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Dystrophinopathies

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Neuromuscular Disorders in Clinical Practice

Abstract

The dystrophinopathies include a spectrum of muscle diseases ranging from asymptomatic increase in creatine kinase, muscle cramps, or cardiomyopathy to Becker and Duchenne muscular dystrophies. All phenotypes are caused by mutations in dystrophin gene (DMD) at Xp21 which encodes dystrophin. This chapter discusses the dystrophinopathies including their genetics and pathogenesis, management, and available and emerging treatments. Although there is no curative treatment for DMD, there are many areas of therapeutic intervention under investigation including repair of the DMD gene defect through viral-mediated gene replacement, exon skipping, and mutation suppression.

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References

  1. Emery A. Population frequency of inherited neuromuscular diseases – A world survey. Neuromuscul Disord. 1991;1:19–29.

    Article  PubMed  CAS  Google Scholar 

  2. Mendell JR, Shilling C, Leslie ND, et al. Evidence based path to newborn screening for Duchenne muscular dystrophy. Ann Neurol. 2012;71(3):304–13.

    Article  PubMed  CAS  Google Scholar 

  3. Prelle A, Medori R, Moggio M, et al. Dystrophin deficiency in a case of congenital myopathy. J Neurol. 1992;239(2):76–8.

    Article  PubMed  CAS  Google Scholar 

  4. Becker PE, Kiener F. A new x-chromosomal muscular dystrophy. Arch Psychiatr Nervenkr Z Gesamte Neurol Psychiatr. 1955;193(4):427–48.

    Article  PubMed  CAS  Google Scholar 

  5. Greenstein RM, Reardon MP, Chan TS, et al. An (X;11) translocation in a girl with Duchenne muscular dystrophy. Repository identification No. GM1695. Cytogenet Cell Genet. 1980;27(4):268.

    Article  PubMed  CAS  Google Scholar 

  6. Davies KE, Pearson PL, Harper PS, et al. Linkage analysis of two cloned DNA sequences flanking the Duchenne muscular dystrophy locus on the short arm of the human X chromosome. Nucleic Acids Res. 1983;11(8):2303–12.

    Article  PubMed  CAS  Google Scholar 

  7. Francke U, Ochs HD, de Martinville B, et al. Minor Xp21 chromosome deletion in a male associated with expression of Duchenne muscular dystrophy, chronic granulomatous disease, retinitis pigmentosa, and McLeod syndrome. Am J Hum Genet. 1985;37(2):250–67.

    PubMed  CAS  Google Scholar 

  8. Boyd Y, Buckle V, Holt S, Munro E, Hunter D, Craig I. Muscular dystrophy in girls with X; autosome translocations. J Med Genet. 1986;23(6):484–90.

    Article  PubMed  CAS  Google Scholar 

  9. Koenig M, Hoffman EP, Bertelson CJ, Monaco AP, Feener C, Kunkel LM. Complete cloning of the Duchenne muscular dystrophy (DMD) cDNA and preliminary genomic organization of the DMD gene in normal and affected individuals. Cell. 1987;50(3):509–17.

    Article  PubMed  CAS  Google Scholar 

  10. Hoffman EP, Brown Jr RH, Kunkel LM. Dystrophin: the protein product of the Duchenne muscular dystrophy locus. Cell. 1987;51(6):919–28.

    Article  PubMed  CAS  Google Scholar 

  11. Koenig M, Kunkel LM. Detailed analysis of the repeat domain of dystrophin reveals four potential hinge segments that may confer flexibility. J Biol Chem. 1990;265(8):4560–6.

    PubMed  CAS  Google Scholar 

  12. Koenig M, Monaco AP, Kunkel LM. The complete sequence of dystrophin predicts a rod-shaped cytoskeletal protein. Cell. 1988;53(2):219–28.

    Article  PubMed  CAS  Google Scholar 

  13. Bork P, Sudol M. The WW domain: a signalling site in dystrophin? Trends Biochem Sci. 1994;19(12):531–3.

    Article  PubMed  CAS  Google Scholar 

  14. Ponting CP, Blake DJ, Davies KE, Kendrick-Jones J, Winder SJ. ZZ and TAZ: new putative zinc fingers in dystrophin and other proteins. Trends Biochem Sci. 1996;21(1):11–3.

    PubMed  CAS  Google Scholar 

  15. Albrecht DE, Froehner SC. Syntrophins and dystrobrevins: defining the dystrophin scaffold at synapses. Neurosignals. 2002;11(3):123–9.

    Article  PubMed  CAS  Google Scholar 

  16. Makover A, Zuk D, Breakstone J, Yaffe D, Nudel U. Brain-type and muscle-type promoters of the dystrophin gene differ greatly in structure. Neuromuscul Disord. 1991;1(1):39–45.

    Article  PubMed  CAS  Google Scholar 

  17. Lederfein D, Levy Z, Augier N, et al. A 71-kilodalton protein is a major product of the Duchenne muscular dystrophy gene in brain and other nonmuscle tissues. Proc Natl Acad Sci U S A. 1992;89(12):5346–50.

    Article  PubMed  CAS  Google Scholar 

  18. Sadoulet-Puccio HM, Kunkel LM. Dystrophin and its isoforms. Brain Pathol. 1996;6(1):25–35.

    Article  PubMed  CAS  Google Scholar 

  19. Nudel U, Zuk D, Einat P, et al. Duchenne muscular dystrophy gene product is not identical in muscle and brain. Nature. 1989;337(6202):76–8.

    Article  PubMed  CAS  Google Scholar 

  20. Gorecki DC, Monaco AP, Derry JM, Walker AP, Barnard EA, Barnard PJ. Expression of four alternative dystrophin transcripts in brain regions regulated by different promoters. Hum Mol Genet. 1992;1(7):505–10.

    Article  PubMed  CAS  Google Scholar 

  21. Nishio H, Takeshima Y, Narita N, et al. Identification of a novel first exon in the human dystrophin gene and of a new promoter located more than 500 kb upstream of the nearest known promoter. J Clin Invest. 1994;94(3):1037–42.

    Article  PubMed  CAS  Google Scholar 

  22. D’Souza VN, Nguyen TM, Morris GE, Karges W, Pillers DA, Ray PN. A novel dystrophin isoform is required for normal retinal electrophysiology. Hum Mol Genet. 1995;4(5):837–42.

    Article  PubMed  Google Scholar 

  23. Lidov HG, Selig S, Kunkel LM. Dp140: A novel 140 kDa CNS transcript from the dystrophin locus. Hum Mol Genet. 1995;4(3):329–35.

    Article  PubMed  CAS  Google Scholar 

  24. Byers TJ, Lidov HG, Kunkel LM. An alternative dystrophin transcript specific to peripheral nerve. Nat Genet. 1993;4(1):77–81.

    Article  PubMed  CAS  Google Scholar 

  25. Lederfein D, Yaffe D, Nudel U. A housekeeping type promoter, located in the 3′ region of the Duchenne muscular dystrophy gene, controls the expression of Dp71, a major product of the gene. Hum Mol Genet. 1993;2(11):1883–8.

    Article  PubMed  CAS  Google Scholar 

  26. Tinsley JM, Blake DJ, Davies KE. Apo-dystrophin-3: A 2.2kb transcript from the DMD locus encoding the dystrophin glycoprotein binding site. Hum Mol Genet. 1993;2(5):521–4.

    Article  PubMed  CAS  Google Scholar 

  27. Daoud F, Angeard N, Demerre B, et al. Analysis of Dp71 contribution in the severity of mental retardation through comparison of Duchenne and Becker patients differing by mutation consequences on Dp71 expression. Hum Mol Genet. 2009;18(20):3779–94.

    Article  PubMed  CAS  Google Scholar 

  28. Brown Jr RH. Dystrophin-associated proteins and the muscular dystrophies. Annu Rev Med. 1997;48:457–66.

    Article  PubMed  CAS  Google Scholar 

  29. Ervasti JM. Dystrophin, its interactions with other proteins, and implications for muscular dystrophy. Biochim Biophys Acta. 2007;1772(2):108–17.

    Article  PubMed  CAS  Google Scholar 

  30. Nigro V, Aurino S, Piluso G. Limb girdle muscular dystrophies: Update on genetic diagnosis and therapeutic approaches. Curr Opin Neurol. 2011;24(5):429–36.

    Article  PubMed  CAS  Google Scholar 

  31. Waite A, Tinsley CL, Locke M, Blake DJ. The neurobiology of the dystrophin-associated glycoprotein complex. Ann Med. 2009;41(5):344–59.

    Article  PubMed  CAS  Google Scholar 

  32. Ervasti JM, Campbell KP. A role for the dystrophin-glycoprotein complex as a transmembrane linker between laminin and actin. J Cell Biol. 1993;122(4):809–23.

    Article  PubMed  CAS  Google Scholar 

  33. Gavassini BF, Carboni N, Nielsen JE, et al. Clinical and molecular characterization of limb-girdle muscular dystrophy due to LAMA2 mutations. Muscle Nerve. 2011;44(5):703–9.

    Article  PubMed  CAS  Google Scholar 

  34. Hayashi YK, Chou FL, Engvall E, et al. Mutations in the integrin alpha7 gene cause congenital myopathy. Nat Genet. 1998;19(1):94–7.

    Article  PubMed  CAS  Google Scholar 

  35. Yoshida M, Suzuki A, Yamamoto H, Noguchi S, Mizuno Y, Ozawa E. Dissociation of the complex of dystrophin and its associated proteins into several unique groups by n-octyl beta-D-glucoside. Eur J Biochem. 1994;222(3):1055–61.

    Article  PubMed  CAS  Google Scholar 

  36. Suzuki A, Yoshida M, Yamamoto H, Ozawa E. Glycoprotein-binding site of dystrophin is confined to the cysteine-rich domain and the first half of the carboxy-terminal domain. FEBS Lett. 1992;308(2):154–60.

    Article  PubMed  CAS  Google Scholar 

  37. Crosbie RH, Heighway J, Venzke DP, Lee JC, Campbell KP. Sarcospan, the 25-kDa transmembrane component of the dystrophin-glycoprotein complex. J Biol Chem. 1997;272(50):31221–4.

    Article  PubMed  CAS  Google Scholar 

  38. Chan YM, Bonnemann CG, Lidov HG, Kunkel LM. Molecular organization of sarcoglycan complex in mouse myotubes in culture. J Cell Biol. 1998;143(7):2033–44.

    Article  PubMed  CAS  Google Scholar 

  39. Sandona D, Betto R. Sarcoglycanopathies: molecular pathogenesis and therapeutic prospects. Expert Rev Mol Med. 2009;11:e28.

    Article  PubMed  Google Scholar 

  40. Kameya S, Miyagoe Y, Nonaka I, et al. alpha1-syntrophin gene disruption results in the absence of neuronal-type nitric-oxide synthase at the sarcolemma but does not induce muscle degeneration. J Biol Chem. 1999;274(4):2193–200.

    Article  PubMed  CAS  Google Scholar 

  41. Yoshida M, Hama H, Ishikawa-Sakurai M, et al. Biochemical evidence for association of dystrobrevin with the sarcoglycan-sarcospan complex as a basis for understanding sarcoglycanopathy. Hum Mol Genet. 2000;9(7):1033–40.

    Article  PubMed  CAS  Google Scholar 

  42. Brenman JE, Chao DS, Xia H, Aldape K, Bredt DS. Nitric oxide synthase complexed with dystrophin and absent from skeletal muscle sarcolemma in Duchenne muscular dystrophy. Cell. 1995;82(5):743–52.

    Article  PubMed  CAS  Google Scholar 

  43. Flanigan KM, von Niederhausern A, Dunn DM, Alder J, Mendell JR, Weiss RB. Rapid direct sequence analysis of the dystrophin gene. Am J Hum Genet. 2003;72(4):931–9.

    Article  PubMed  CAS  Google Scholar 

  44. Takeshima Y, Yagi M, Okizuka Y, et al. Mutation spectrum of the dystrophin gene in 442 Duchenne/Becker muscular dystrophy cases from one Japanese referral center. J Hum Genet. 2010;55(6):379–88.

    Article  PubMed  CAS  Google Scholar 

  45. Mendell JR, Buzin CH, Feng J, et al. Diagnosis of Duchenne dystrophy by enhanced detection of small mutations. Neurology. 2001;57(4):645–50.

    Article  PubMed  CAS  Google Scholar 

  46. Flanigan KM, Dunn DM, von Niederhausern A, et al. Mutational spectrum of DMD mutations in dystrophinopathy patients: Application of modern diagnostic techniques to a large cohort. Hum Mutat. 2009;30(12):1657–66.

    Article  PubMed  CAS  Google Scholar 

  47. Towbin JA, Hejtmancik JF, Brink P, et al. X-linked dilated cardiomyopathy. Molecular genetic evidence of linkage to the Duchenne muscular dystrophy (dystrophin) gene at the Xp21 locus. Circulation. 1993;87(6):1854–65.

    Article  PubMed  CAS  Google Scholar 

  48. Beggs AH. Dystrophinopathy, the expanding phenotype. Dystrophin abnormalities in X-linked dilated cardiomyopathy. Circulation. 1997;95(10):2344–7.

    Article  PubMed  CAS  Google Scholar 

  49. Yoshida K, Nakamura A, Yazaki M, Ikeda S, Takeda S. Insertional mutation by transposable element, L1, in the DMD gene results in X-linked dilated cardiomyopathy. Hum Mol Genet. 1998;7(7):1129–32.

    Article  PubMed  CAS  Google Scholar 

  50. Ortiz-Lopez R, Li H, Su J, Goytia V, Towbin JA. Evidence for a dystrophin missense mutation as a cause of X-linked dilated cardiomyopathy. Circulation. 1997;95(10):2434–40.

    Article  PubMed  CAS  Google Scholar 

  51. Kaspar RW, Allen HD, Ray WC, et al. Analysis of dystrophin deletion mutations predicts age of cardiomyopathy onset in Becker muscular dystrophy. Circ Cardiovasc Genet. 2009;2(6):544–51.

    Article  PubMed  CAS  Google Scholar 

  52. Bakker E, Van Broeckhoven C, Bonten EJ, et al. Germline mosaicism and Duchenne muscular dystrophy mutations. Nature. 1987;329(6139):554–6.

    Article  PubMed  CAS  Google Scholar 

  53. Darras BT, Francke U. A partial deletion of the muscular dystrophy gene transmitted twice by an unaffected male. Nature. 1987;329(6139):556–8.

    Article  PubMed  CAS  Google Scholar 

  54. Engel AG, Franzini-Armstrong C. Myology. 2nd ed. New York: McGraw-Hill; 1994.

    Google Scholar 

  55. van Essen AJ, Abbs S, Baiget M, et al. Parental origin and germline mosaicism of deletions and duplications of the dystrophin gene: a European study. Hum Genet. 1992;88(3):249–57.

    PubMed  Google Scholar 

  56. Mandel JL. Dystrophin. The gene and its product. Nature. 1989;339(6226):584–6.

    Article  PubMed  CAS  Google Scholar 

  57. Matthews PM, Benjamin D, Van Bakel I, et al. Muscle X-inactivation patterns and dystrophin expression in Duchenne muscular dystrophy carriers. Neuromuscul Disord. 1995;5(3):209–20.

    Article  PubMed  CAS  Google Scholar 

  58. Matthews PM, Karpati G. Pattern of X-chromosome inactivation as a key determinant of the clinicopathologic phenotype of Duchenne muscular dystrophy carriers. Neurology. 1996;46(4):1189–91.

    Article  PubMed  CAS  Google Scholar 

  59. Pena SD, Karpati G, Carpenter S, Fraser FC. The clinical consequences of X-chromosome inactivation: Duchenne muscular ­dystrophy in one of monozygotic twins. J Neurol Sci. 1987;79(3):337–44.

    Article  PubMed  CAS  Google Scholar 

  60. Mokri B, Engel AG. Duchenne dystrophy: electron microscopic findings pointing to a basic or early abnormality in the plasma membrane of the muscle fiber. Neurology. 1975;25(12):1111–20.

    Article  PubMed  CAS  Google Scholar 

  61. Menke A, Jockusch H. Decreased osmotic stability of dystrophin-less muscle cells from the mdx mouse. Nature. 1991;349(6304):69–71.

    Article  PubMed  CAS  Google Scholar 

  62. Matsumura K, Campbell KP. Dystrophin-glycoprotein complex: its role in the molecular pathogenesis of muscular dystrophies. Muscle Nerve. 1994;17(1):2–15.

    Article  PubMed  CAS  Google Scholar 

  63. Petrof BJ, Shrager JB, Stedman HH, Kelly AM, Sweeney HL. Dystrophin protects the sarcolemma from stresses developed during muscle contraction. Proc Natl Acad Sci U S A. 1993;90(8):3710–4.

    Article  PubMed  CAS  Google Scholar 

  64. Carpenter S, Karpati G. Segmental necrosis and its demarcation in experimental micropuncture injury of skeletal muscle fibers. J Neuropathol Exp Neurol. 1989;48(2):154–70.

    Article  PubMed  CAS  Google Scholar 

  65. Mendell JR, Engel WK, Derrer EC. Duchenne muscular dystrophy: functional ischemia reproduces its characteristic lesions. Science. 1971;172(988):1143–5.

    Article  PubMed  CAS  Google Scholar 

  66. Percival JM, Anderson KN, Huang P, Adams ME, Froehner SC. Golgi and sarcolemmal neuronal NOS differentially regulate contraction-induced fatigue and vasoconstriction in exercising mouse skeletal muscle. J Clin Invest. 2010;120(3):816–26.

    Article  PubMed  CAS  Google Scholar 

  67. Brooke MH, Fenichel GM, Griggs RC, et al. Clinical investigation in Duchenne dystrophy: 2. Determination of the “power” of therapeutic trials based on the natural history. Muscle Nerve. 1983;6(2):91–103.

    Article  PubMed  CAS  Google Scholar 

  68. Griggs RC, Mendell JR, Miller RG. Evaluation and treatment of myopathies. Philadelphia: Davis; 1995.

    Google Scholar 

  69. Perlstein MA. Deep-tendon reflexes in pseudohypertrophic muscular dystrophy: rate and order of loss. JAMA. 1965;193:540–1.

    Article  PubMed  CAS  Google Scholar 

  70. Kaminski HJ, al-Hakim M, Leigh RJ, Katirji MB, Ruff RL. Extraocular muscles are spared in advanced Duchenne dystrophy. Ann Neurol. 1992;32(4):586–8.

    Article  PubMed  CAS  Google Scholar 

  71. Wagner MB, Vignos Jr PJ, Carlozzi C. Duchenne muscular dystrophy: a study of wrist and hand function. Muscle Nerve. 1989;12(3):236–44.

    Article  PubMed  CAS  Google Scholar 

  72. Brooke MH, Fenichel GM, Griggs RC, et al. Duchenne muscular dystrophy: patterns of clinical progression and effects of supportive therapy. Neurology. 1989;39(4):475–81.

    Article  PubMed  CAS  Google Scholar 

  73. Dubowitz V. Muscle biopsy: a practical approach. London: Bailliere Tindall; 1985.

    Google Scholar 

  74. Fukunaga H, Sonoda Y, Atsuchi H, Osame M. Respiratory failure and its care in Duchenne muscular dystrophy. Rinsho Shinkeigaku. 1991;31(2):154–8.

    PubMed  CAS  Google Scholar 

  75. Nigro G, Comi LI, Politano L, Bain RJ. The incidence and evolution of cardiomyopathy in Duchenne muscular dystrophy. Int J Cardiol. 1990;26(3):271–7.

    Article  PubMed  CAS  Google Scholar 

  76. Griggs RC, Reeves W, Moxley RT. The heart in Duchenne dystrophy. In: Rowland LP, editor. Pathogenesis of human muscular dystrophies. Amsterdam: Excerpta Medica; 1977. p. 661.

    Google Scholar 

  77. James J, Kinnett K, Wang Y, Ittenbach RF, Benson DW, Cripe L. Electrocardiographic abnormalities in very young Duchenne muscular dystrophy patients precede the onset of cardiac dysfunction. Neuromuscul Disord. 2011;21(7):462–7.

    Article  PubMed  Google Scholar 

  78. Thrush PT, Allen HD, Viollet L, Mendell JR. Re-examination of the electrocardiogram in boys with Duchenne muscular dystrophy and correlation with its dilated cardiomyopathy. Am J Cardiol. 2009;103(2):262–5.

    Article  PubMed  Google Scholar 

  79. Frankel KA, Rosser RJ. The pathology of the heart in progressive muscular dystrophy: epimyocardial fibrosis. Hum Pathol. 1976;7(4):375–86.

    Article  PubMed  CAS  Google Scholar 

  80. James TN. Observations on the cardiovascular involvement, including the cardiac conduction system, in progressive muscular dystrophy. Am Heart J. 1962;63:48–56.

    Article  PubMed  CAS  Google Scholar 

  81. Perloff JK, Roberts WC, De Leon Jr AC, O’Doherty D. The distinctive electrocardiogram of Duchenne’s progressive muscular dystrophy. An electrocardiographic-pathologic correlative study. Am J Med. 1967;42(2):179–88.

    Article  PubMed  CAS  Google Scholar 

  82. Bilchick KC, Salerno M, Plitt D, et al. Prevalence and distribution of regional scar in dysfunctional myocardial segments in Duchenne muscular dystrophy. J Cardiovasc Magn Reson. 2011;13:20.

    Article  PubMed  Google Scholar 

  83. Allen HD, Mendell JM, Flanigan K, Hoffman T. The heart in muscular dystrophies. In: HD Allen, DJ Driscoll, RE Shaddy, TF Feltes, editors. Moss and Adams’ heart disease in infants, children and adolescents. 8th ed. Philadelphia: Williams & Wilkins Publishers; 2012.

    Google Scholar 

  84. Farah MG, Evans EB, Vignos Jr PJ. Echocardiographic evaluation of left ventricular function in Duchenne’s muscular dystrophy. Am J Med. 1980;69(2):248–54.

    Article  PubMed  CAS  Google Scholar 

  85. Mento G, Tarantino V, Bisiacchi PS. The neuropsychological profile of infantile Duchenne muscular dystrophy. Clin Neuropsychol. 2011;25(8):1359–77.

    Article  PubMed  Google Scholar 

  86. Daoud F, Candelario-Martinez A, Billard JM, et al. Role of mental retardation-associated dystrophin-gene product Dp71 in excitatory synapse organization, synaptic plasticity and behavioral functions. PLoS One. 2009;4(8):e6574.

    Article  CAS  Google Scholar 

  87. Leibowitz D, Dubowitz V. Intellect and behaviour in Duchenne muscular dystrophy. Dev Med Child Neurol. 1981;23(5):577–90.

    PubMed  CAS  Google Scholar 

  88. Barohn RJ, Levine EJ, Olson JO, Mendell JR. Gastric hypomotility in Duchenne’s muscular dystrophy. N Engl J Med. 1988;319(1):15–8.

    Article  PubMed  CAS  Google Scholar 

  89. Yazaki M, Yoshida K, Nakamura A, et al. Clinical characteristics of aged Becker muscular dystrophy patients with onset after 30 years. Eur Neurol. 1999;42(3):145–9.

    Article  PubMed  CAS  Google Scholar 

  90. Hoffman EP, Fischbeck KH, Brown RH, et al. Characterization of dystrophin in muscle-biopsy specimens from patients with Duchenne’s or Becker’s muscular dystrophy. N Engl J Med. 1988;318(21):1363–8.

    Article  PubMed  CAS  Google Scholar 

  91. Maeda M, Nakao S, Miyazato H, et al. Cardiac dystrophin abnormalities in Becker muscular dystrophy assessed by endomyocardial biopsy. Am Heart J. 1995;129(4):702–7.

    Article  PubMed  CAS  Google Scholar 

  92. Doriguzzi C, Palmucci L, Mongini T, Chiado-Piat L, Restagno G, Ferrone M. Exercise intolerance and recurrent myoglobinuria as the only expression of Xp21 Becker type muscular dystrophy. J Neurol. 1993;240(5):269–71.

    Article  PubMed  CAS  Google Scholar 

  93. Melacini P, Fanin M, Danieli GA, et al. Cardiac involvement in Becker muscular dystrophy. J Am Coll Cardiol. 1993;22(7):1927–34.

    Article  PubMed  CAS  Google Scholar 

  94. Angelini C, Fanin M, Freda MP, et al. Prognostic factors in mild dystrophinopathies. J Neurol Sci. 1996;142(1–2):70–8.

    Article  PubMed  CAS  Google Scholar 

  95. Yilmaz A, Gdynia HJ, Baccouche H, et al. Cardiac involvement in patients with Becker muscular dystrophy: new diagnostic and pathophysiological insights by a CMR approach. J Cardiovasc Magn Reson. 2008;10:50.

    Article  PubMed  Google Scholar 

  96. Emery AE. Abnormalities of the electrocardiogram in female carriers of Duchenne muscular dystrophy. Br Med J. 1969;2(5654):418–20.

    Article  PubMed  CAS  Google Scholar 

  97. Hoffman EP, Kunkel LM, Angelini C, Clarke A, Johnson M, Harris JB. Improved diagnosis of Becker muscular dystrophy by dystrophin testing. Neurology. 1989;39(8):1011–7.

    Article  PubMed  CAS  Google Scholar 

  98. Samaha FJ, Quinlan JG. Myalgia and cramps: dystrophinopathy with wide-ranging laboratory findings. J Child Neurol. 1996;11(1):21–4.

    Article  PubMed  CAS  Google Scholar 

  99. Kuhn E, Fiehn W, Schroder JM, Assmus H, Wagner A. Early myocardial disease and cramping myalgia in Becker-type muscular dystrophy: a kindred. Neurology. 1979;29(8):1144–9.

    Article  PubMed  CAS  Google Scholar 

  100. Borgeat A, Goy JJ, Sigwart U. Acute pulmonary edema as the inaugural symptom of Becker’s muscular dystrophy in a 19-year-old patient. Clin Cardiol. 1987;10(2):127–9.

    Article  PubMed  CAS  Google Scholar 

  101. Yazawa M, Ikeda S, Owa M, et al. A family of Becker’s progressive muscular dystrophy with severe cardiomyopathy. Eur Neurol. 1987;27(1):13–9.

    Article  PubMed  CAS  Google Scholar 

  102. Casazza F, Brambilla G, Salvato A, Morandi L, Gronda E, Bonacina E. Cardiac transplantation in Becker muscular dystrophy. J Neurol. 1988;235(8):496–8.

    Article  PubMed  CAS  Google Scholar 

  103. Sethna NF, Rockoff MA, Worthen HM, Rosnow JM. Anesthesia-related complications in children with Duchenne muscular dystrophy. Anesthesiology. 1988;68(3):462–5.

    Article  PubMed  CAS  Google Scholar 

  104. Connuck DM, Sleeper LA, Colan SD, et al. Characteristics and outcomes of cardiomyopathy in children with Duchenne or Becker muscular dystrophy: a comparative study from the Pediatric Cardiomyopathy Registry. Am Heart J. 2008;155(6):998–1005.

    Article  PubMed  Google Scholar 

  105. Cox GF, Kunkel LM. Dystrophies and heart disease. Curr Opin Cardiol. 1997;12(3):329–43.

    Article  PubMed  CAS  Google Scholar 

  106. Cartier L, Hernandez JE, Stuardo A, Gonzalez J, Villagra R. Quadriceps myopathy: a type of late focal dystrophy in a case. Rev Med Chil. 1995;123(1):81–4.

    PubMed  CAS  Google Scholar 

  107. Sunohara N, Arahata K, Hoffman EP, et al. Quadriceps myopathy: forme fruste of Becker muscular dystrophy. Ann Neurol. 1990;28(5):634–9.

    Article  PubMed  CAS  Google Scholar 

  108. Wada Y, Itoh Y, Furukawa T, Tsukagoshi H, Arahata K. “Quadriceps myopathy”: a clinical variant form of Becker muscular dystrophy. J Neurol. 1990;237(5):310–2.

    Article  PubMed  CAS  Google Scholar 

  109. Beggs AH, Hoffman EP, Snyder JR, et al. Exploring the molecular basis for variability among patients with Becker muscular dystrophy: dystrophin gene and protein studies. Am J Hum Genet. 1991;49(1):54–67.

    PubMed  CAS  Google Scholar 

  110. von Mitzlaff HC, Liechti-Gallati S, Rosler KM, Burgunder JM. Quadriceps myopathy as dystrophin-associated myopathy. Schweiz Med Wochenschr. 1993;123(40):1865–9.

    Google Scholar 

  111. Gospe Jr SM, Lazaro RP, Lava NS, Grootscholten PM, Scott MO, Fischbeck KH. Familial X-linked myalgia and cramps: a nonprogressive myopathy associated with a deletion in the dystrophin gene. Neurology. 1989;39(10):1277–80.

    Article  PubMed  Google Scholar 

  112. Donofrio PD, Challa VR, Hackshaw BT, Mills SA, Cordell AR. Cardiac transplantation in a patient with muscular dystrophy and cardiomyopathy. Arch Neurol. 1989;46(6):705–7.

    Article  PubMed  CAS  Google Scholar 

  113. Palmucci L, Doriguzzi C, Mongini T, et al. Dilating cardiomyopathy as the expression of Xp21 Becker type muscular dystrophy. J Neurol Sci. 1992;111(2):218–21.

    Article  PubMed  CAS  Google Scholar 

  114. Muntoni F, Cau M, Ganau A, et al. Brief report: deletion of the dystrophin muscle-promoter region associated with X-linked dilated cardiomyopathy. N Engl J Med. 1993;329(13):921–5.

    Article  PubMed  CAS  Google Scholar 

  115. Emery AE. Emery-Dreifuss syndrome. J Med Genet. 1989;26(10):637–41.

    Article  PubMed  CAS  Google Scholar 

  116. Meinke P, Nguyen TD, Wehnert MS. The LINC complex and human disease. Biochem Soc Trans. 2011;39(6):1693–7.

    Article  PubMed  CAS  Google Scholar 

  117. Bertini E, Donati MA, Broda P, et al. Phenotypic heterogeneity in two unrelated Danon patients associated with the same LAMP-2 gene mutation. Neuropediatrics. 2005;36(5):309–13.

    Article  PubMed  CAS  Google Scholar 

  118. Spencer CT, Bryant RM, Day J, et al. Cardiac and clinical phenotype in Barth syndrome. Pediatrics. 2006;118(2):e337–46.

    Article  PubMed  Google Scholar 

  119. Angelini C, Fanin M, Pegoraro E, Freda MP, Cadaldini M, Martinello F. Clinical-molecular correlation in 104 mild X-linked muscular dystrophy patients: characterization of sub-clinical phenotypes. Neuromuscul Disord. 1994;4(4):349–58.

    Article  PubMed  CAS  Google Scholar 

  120. Yoshida K, Ikeda S, Nakamura A, et al. Molecular analysis of the Duchenne muscular dystrophy gene in patients with Becker muscular dystrophy presenting with dilated cardiomyopathy. Muscle Nerve. 1993;16(11):1161–6.

    Article  PubMed  CAS  Google Scholar 

  121. Ferlini A, Sewry C, Melis MA, Mateddu A, Muntoni F. X-linked dilated cardiomyopathy and the dystrophin gene. Neuromuscul Disord. 1999;9(5):339–46.

    Article  PubMed  CAS  Google Scholar 

  122. Neri M, Torelli S, Brown S, et al. Dystrophin levels as low as 30% are sufficient to avoid muscular dystrophy in the human. Neuromuscul Disord. 2007;17(11–12):913–8.

    Article  PubMed  Google Scholar 

  123. Towbin JA. The role of cytoskeletal proteins in cardiomyopathies. Curr Opin Cell Biol. 1998;10(1):131–9.

    Article  PubMed  CAS  Google Scholar 

  124. Gold R, Kress W, Meurers B, Meng G, Reichmann H, Muller CR. Becker muscular dystrophy: detection of unusual disease courses by combined approach to dystrophin analysis. Muscle Nerve. 1992;15(2):214–8.

    Article  PubMed  CAS  Google Scholar 

  125. Moser H, Emery AE. The manifesting carrier in Duchenne muscular dystrophy. Clin Genet. 1974;5(4):271–84.

    Article  PubMed  CAS  Google Scholar 

  126. Olson BJ, Fenichel GM. Progressive muscle disease in a young woman with family history of Duchenne’s muscular dystrophy. Arch Neurol. 1982;39(6):378–80.

    Article  PubMed  CAS  Google Scholar 

  127. Moser H. Duchenne muscular dystrophy: pathogenetic aspects and genetic prevention. Hum Genet. 1984;66(1):17–40.

    Article  PubMed  CAS  Google Scholar 

  128. Minetti C, Chang HW, Medori R, et al. Dystrophin deficiency in young girls with sporadic myopathy and normal karyotype. Neurology. 1991;41(8):1288–92.

    Article  PubMed  CAS  Google Scholar 

  129. Hoffman EP, Arahata K, Minetti C, Bonilla E, Rowland LP. Dystrophinopathy in isolated cases of myopathy in females. Neurology. 1992;42(5):967–75.

    Article  PubMed  CAS  Google Scholar 

  130. Hoogerwaard EM, van der Wouw PA, Wilde AA, et al. Cardiac involvement in carriers of Duchenne and Becker muscular dystrophy. Neuromuscul Disord. 1999;9(5):347–51.

    Article  PubMed  CAS  Google Scholar 

  131. Weiss RM, Kerber RE, Jones JK, et al. Exercise-induced left ventricular systolic dysfunction in women heterozygous for dystrophinopathy. J Am Soc Echocardiogr. 2010;23(8):848–53.

    Article  PubMed  Google Scholar 

  132. Melacini P, Fanin M, Duggan DJ, et al. Heart involvement in muscular dystrophies due to sarcoglycan gene mutations. Muscle Nerve. 1999;22(4):473–9.

    Article  PubMed  CAS  Google Scholar 

  133. Fanin M, Melacini P, Boito C, Pegoraro E, Angelini C. LGMD2E patients risk developing dilated cardiomyopathy. Neuromuscul Disord. 2003;13(4):303–9.

    Article  PubMed  CAS  Google Scholar 

  134. Duggan DJ, Gorospe JR, Fanin M, Hoffman EP, Angelini C. Mutations in the sarcoglycan genes in patients with myopathy. N Engl J Med. 1997;336(9):618–24.

    Article  PubMed  CAS  Google Scholar 

  135. Schwartz M, Hertz JM, Sveen ML, Vissing J. LGMD2I presenting with a characteristic Duchenne or Becker muscular dystrophy phenotype. Neurology. 2005;64(9):1635–7.

    Article  PubMed  CAS  Google Scholar 

  136. Brockington M, Yuva Y, Prandini P, et al. Mutations in the fukutin-related protein gene (FKRP) identify limb girdle muscular dystrophy 2I as a milder allelic variant of congenital muscular dystrophy MDC1C. Hum Mol Genet. 2001;10(25):2851–9.

    Article  PubMed  CAS  Google Scholar 

  137. de Paula F, Vieira N, Starling A, et al. Asymptomatic carriers for homozygous novel mutations in the FKRP gene: the other end of the spectrum. Eur J Hum Genet. 2003;11(12):923–30.

    Article  PubMed  CAS  Google Scholar 

  138. Mercuri E, Brockington M, Straub V, et al. Phenotypic spectrum associated with mutations in the fukutin-related protein gene. Ann Neurol. 2003;53(4):537–42.

    Article  PubMed  CAS  Google Scholar 

  139. Muller T, Krasnianski M, Witthaut R, Deschauer M, Zierz S. Dilated cardiomyopathy may be an early sign of the C826A fukutin-related protein mutation. Neuromuscul Disord. 2005;15(5):372–6.

    Article  PubMed  CAS  Google Scholar 

  140. Poppe M, Cree L, Bourke J, et al. The phenotype of limb-girdle muscular dystrophy type 2I. Neurology. 2003;60(8):1246–51.

    Article  PubMed  CAS  Google Scholar 

  141. Kamakura K, Kawai M, Arahata K, Koizumi H, Watanabe K, Sugita H. A manifesting carrier of Duchenne muscular dystrophy with severe myocardial symptoms. J Neurol. 1990;237(8):483–5.

    Article  PubMed  CAS  Google Scholar 

  142. Manole E. Immunohistochemistry in the diagnosis of dystrophinopathies. Rom J Neurol Psychiatry. 1995;33(1):51–5.

    PubMed  CAS  Google Scholar 

  143. Jennekens FG, ten Kate LP, de Visser M, Wintzen AR. Diagnostic criteria for Duchenne and Becker muscular dystrophy and myotonic dystrophy. Neuromuscul Disord. 1991;1(6):389–91.

    Article  PubMed  CAS  Google Scholar 

  144. Lalic T, Vossen RH, Coffa J, et al. Deletion and duplication screening in the DMD gene using MLPA. Eur J Hum Genet. 2005;13(11):1231–4.

    Article  PubMed  CAS  Google Scholar 

  145. Pestronk A, Parhad IM, Drachman DB, Price DL. Membrane myopathy: morphological similarities to Duchenne muscular ­dystrophy. Muscle Nerve. 1982;5(3):209–14.

    Article  PubMed  CAS  Google Scholar 

  146. Nicholson LV, Davison K, Falkous G, et al. Dystrophin in skeletal muscle. I. Western blot analysis using a monoclonal antibody. J Neurol Sci. 1989;94(1–3):125–36.

    Article  PubMed  CAS  Google Scholar 

  147. Munsat TL, Baloh R, Pearson CM, Fowler Jr W. Serum enzyme alterations in neuromuscular disorders. JAMA. 1973;226(13):1536–43.

    Article  PubMed  CAS  Google Scholar 

  148. Winnard AV, Jia-Hsu Y, Gibbs RA, Mendell JR, Burghes AH. Identification of a 2 base pair nonsense mutation causing a cryptic splice site in a DMD patient. Hum Mol Genet. 1992;1(8):645–6.

    Article  PubMed  CAS  Google Scholar 

  149. Ervasti JM, Ohlendieck K, Kahl SD, Gaver MG, Campbell KP. Deficiency of a glycoprotein component of the dystrophin complex in dystrophic muscle. Nature. 1990;345(6273):315–9.

    Article  PubMed  CAS  Google Scholar 

  150. Karpati G, Carpenter S, Morris GE, Davies KE, Guerin C, Holland P. Localization and quantitation of the chromosome 6-encoded dystrophin-related protein in normal and pathological human muscle. J Neuropathol Exp Neurol. 1993;52(2):119–28.

    Article  PubMed  CAS  Google Scholar 

  151. Spencer Jr GE, Vignos Jr PJ. Bracing for ambulation in childhood progressive muscular dystrophy. J Bone Joint Surg Am. 1962;44-A:234–42.

    PubMed  Google Scholar 

  152. Vignos PJ, Wagner MB, Karlinchak B, Katirji B. Evaluation of a program for long-term treatment of Duchenne muscular dystrophy. Experience at the University Hospitals of Cleveland. J Bone Joint Surg Am. 1996;78(12):1844–52.

    PubMed  CAS  Google Scholar 

  153. Shapiro F, Bresnan MJ. Orthopaedic management of childhood neuromuscular disease. Part III: diseases of muscle. J Bone Joint Surg Am. 1982;64(7):1102–7.

    PubMed  CAS  Google Scholar 

  154. Dubousset J, Queneau P. Role and indications for surgery in Duchenne de Boulogne muscular dystrophy with rapid development. Rev Chir Orthop Reparatrice Appar Mot. 1983;69(3):207–20.

    PubMed  CAS  Google Scholar 

  155. Williams EA, Read L, Ellis A, Morris P, Galasko CS. The management of equinus deformity in Duchenne muscular dystrophy. J Bone Joint Surg Br. 1984;66(4):546–50.

    PubMed  CAS  Google Scholar 

  156. Heckmatt JZ, Dubowitz V, Hyde SA, Florence J, Gabain AC, Thompson N. Prolongation of walking in Duchenne muscular dystrophy with lightweight orthoses: review of 57 cases. Dev Med Child Neurol. 1985;27(2):149–54.

    Article  PubMed  CAS  Google Scholar 

  157. Rideau Y, Duport G, Delaubier A. The 1st reproducible remissions in the evolution of Duchenne’s muscular dystrophy. Bull Acad Natl Med. 1986;170(5):605–10.

    PubMed  CAS  Google Scholar 

  158. Rodillo EB, Fernandez-Bermejo E, Heckmatt JZ, Dubowitz V. Prevention of rapidly progressive scoliosis in Duchenne muscular dystrophy by prolongation of walking with orthoses. J Child Neurol. 1988;3(4):269–74.

    Article  PubMed  CAS  Google Scholar 

  159. Shapiro F, Specht L. The diagnosis and orthopaedic treatment of inherited muscular diseases of childhood. J Bone Joint Surg Am. 1993;75(3):439–54.

    PubMed  CAS  Google Scholar 

  160. Muntoni F, Bushby K, Manzur AY. Muscular dystrophy campaign funded workshop on management of scoliosis in Duchenne muscular dystrophy, 24 January 2005, London, UK. Neuromuscul Disord. 2006;16(3):210–9.

    Article  PubMed  Google Scholar 

  161. Ciafaloni E, Moxley RT. Treatment options for Duchenne muscular dystrophy. Curr Treat Options Neurol. 2008;10(2):86–93.

    Article  PubMed  Google Scholar 

  162. Shapiro F, Sethna N, Colan S, Wohl ME, Specht L. Spinal fusion in Duchenne muscular dystrophy: a multidisciplinary approach. Muscle Nerve. 1992;15(5):604–14.

    Article  PubMed  CAS  Google Scholar 

  163. King WM, Ruttencutter R, Nagaraja HN, et al. Orthopedic outcomes of long-term daily corticosteroid treatment in Duchenne muscular dystrophy. Neurology. 2007;68(19):1607–13.

    Article  PubMed  CAS  Google Scholar 

  164. Swank SM, Brown JC, Perry RE. Spinal fusion in Duchenne’s muscular dystrophy. Spine (Phila Pa 1976). 1982;7(5):484–91.

    Article  CAS  Google Scholar 

  165. Weimann RL, Gibson DA, Moseley CF, Jones DC. Surgical stabilization of the spine in Duchenne muscular dystrophy. Spine (Phila Pa 1976). 1983;8(7):776–80.

    Article  CAS  Google Scholar 

  166. Seeger BR, Sutherland AD, Clark MS. Orthotic management of scoliosis in Duchenne muscular dystrophy. Arch Phys Med Rehabil. 1984;65(2):83–6.

    PubMed  CAS  Google Scholar 

  167. Sussman MD. Advantage of early spinal stabilization and fusion in patients with Duchenne muscular dystrophy. J Pediatr Orthop. 1984;4(5):532–7.

    PubMed  CAS  Google Scholar 

  168. Cambridge W, Drennan JC. Scoliosis associated with Duchenne muscular dystrophy. J Pediatr Orthop. 1987;7(4):436–40.

    Article  PubMed  CAS  Google Scholar 

  169. Colbert AP, Craig C. Scoliosis management in Duchenne muscular dystrophy: prospective study of modified Jewett hyperextension brace. Arch Phys Med Rehabil. 1987;68(5 Pt 1):302–4.

    PubMed  CAS  Google Scholar 

  170. Bushby K, Finkel R, Birnkrant DJ, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol. 2010;9(2):177–89.

    Article  PubMed  CAS  Google Scholar 

  171. Hukins CA, Hillman DR. Daytime predictors of sleep hypoventilation in Duchenne muscular dystrophy. Am J Respir Crit Care Med. 2000;161(1):166–70.

    Article  PubMed  CAS  Google Scholar 

  172. Doing AH, Renlund DG, Smith RA. Becker muscular dystrophy-related cardiomyopathy: a favorable response to medical therapy. J Heart Lung Transplant. 2002;21(4):496–8.

    Article  PubMed  Google Scholar 

  173. Stollberger C, Finsterer J. Left ventricular synchronization by biventricular pacing in Becker muscular dystrophy as assessed by tissue Doppler imaging. Heart Lung. 2005;34(5):317–20.

    Article  PubMed  Google Scholar 

  174. Breucking E, Reimnitz P, Schara U, Mortier W. Anesthetic complications. The incidence of severe anesthetic complications in patients and families with progressive muscular dystrophy of the Duchenne and Becker types. Anaesthesist. 2000;49(3):187–95.

    Article  PubMed  CAS  Google Scholar 

  175. Mendell JR, Moxley RT, Griggs RC, et al. Randomized, double-blind six-month trial of prednisone in Duchenne’s muscular dystrophy. N Engl J Med. 1989;320(24):1592–7.

    Article  PubMed  CAS  Google Scholar 

  176. Griggs RC, Moxley 3rd RT, Mendell JR, et al. Duchenne dystrophy: randomized, controlled trial of prednisone (18 months) and azathioprine (12 months). Neurology. 1993;43(3 Pt 1):520–7.

    Article  PubMed  CAS  Google Scholar 

  177. Bonifati MD, Ruzza G, Bonometto P, et al. A multicenter, double-blind, randomized trial of deflazacort versus prednisone in Duchenne muscular dystrophy. Muscle Nerve. 2000;23(9):1344–7.

    Article  PubMed  CAS  Google Scholar 

  178. Moxley 3rd RT, Ashwal S, Pandya S, et al. Practice parameter: corticosteroid treatment of Duchenne dystrophy: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2005;64(1):13–20.

    Article  PubMed  CAS  Google Scholar 

  179. Manzur AY, Kuntzer T, Pike M, Swan A. Glucocorticoid corticosteroids for Duchenne muscular dystrophy. Cochrane Database Syst Rev. 2004;2:CD003725.

    PubMed  Google Scholar 

  180. Bushby K, Finkel R, Birnkrant DJ, et al. Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and pharmacological and psychosocial management. Lancet Neurol. 2010;9(1):77–93.

    Article  PubMed  Google Scholar 

  181. England SB, Nicholson LV, Johnson MA, et al. Very mild muscular dystrophy associated with the deletion of 46% of dystrophin. Nature. 1990;343(6254):180–2.

    Article  PubMed  CAS  Google Scholar 

  182. Mendell JR, Campbell K, Rodino-Klapac L, et al. Dystrophin immunity in Duchenne’s muscular dystrophy. N Engl J Med. 2010;363(15):1429–37.

    Article  PubMed  CAS  Google Scholar 

  183. Tinsley J, Deconinck N, Fisher R, et al. Expression of full-length utrophin prevents muscular dystrophy in mdx mice. Nat Med. 1998;4(12):1441–4.

    Article  PubMed  CAS  Google Scholar 

  184. Gilbert R, Nalbantoglu J, Petrof BJ, et al. Adenovirus-mediated utrophin gene transfer mitigates the dystrophic phenotype of mdx mouse muscles. Hum Gene Ther. 1999;10(8):1299–310.

    Article  PubMed  CAS  Google Scholar 

  185. Krag TO, Bogdanovich S, Jensen CJ, et al. Heregulin ameliorates the dystrophic phenotype in mdx mice. Proc Natl Acad Sci U S A. 2004;101(38):13856–60.

    Article  PubMed  CAS  Google Scholar 

  186. Moorwood C, Lozynska O, Suri N, Napper AD, Diamond SL, Khurana TS. Drug discovery for Duchenne muscular dystrophy via utrophin promoter activation screening. PLoS One. 2011;6(10):e26169.

    Article  PubMed  CAS  Google Scholar 

  187. Tinsley JM, Fairclough RJ, Storer R, et al. Daily treatment with SMTC1100, a novel small molecule utrophin upregulator, dramatically reduces the dystrophic symptoms in the mdx mouse. PLoS One. 2011;6(5):e19189.

    Article  PubMed  CAS  Google Scholar 

  188. Amenta AR, Yilmaz A, Bogdanovich S, et al. Biglycan recruits utrophin to the sarcolemma and counters dystrophic pathology in mdx mice. Proc Natl Acad Sci U S A. 2011;108(2):762–7.

    Article  PubMed  CAS  Google Scholar 

  189. Mann CJ, Honeyman K, Cheng AJ, et al. Antisense-induced exon skipping and synthesis of dystrophin in the mdx mouse. Proc Natl Acad Sci U S A. 2001;98(1):42–7.

    Article  PubMed  CAS  Google Scholar 

  190. Goyenvalle A, Babbs A, Powell D, et al. Prevention of dystrophic pathology in severely affected dystrophin/utrophin-deficient mice by morpholino-oligomer-mediated exon-skipping. Mol Ther. 2010;18(1):198–205.

    Article  PubMed  CAS  Google Scholar 

  191. Yokota T, Lu QL, Partridge T, et al. Efficacy of systemic morpholino exon-skipping in Duchenne dystrophy dogs. Ann Neurol. 2009;65(6):667–76.

    Article  PubMed  Google Scholar 

  192. van Deutekom JC, Janson AA, Ginjaar IB, et al. Local dystrophin restoration with antisense oligonucleotide PRO051. N Engl J Med. 2007;357(26):2677–86.

    Article  PubMed  Google Scholar 

  193. Kinali M, Arechavala-Gomeza V, Feng L, et al. Local restoration of dystrophin expression with the morpholino oligomer AVI-4658 in Duchenne muscular dystrophy: a single-blind, placebo-controlled, dose-escalation, proof-of-concept study. Lancet Neurol. 2009;8(10):918–28.

    Article  PubMed  CAS  Google Scholar 

  194. Goemans NM, Tulinius M, van den Akker JT, et al. Systemic administration of PRO051 in Duchenne’s muscular dystrophy. N Engl J Med. 2011;364(16):1513–22.

    Article  PubMed  CAS  Google Scholar 

  195. Cirak S, Arechavala-Gomeza V, Guglieri M, et al. Exon skipping and dystrophin restoration in patients with Duchenne muscular dystrophy after systemic phosphorodiamidate morpholino oligomer treatment: an open-label, phase 2, dose-escalation study. Lancet. 2011;378(9791):595–605.

    Article  PubMed  CAS  Google Scholar 

  196. Barton-Davis ER, Cordier L, Shoturma DI, Leland SE, Sweeney HL. Aminoglycoside antibiotics restore dystrophin function to skeletal muscles of mdx mice. J Clin Invest. 1999;104(4):375–81.

    Article  PubMed  CAS  Google Scholar 

  197. Welch EM, Barton ER, Zhuo J, et al. PTC124 targets genetic disorders caused by nonsense mutations. Nature. 2007;447(7140):87–91.

    Article  PubMed  CAS  Google Scholar 

  198. Hirawat S, Welch EM, Elfring GL, et al. Safety, tolerability, and pharmacokinetics of PTC124, a nonaminoglycoside nonsense mutation suppressor, following single- and multiple-dose administration to healthy male and female adult volunteers. J Clin Pharmacol. 2007;47(4):430–44.

    Article  PubMed  CAS  Google Scholar 

  199. Gold RH. The evolution of mammography. Radiol Clin North Am. 1992;30(1):1–19.

    PubMed  CAS  Google Scholar 

  200. Wilschanski M, Miller LL, Shoseyov D, et al. Chronic ataluren (PTC124) treatment of nonsense mutation cystic fibrosis. Eur Respir J. 2011;38(1):59–69.

    Article  PubMed  CAS  Google Scholar 

  201. McPherron AC, Lawler AM, Lee SJ. Regulation of skeletal muscle mass in mice by a new TGF-beta superfamily member. Nature. 1997;387(6628):83–90.

    Article  PubMed  CAS  Google Scholar 

  202. Schuelke M, Wagner KR, Stolz LE, et al. Myostatin mutation associated with gross muscle hypertrophy in a child. N Engl J Med. 2004;350(26):2682–8.

    Article  PubMed  CAS  Google Scholar 

  203. Wagner KR, Fleckenstein JL, Amato AA, et al. A phase I/II trial of MYO-029 in adult subjects with muscular dystrophy. Ann Neurol. 2008;63(5):561–71.

    Article  PubMed  CAS  Google Scholar 

  204. Bogdanovich S, Krag TO, Barton ER, et al. Functional improvement of dystrophic muscle by myostatin blockade. Nature. 2002;420(6914):418–21.

    Article  PubMed  CAS  Google Scholar 

  205. Haidet AM, Rizo L, Handy C, et al. Long-term enhancement of skeletal muscle mass and strength by single gene administration of myostatin inhibitors. Proc Natl Acad Sci U S A. 2008;105(11):4318–22.

    Article  PubMed  CAS  Google Scholar 

  206. Kota J, Handy CR, Haidet AM, et al. Follistatin gene delivery enhances muscle growth and strength in nonhuman primates. Sci Transl Med. 2009;1(6):6ra15.

    Article  PubMed  CAS  Google Scholar 

  207. Fryburg DA. Insulin-like growth factor I exerts growth hormone- and insulin-like actions on human muscle protein metabolism. Am J Physiol. 1994;267(2 Pt 1):E331–6.

    PubMed  CAS  Google Scholar 

  208. Rosenthal SM, Cheng ZQ. Opposing early and late effects of insulin-like growth factor I on differentiation and the cell cycle regulatory retinoblastoma protein in skeletal myoblasts. Proc Natl Acad Sci U S A. 1995;92(22):10307–11.

    Article  PubMed  CAS  Google Scholar 

  209. Engert JC, Berglund EB, Rosenthal N. Proliferation precedes differentiation in IGF-I-stimulated myogenesis. J Cell Biol. 1996;135(2):431–40.

    Article  PubMed  CAS  Google Scholar 

  210. Musaro A, McCullagh KJ, Naya FJ, Olson EN, Rosenthal N. IGF-1 induces skeletal myocyte hypertrophy through calcineurin in association with GATA-2 and NF-ATc1. Nature. 1999;400(6744):581–5.

    Article  PubMed  CAS  Google Scholar 

  211. Barton ER, Morris L, Musaro A, Rosenthal N, Sweeney HL. Muscle-specific expression of insulin-like growth factor I counters muscle decline in mdx mice. J Cell Biol. 2002;157(1):137–48.

    Article  PubMed  CAS  Google Scholar 

  212. Shavlakadze T, White J, Hoh JF, Rosenthal N, Grounds MD. Targeted expression of insulin-like growth factor-I reduces early myofiber necrosis in dystrophic mdx mice. Mol Ther. 2004;10(5):829–43.

    Article  PubMed  CAS  Google Scholar 

  213. Zhou L, Lu H. Targeting fibrosis in Duchenne muscular dystrophy. J Neuropathol Exp Neurol. 2010;69(8):771–6.

    Article  PubMed  Google Scholar 

  214. Cacchiarelli D, Martone J, Girardi E, et al. MicroRNAs involved in molecular circuitries relevant for the Duchenne muscular dystrophy pathogenesis are controlled by the dystrophin/nNOS pathway. Cell Metab. 2010;12(4):341–51.

    Article  PubMed  CAS  Google Scholar 

  215. Chang WJ, Iannaccone ST, Lau KS, et al. Neuronal nitric oxide synthase and dystrophin-deficient muscular dystrophy. Proc Natl Acad Sci U S A. 1996;93(17):9142–7.

    Article  PubMed  CAS  Google Scholar 

  216. Wheway JM, Roberts RG. The dystrophin lymphocyte promoter revisited: 4.5-megabase intron, or artifact? Neuromuscul Disord. 2003;13(1):17–20.

    Article  PubMed  Google Scholar 

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Sahenk, Z., Rodino-Klapac, L.R. (2014). Dystrophinopathies. In: Katirji, B., Kaminski, H., Ruff, R. (eds) Neuromuscular Disorders in Clinical Practice. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6567-6_56

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