Human Genetics

, Volume 135, Issue 7, pp 685–698 | Cite as

Determining the role of skewed X-chromosome inactivation in developing muscle symptoms in carriers of Duchenne muscular dystrophy

  • Emanuela Viggiano
  • Manuela Ergoli
  • Esther Picillo
  • Luisa PolitanoEmail author


Duchenne and Becker dystrophinopathies (DMD and BMD) are X-linked recessive disorders caused by mutations in the dystrophin gene that lead to absent or reduced expression of dystrophin in both skeletal and heart muscles. DMD/BMD female carriers are usually asymptomatic, although about 8 % may exhibit muscle or cardiac symptoms. Several mechanisms leading to a reduced dystrophin have been hypothesized to explain the clinical manifestations and, in particular, the role of the skewed XCI is questioned. In this review, the mechanism of XCI and its involvement in the phenotype of BMD/DMD carriers with both a normal karyotype or with X;autosome translocations with breakpoints at Xp21 (locus of the DMD gene) will be analyzed. We have previously observed that DMD carriers with moderate/severe muscle involvement, exhibit a moderate or extremely skewed XCI, in particular if presenting with an early onset of symptoms, while DMD carriers with mild muscle involvement present a random XCI. Moreover, we found that among 87.1 % of the carriers with X;autosome translocations involving the locus Xp21 who developed signs and symptoms of dystrophinopathy such as proximal muscle weakness, difficulty to run, jump and climb stairs, 95.2 % had a skewed XCI pattern in lymphocytes. These data support the hypothesis that skewed XCI is involved in the onset of phenotype in DMD carriers, the X chromosome carrying the normal DMD gene being preferentially inactivated and leading to a moderate–severe muscle involvement.


Dyskeratosis Congenita Muscle Symptom Dystrophin Expression XIST Gene Autosome Translocation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank the patients and families for their cooperation. The samples analyzed were derived from the Naples Human Genetic BioBank that is part of Telethon Network of Genetic Biobanks and EuroBioBank. The financial support of Telethon (Project GTB12001H to LP) is acknowledged.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Emanuela Viggiano
    • 1
  • Manuela Ergoli
    • 1
  • Esther Picillo
    • 1
  • Luisa Politano
    • 1
    Email author
  1. 1.Cardiomyology and Medical Genetics, Department of Experimental Medicine, I PoliclinicoSecond University of NaplesNaplesItaly

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