Abstract
An involvement of the immune system has been suggested in Rett syndrome (RTT), a devastating neurodevelopmental disorder related to oxidative stress, and caused by a mutation in the methyl-CpG binding protein 2 gene ( MECP2 ) or, more rarely, cyclin-dependent kinase-like 5 ( CDKL5 ). To date, it is unclear whether both mutations may have an impact on the circulating cytokine patterns. In the present study, cytokines involved in the Th1-, Th2-, and T regulatory (T-reg) response, as well as chemokines, were investigated in MECP2 - ( MECP2 -RTT) ( n = 16 ) and CDKL5 -Rett syndrome ( CDKL5 -RTT) ( n = 8 ), before and after ω -3 polyunsaturated fatty acids (PUFAs) supplementation. A major cytokine dysregulation was evidenced in untreated RTT patients. In MECP2 -RTT, a Th2-shifted balance was evidenced, whereas in CDKL5 -RTT both Th1- and Th2-related cytokines (except for IL-4) were upregulated. In MECP2 -RTT, decreased levels of IL-22 were observed, whereas increased IL-22 and T-reg cytokine levels were evidenced in CDKL5 -RTT. Chemokines were unchanged. The cytokine dysregulation was proportional to clinical severity, inflammatory status, and redox imbalance. Omega-3 PUFAs partially counterbalanced cytokine changes, as well as aberrant redox homeostasis and the inflammatory status. RTT is associated with a subclinical immune dysregulation as the likely consequence of a defective inflammation regulatory signaling system.