A review on mechanistic insights into structure and function of dystrophin protein in pathophysiology and therapeutic targeting of Duchenne muscular dystrophy

Int J Biol Macromol. 2024 Apr;264(Pt 1):130544. doi: 10.1016/j.ijbiomac.2024.130544. Epub 2024 Feb 29.

Abstract

Duchenne Muscular Dystrophy (DMD) is an X-linked recessive genetic disorder characterized by progressive and severe muscle weakening and degeneration. Among the various forms of muscular dystrophy, it stands out as one of the most common and impactful, predominantly affecting boys. The condition arises due to mutations in the dystrophin gene, a key player in maintaining the structure and function of muscle fibers. The manuscript explores the structural features of dystrophin protein and their pivotal roles in DMD. We present an in-depth analysis of promising therapeutic approaches targeting dystrophin and their implications for the therapeutic management of DMD. Several therapies aiming to restore dystrophin protein or address secondary pathology have obtained regulatory approval, and many others are ongoing clinical development. Notably, recent advancements in genetic approaches have demonstrated the potential to restore partially functional dystrophin forms. The review also provides a comprehensive overview of the status of clinical trials for major therapeutic genetic approaches for DMD. In addition, we have summarized the ongoing therapeutic approaches and advanced mechanisms of action for dystrophin restoration and the challenges associated with DMD therapeutics.

Keywords: Duchenne muscular dystrophy; Genetic disease; Musculoskeletal disease; Neuromuscular disease; Pathophysiology; Therapeutic management.

Publication types

  • Review

MeSH terms

  • Dystrophin / genetics
  • Dystrophin / metabolism
  • Dystrophin / therapeutic use
  • Genetic Diseases, X-Linked*
  • Humans
  • Male
  • Muscle Fibers, Skeletal / metabolism
  • Muscular Dystrophy, Duchenne* / genetics
  • Muscular Dystrophy, Duchenne* / pathology
  • Muscular Dystrophy, Duchenne* / therapy

Substances

  • Dystrophin