The Interplay of Mitophagy and Inflammation in Duchenne Muscular Dystrophy.

The Interplay of Mitophagy and Inflammation in Duchenne Muscular Dystrophy.
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DOI:
10.3390/life11070648
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发表时间:
2021-07-04
期刊:
Life (Basel, Switzerland)
影响因子:
--
通讯作者:
Alexander MS
Alexander MS
中科院分区:
其他
文献类型:
--
作者:
Reid AL;Alexander MS

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杜氏肌营养不良症(DMD)是一种x连锁的神经肌肉疾病,由肌营养不良蛋白基因的致病性破坏引起,导致无功能的肌营养不良蛋白。DMD患者会出现行动不便、心律失常、代谢综合征和呼吸衰竭。在分子水平上,肌肉中肌营养不良蛋白的缺乏导致肌纤维死亡、纤维化浸润和线粒体功能障碍。虽然抗肌萎缩蛋白替代基因疗法和外显子跳跃方法正在临床试验中进行,但目前尚无治愈DMD的方法。线粒体功能障碍是在DMD肌纤维中观察到的第一批细胞变化之一,发生在肌肉疾病发病之前,并随着疾病的严重程度而进展。这可以通过线粒体功能降低、线粒体形态异常和线粒体自噬受损(受损线粒体的降解)来观察。功能失调的线粒体释放高水平的活性氧(ROS),可以激活促炎途径,如IL-1β和IL-6。DMD中线粒体自噬受损导致炎症增加,并进一步加重疾病病理,这可以通过肌肉损伤增加和纤维化增加来证明。本文将重点讨论杜氏肌营养不良中线粒体自噬和炎症之间的重要相互作用作为病理机制,并描述候选和已建立的调节这些途径的治疗靶点。
Duchenne muscular dystrophy (DMD) is an X-linked neuromuscular disease caused by a pathogenic disruption of the DYSTROPHIN gene that results in non-functional dystrophin protein. DMD patients experience loss of ambulation, cardiac arrhythmia, metabolic syndrome, and respiratory failure. At the molecular level, the lack of dystrophin in the muscle results in myofiber death, fibrotic infiltration, and mitochondrial dysfunction. There is no cure for DMD, although dystrophin-replacement gene therapies and exon-skipping approaches are being pursued in clinical trials. Mitochondrial dysfunction is one of the first cellular changes seen in DMD myofibers, occurring prior to muscle disease onset and progresses with disease severity. This is seen by reduced mitochondrial function, abnormal mitochondrial morphology and impaired mitophagy (degradation of damaged mitochondria). Dysfunctional mitochondria release high levels of reactive oxygen species (ROS), which can activate pro-inflammatory pathways such as IL-1β and IL-6. Impaired mitophagy in DMD results in increased inflammation and further aggravates disease pathology, evidenced by increased muscle damage and increased fibrosis. This review will focus on the critical interplay between mitophagy and inflammation in Duchenne muscular dystrophy as a pathological mechanism, as well as describe both candidate and established therapeutic targets that regulate these pathways.
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