Functional muscle ischemia in Duchenne and Becker muscular dystrophy.

Functional muscle ischemia in Duchenne and Becker muscular dystrophy.
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DOI:
10.3389/fphys.2013.00381
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发表时间:
2013-12-18
影响因子:
4
通讯作者:
Thomas GD
Thomas GD
中科院分区:
医学2区
文献类型:
--
作者:
Thomas GD

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杜氏肌营养不良症和贝克尔肌营养不良症 (DMD/BMD) 是一系列毁灭性的 X 连锁肌肉萎缩性疾病,目前尚无治疗方法。 DMD/BMD 是由编码肌营养不良蛋白的基因突变引起的,肌营养不良蛋白是一种细胞骨架蛋白,可以稳定肌肉膜,也可以将其他蛋白靶向肌膜。其中包括神经元一氧化氮合酶 (nNOSμ) 的肌肉特异性亚型,它与肌营养不良蛋白杆结构域内的血影蛋白样重复序列和接头蛋白 α-肌营养不良蛋白结合。肌营养不良蛋白缺乏会导致肌膜 nNOSμ 损失,并减少肌肉源性一氧化氮 (NO) 向微脉管系统的旁分泌信号传导,从而使患病肌纤维在运动过程中容易出现功能性肌肉缺血。反复出现的功能性缺血叠加在已经因肌营养不良蛋白缺乏而减弱的肌纤维上,导致依赖于使用的局灶性肌肉损伤。增强营养不良性肌肉中 nNOSμ-NO 信号传导的遗传和药理学策略可减轻功能性肌肉缺血,并有望成为治疗 DMD/BMD 的新型治疗干预措施。
Duchenne and Becker muscular dystrophy (DMD/BMD) comprise a spectrum of devastating X-linked muscle wasting disease for which there is no treatment. DMD/BMD is caused by mutations in the gene encoding dystrophin, a cytoskeletal protein that stabilizes the muscle membrane and also targets other proteins to the sarcolemma. Among these is the muscle-specific isoform of neuronal nitric oxide synthase (nNOSμ) which binds spectrin-like repeats within dystrophin's rod domain and the adaptor protein α-syntrophin. Dystrophin deficiency causes loss of sarcolemmal nNOSμ and reduces paracrine signaling of muscle-derived nitric oxide (NO) to the microvasculature, which renders the diseased muscle fibers susceptible to functional muscle ischemia during exercise. Repeated bouts of functional ischemia superimposed on muscle fibers already weakened by dystrophin deficiency result in use-dependent focal muscle injury. Genetic and pharmacologic strategies to boost nNOSμ-NO signaling in dystrophic muscle alleviate functional muscle ischemia and show promise as novel therapeutic interventions for the treatment of DMD/BMD.
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