HDAC inhibitors rescue MeCP2T158M speckles in a high content screen

Rett syndrome (OMIM 312750) is a rare neurodevelopmental disorder caused by de novo mutations in the Methyl-CpG Binding Protein 2 (MeCP2) gene located on the X-Chromosome, typically affecting girls. Currently, available therapy for Rett Syndrome is only symptomatic. Rett syndrome symptoms first appear between 6 to 18 months of age, characterized by microcephaly and lack of motor coordination being the most prevalent. The disease continues to progress until adulthood when it reaches a stationary phase. More than 800 different mutations causing Rett syndrome have been described, yet the most common is T158M (9% prevalence), located in the Methyl-Binding domain (MBD) of MeCP2. Due to its importance for DNA binding through recognition of methylated CpG, mutations in the MBD have a significant impact on the stability and function of MeCP2. MeCP2 is a nuclear protein and accumulates in liquid-liquid phase condensates visualized as speckles in NIH3T3 by microscopy. We developed a high content phenotypic assay, detecting fluorescent MeCP2 speckles in NIH3T3 cells. The assay allows to identify small molecules that stabilize MeCP2-T158M and phenotypically rescue speckle formation. To validate the assay, a collection of 3572 drugs was screened, including FDA-approved drugs, compounds in clinical trials and biologically annotated tool compounds. 18 hits were identified showing at least 25% of rescue of speckles in the mutant cell line while not affecting wild-type MeCP2 speckles. Primary hits were confirmed in a dose response assay and in a thermal shift assay with recombinant MeCP2. One class of identified hits represents histone deacetylase inhibitors (HDACis) showing 25% speckle rescue of mutant MeCP2 without toxicity. This screening strategycan be expanded to additional compound libraries and support novel drug discovery.