In vitro cellular phenotypes of cortical neurons from R255X MECP2 knock-in mice are improved by either expression of wildtype MeCP2 or ‘read-through’ with G418

Approximately 60% of individuals with Rett syndrome (RTT) carry a nonsense variant in the MECP2 gene; thus, there is an unmet need to identify novel nonsense suppression compound(s) that can restore full length MeCP2 protein levels and function. Here, we characterized neuronal phenotypes in cultured cortical neurons from newborn knock-in mice harboring the MECP2 R255X variant. After 2 weeks in vitro , R255X mutant neurons showed smaller cell bodies, shorter dendrites, fewer dendritic branches, and a lower density of excitatory synapses when compared to wildtype (WT) neurons. Transduction of AAV9-MeCP2-GFP in R255X mutant neurons made these cellular phenotypes similar to those in WT neurons, including soma size, dendritic length and branching, and excitatory synapse density. As proof of principle for the potential clinical use of ‘read-through’ compounds, cultured R255X mutant neurons treated with the aminoglycoside G418 for 72h in vitro showed cell body size and excitatory synapse density similar to WT neurons. We expect these combined approaches will identify effective compounds to suppress translation termination at a premature termination codon, which can be moved to further preclinical functional and behavioral studies in R255X MECP2 knock-in mice.