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Updated: Apr 6, 2026

Real-Time Analysis of Bioenergetics in Primary Human Retinal Pigment Epithelial Cells Using High-Resolution Respirometry
Published on: February 3, 2023
Impaired enzymatic defensive activity, mitochondrial dysfunction and proteasome activation are involved in RTT cell
Carlo Cervellati1, Claudia Sticozzi2, Arianna Romani1
1Department of Biomedical and Specialist Surgical Sciences, Section of Medical Biochemistry, Molecular Biology and Genetics, University of Ferrara, Ferrara, Italy.
Abstract:
A strong correlation between oxidative stress (OS) and Rett syndrome (RTT), a rare neurodevelopmental disorder affecting females in the 95% of the cases, has been well documented although the source of OS and the effect of a redox imbalance in this pathology has not been yet investigated. Using freshly isolated skin fibroblasts from RTT patients and healthy subjects, we have demonstrated in RTT cells high levels of H2O2 and HNE protein adducts. These findings correlated with the constitutive activation of NADPH-oxidase (NOX) and that was prevented by a NOX inhibitor and iron chelator pre-treatment, showing its direct involvement. In parallel, we demonstrated an increase in mitochondrial oxidant production, altered mitochondrial biogenesis and impaired proteasome activity in RTT samples. Further, we found that the key cellular defensive enzymes: glutathione peroxidase, superoxide dismutase and thioredoxin reductases activities were also significantly lower in RTT. Taken all together, our findings suggest that the systemic OS levels in RTT can be a consequence of both: increased endogenous oxidants as well as altered mitochondrial biogenesis with a decreased activity of defensive enzymes that leads to posttranslational oxidant protein modification and a proteasome activity impairment.
Insights
Oxidative stress (OS) in Rett syndrome (RTT) stems from increased oxidants and impaired defense mechanisms. This study reveals elevated H2O2, NOX activation, and mitochondrial dysfunction in RTT cells, contributing to redox imbalance.
Area of Science:
- Neuroscience
- Biochemistry
- Cell Biology
Background:
- Rett syndrome (RTT) is a rare neurodevelopmental disorder primarily affecting females.
- A strong correlation between oxidative stress (OS) and RTT is documented, but its source and redox imbalance effects remain unclear.
Purpose of the Study:
- To investigate the sources of OS and the impact of redox imbalance in RTT.
- To analyze cellular mechanisms contributing to OS in RTT patients.
Main Methods:
- Analysis of skin fibroblasts from RTT patients and healthy controls.
- Measurement of hydrogen peroxide (H2O2) and 4-hydroxynonenal (HNE) protein adducts.
- Assessment of NADPH-oxidase (NOX) activity, mitochondrial function, and proteasome activity.
- Enzyme activity assays for glutathione peroxidase, superoxide dismutase, and thioredoxin reductases.
Main Results:
- RTT fibroblasts exhibited elevated H2O2 and HNE protein adducts.
- Constitutive activation of NOX was observed in RTT cells, responsive to NOX inhibitors and iron chelators.
- Increased mitochondrial oxidant production, altered mitochondrial biogenesis, and impaired proteasome activity were found in RTT samples.
- Activities of key antioxidant enzymes (glutathione peroxidase, superoxide dismutase, thioredoxin reductases) were significantly reduced in RTT.
Conclusions:
- Systemic OS in RTT results from increased endogenous oxidants and impaired mitochondrial biogenesis.
- Decreased antioxidant enzyme activity contributes to posttranslational protein modification and proteasome impairment in RTT.
- These findings highlight the critical role of redox imbalance in RTT pathogenesis.
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