Modulating fast skeletal muscle contraction protects skeletal muscle in animal models of Duchenne muscular dystrophy

AJ Russell, M DuVall, B Barthel, Y Qian… - The Journal of …, 2023 - Am Soc Clin Investig
AJ Russell, M DuVall, B Barthel, Y Qian, AK Peter, BL Newell-Stamper, K Hunt, S Lehman…
The Journal of clinical investigation, 2023Am Soc Clin Investig
Duchenne muscular dystrophy (DMD) is a lethal muscle disease caused by absence of the
protein dystrophin, which acts as a structural link between the basal lamina and contractile
machinery to stabilize muscle membranes in response to mechanical stress. In DMD,
mechanical stress leads to exaggerated membrane injury and fiber breakdown, with fast
fibers being the most susceptible to damage. A major contributor to this injury is muscle
contraction, controlled by the motor protein myosin. However, how muscle contraction and …
Duchenne muscular dystrophy (DMD) is a lethal muscle disease caused by absence of the protein dystrophin, which acts as a structural link between the basal lamina and contractile machinery to stabilize muscle membranes in response to mechanical stress. In DMD, mechanical stress leads to exaggerated membrane injury and fiber breakdown, with fast fibers being the most susceptible to damage. A major contributor to this injury is muscle contraction, controlled by the motor protein myosin. However, how muscle contraction and fast muscle fiber damage contribute to the pathophysiology of DMD has not been well characterized. We explored the role of fast skeletal muscle contraction in DMD with a potentially novel, selective, orally active inhibitor of fast skeletal muscle myosin, EDG-5506. Surprisingly, even modest decreases of contraction (<15%) were sufficient to protect skeletal muscles in dystrophic mdx mice from stress injury. Longer-term treatment also decreased muscle fibrosis in key disease-implicated tissues. Importantly, therapeutic levels of myosin inhibition with EDG-5506 did not detrimentally affect strength or coordination. Finally, in dystrophic dogs, EDG-5506 reversibly reduced circulating muscle injury biomarkers and increased habitual activity. This unexpected biology may represent an important alternative treatment strategy for Duchenne and related myopathies.
The Journal of Clinical Investigation
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