possess a broad therapeutic potential in both humans and animals models of various neurological and neurodegenerative disease etiologies. My research focus was to identify the therapeutic efficacy and potential mechanism(s) of action of calorie restriction (CR) and the ketogenic diet (KD) in both the epileptic EL mouse model and the Mecp2<super>308/y<super/> mouse model of Rett syndrome. My findings indicate that both the KD and CR can reduce seizure susceptibility in EL mice, a natural model for multifactorial idiopathic generalized epilepsy. CR and circulating glucose and ketone levels significantly influence the therapeutic efficacy of the KD. A concurrent reduction in circulating plasma glucose levels and elevation in circulating plasma &beta-hydroxybutyrate levels was predicted to associate with the anticonvulsant effect of these diets in EL mice. For the first time, I was able to show that a KD fed in unrestricted amount is able to reduce seizure threshold in EL mice. Interestingly, supplementation of calories in the form of carbohydrate in the water of calorie-restricted EL mice results in a diminished anticonvulsant efficacy of the KD. In my effort to elucidate the neuroprotective mechanism(s) associated with these changes in metabolite availability, I started investigating the complex alterations occurring in multiple integrated neural and metabolic processes. Furthermore, I showed that a restricted KD diet improves aspects of the behavioral abnormalities seen in Rett mice, in particular with respect to anxiety. Finally, for the first time, I provide a standardized protocol for the implementation of diet therapies in the management of an array of neurological and neurodegenerative diseases, which ultimately may help elucidate the complex neuroprotective mechanism(s) of CR and the KD. This research overall has provided a new understanding in the therapeutic efficacy of diets in epilepsy and Rett Syndrome. / Thesis (PhD) — Boston College, 2010. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Biology.

The prevalence of Autism Spectrum Disorder (ASD) and its defining features has been increasingly investigated in genetic syndromes associated with intellectual disability, with syndrome specific profiles reported. The experience of catatonia and other movement disorders in people with ASD has been increasing highlighted within both research and diagnostic guidelines. However, these issues have not typically been investigated alongside other features of ASD within research into genetic syndromes. The first paper in this thesis provides a review of the literature on movement disorders in genetic syndromes associated with ASD, which focuses on the prevalence of reported movement disorders, the methods of assessment used, and the quality of research to date. An empirical study is reported in Paper 2. Within a cohort of individuals with Cornelia de Lange and Fragile X syndromes the prevalence of attenuated behaviour [autistic catatonia] is examined, based on parent/carer report, and the extent to which features of ASD predict later attenuated behaviour is investigated. Paper 3 provides a critical reflection on the first two papers as well as some wider considerations on undertaking research in this area. The results of both the literature review and the empirical study indicated that across a number of genetic syndromes (Angelman syndrome, Cornelia de Lange syndrome, Fragile X syndrome and Rett syndrome) attenuated behaviour [autistic catatonia] and/or movement disorders affect a substantial proportion of individuals. Furthermore, repetitive behaviours, one of the characteristic features of ASD, appear to predict later attenuated behaviour in Cornelia de Lange and Fragile X syndromesThe results presented in this thesis have important implications for the way services support individuals with specific genetic syndromes. Paper 1 confirms the high prevalence of movement problems in Angelman and Rett syndromes, and Paper 2 provides a new insight into movement problems in Cornelia de Lange and Fragile X syndromes. Movement disorders are reported to impact negatively on wellbeing and quality of life in people with ASD, and are likely to have a similar impact on the lives of people with genetic syndromes. Greater awareness and recognition of movement problems in CdLS and FXS is required, and although specialist services may already be aware of some of the above issues, there should be an increased emphasis on ensuring that community services are aware of the needs of individuals with genetic syndromes, including the implications of movement problems for support needs and quality of life.

Rett syndrome (RTT) is a severe neurological disorder that affects approximately 1:10000 girls. Classical RTT is defined by a developmental regression phase and subsequent stabilisation of diagnostic criteria, which include partial or complete loss of spoken language, dyspraxic gait and stereotypic hand movements such as hand mouthing. RTT is a monogenic disorder, with the majority of cases being due to loss-of-function mutations in MeCP2 (methyl-CpG binding protein 2). Due to this clear genotype-phenotype link multiple RTT mouse models have been used to elucidate the molecular details, and consequent neuropathogenesis, of this complex neurological disease, as well as for the development of potential therapeutics for RTT. However, as the molecular details become clearer, the need for a simpler model system becomes evident. Human induced pluripotent stem cells (hiPSCs) generated from RTT patient fibroblasts are an option; however the handling of these cells is laborious, time-consuming and expensive and they often differentiate into a heterogeneous population of cells. To explore an alternative human model system I have been genetically engineering and experimenting with the human dopaminergic LUHMES cell line. LUHMES cells are an immortalised pre-neuronal cell line derived from an 8-week old, female foetus and can readily be differentiated into a homogeneous population of mature, electrically active neurons in just one week. In this thesis I have assessed the phenotypic properties of the wild-type cell line, demonstrated the ease of genetic manipulation of LUHMES cells by CRISPR/Cas9 approaches, generated seven mutant MECP2 LUHMES cell lines and explored the potential of protein therapy as a therapeutic approach for RTT. The LUHMES cell line proves to be extremely easy to handle and robust and has yielded novel molecular insights into the function of MeCP2 in human neurons. In particular, MeCP2-null cells show a striking relationship between the level of gene body methylation and the extent of transcriptional upregulation when compared to wild-type neurons. In contrast neurons that express a form of MeCP2 that can bind to DNA but cannot recruit a transcriptional corepressor complex (the R306C mutant) do not exhibit substantial gene expression alterations, yet do display a consistent decrease in total RNA amount. This decrease in total RNA is recapitulated in MeCP2-null LUHMES-derived neurons and in brain regions from MeCP2-R306C mice. The requirement for functional DNA binding for normal gene-body methylation dependent gene repression is demonstrated by assessing LUHMES cells that overexpress MeCP2-R111G, a protein that cannot bind to DNA. Furthermore, overexpression of the MeCP2-R306C protein highlights the importance of NCoR binding for normal gene repression, but also demonstrates that MeCP2-R306C protein retains some gene repression activity. Thinking more broadly, this cell line also has applications as a model system for a variety of other neurological disorders; as a simplified model system to elucidate molecular and neurological phenotypes, and as a relevant human system that can be cultured in a high-throughput manner for testing therapeutic strategies.

Rett syndrome is a neurodevelopmental disorder that is predominately caused by mutations of the MECP2 gene. As neuronal apoptosis is not observed in RTT patients and MeCP2-deficient mice, the neurological deficits may be reversible. To address this, we reactivated MeCP2 expression ubiquitously in MeCP2-deficient mice after symptom onset. Our results showed that life span, behavioural performances, EEG activity, thermoregulation, and daily rhythmic activity were significantly improved after MeCP2 reactivation. Furthermore, the extent of improvement was dependent upon the efficiency of MeCP2 reactivation. To assess the role of the catecholaminergic system in Rett syndrome pathophysiology, we selectively preserved MeCP2 function within tyrosine hydroxylase expressing cells. We observed a significant improvement in the life span of male rescue mice and reduced sudden unexplained death rates in female rescue mice. Behavioural performances and EEG patterns were also significantly improved.

Rett syndrome is a neurodevelopmental disorder that is predominately caused by mutations of the MECP2 gene. As neuronal apoptosis is not observed in RTT patients and MeCP2-deficient mice, the neurological deficits may be reversible. To address this, we reactivated MeCP2 expression ubiquitously in MeCP2-deficient mice after symptom onset. Our results showed that life span, behavioural performances, EEG activity, thermoregulation, and daily rhythmic activity were significantly improved after MeCP2 reactivation. Furthermore, the extent of improvement was dependent upon the efficiency of MeCP2 reactivation. To assess the role of the catecholaminergic system in Rett syndrome pathophysiology, we selectively preserved MeCP2 function within tyrosine hydroxylase expressing cells. We observed a significant improvement in the life span of male rescue mice and reduced sudden unexplained death rates in female rescue mice. Behavioural performances and EEG patterns were also significantly improved.