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Dystrophin threshold level necessary for normalisation of nNOS, iNOS and RyR1 nitrosylation in GRMD dystrophinopathy
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Edité par CCSD ; Mary Ann Liebert -
International audience. Currently, the clinically most advanced strategy to treat Duchenne muscular dystrophy (DMD) is the exon skipping strategy. Whereas antisense oligonucleotide-based clinical trials are underway for DMD, it is essential to determine a dystrophin restoration threshold needed to ensure improvement of muscle physiology at the molecular level. A preclinical trial was recently conducted in golden retriever muscular dystrophy (GRMD) dogs treated in a forelimb by locoregional delivery of rAAV8-U7snRNA to promote exon skipping on the canine dystrophin messenger. Here, we exploited the rAAV8-U7snRNA transduced GRMD muscle samples, well-characterized for their percentage of dystrophin-positive fibers, in the aim to define a threshold of dystrophin rescue necessary for normalization of the status of the neuronal nitric oxide synthase mu (nNOSµ), the inducible nitric oxide synthase (iNOS), and the ryanodine receptor-calcium release channel type 1 (RyR1), crucial actors for an efficient contractile function. Results showed that the restoration of dystrophin in 40% of muscle fibers is needed to decrease the abnormal cytosolic nNOSµ expression and to reduce the overexpression of iNOS, these two parameters leading to a reduction of the NO level into the muscle fiber. Furthermore, the same percentage of dystrophin-positive fibers of 40 % was associated with the normalization of the RyR1 nitrosylation status and to a stabilization of the RyR1/calstabin1 complex that is required to facilitate coupled gating. We concluded that a minimal threshold of 40% of dystrophin-positive fibers is necessary for the reinstatement of central proteins needed for a proper muscle contractile function, and thus identified a rate of dystrophin expression significantly improving, at the molecular level, the dystrophic muscle physiology.
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