1. Departments of Molecular and Integrative Physiology and
2. Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109-0622, USA
3. *These authors contributed equally to this work

Correspondence to: Joseph M. Metzger^1,2 Correspondence and requests for materials should be addressed to J.M. (Email: metzgerj@umich.edu).

Abstract

Dystrophin deficiency causes Duchenne muscular dystrophy (DMD) in humans, an inherited and progressive disease of striated muscle deterioration that frequently involves pronounced cardiomyopathy¹. Heart failure is the second leading cause of fatalities in DMD^{1, 2}. Progress towards defining the molecular basis of disease in DMD has mostly come from studies on skeletal muscle, with comparatively little attention directed to cardiac muscle. The pathophysiological mechanisms involved in cardiac myocytes may differ significantly from skeletal myofibres; this is underscored by the presence of significant cardiac disease in patients with truncated or reduced levels of dystrophin but without skeletal muscle disease³. Here we show that intact, isolated dystrophin-deficient cardiac myocytes have reduced compliance and increased susceptibility to stretch-mediated calcium overload, leading to cell contracture and death, and that application of the membrane sealant poloxamer 188 corrects these defects in vitro. In vivo administration of poloxamer 188 to dystrophic mice instantly improved ventricular geometry and blocked the development of acute cardiac failure during a dobutamine-mediated stress protocol. Once issues relating to optimal dosing and long-term effects of poloxamer 188 in humans have been resolved, chemical-based membrane sealants could represent a new therapeutic approach for preventing or reversing the progression of cardiomyopathy and heart failure in muscular dystrophy.

1. Departments of Molecular and Integrative Physiology and
2. Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109-0622, USA
3. *These authors contributed equally to this work

Correspondence to: Joseph M. Metzger^1,2 Correspondence and requests for materials should be addressed to J.M. (Email: metzgerj@umich.edu).

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