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Pathogenesis of membrane damage in Duchenne Muscular Dystrophy (DMD)

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In healthy patients dystrophin is localised just under the cell membrane. It is absent in the Duchenne patient. The pathogenesis of the disease is unknown. Since the discovery and cloning of the dystrophin gene, potential gene therapy is the object of intense research. The group of the Institut Gustave Roussy in Villejuif (France) has succeeded in inserting a large part of the dystrophin cDNA into an adenovirus. The resulting protein has been called "mini- dystrophin" and is stably expressed in transfected muscle fibres of young mice. It is essential to test if minidystrophin can confer a functional recovery where it is expressed. The possibility to sustain forced elongations during contraction will be critical test for the evaluation of the functional recovery. A study has been conducted in the Department of Physiology in Brussels (Belgium) which shows that fast skeletal muscles from mdx mice are very sensitive to mechanical stress, a finding which points towards a genuine membrane weakness in dystrophin lacking fibres. It is also tested if the over-expression of utrophin can substitute for dystrophin. The group of the II Institute of Physiology in Heidelberg (Germany)has shown that native sarcolemma vesicles obtained from mdx muscle fibres are mechanically less stable compared to normal controls. Similar experiments will be carried out on minidystrophin containing membrane vesicles and the tensile strength of these minidystrophin membranes will be determined. Given the high efficiency of the minidystrophin transfection with the adenoviral carrier, this method is likely to become the first realistic gene therapy in Duchenne patients. However, before investing in developing this therapy, it is essential to know if minidystrophin can functionally replace dystrophin. The project is suitably designed to bring the answer.

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