Dystrophic Cardiomyopathy-Potential Role of Calcium in Pathogenesis, Treatment and Novel Therapies.
Duchenne muscular dystrophy (DMD) is caused by defects in theDMDgene and results in progressive wasting of skeletal and cardiac muscle due to an absence of functional dystrophin. Cardiomyopathy is prominent in DMD patients, and contributes significantly to mortality. This is particularly true following respiratory interventions that reduce death rate and increase ambulation and consequently cardiac load. Cardiomyopathy shows an increasing prevalence with age and disease progression, and over 95% of patients exhibit dilated cardiomyopathy by the time they reach adulthood. Development of the myopathy is complex, and elevations in intracellular calcium, functional muscle ischemia, and mitochondrial dysfunction characterise the pathophysiology. Current therapies are limited to treating symptoms of the disease and there is therefore an urgent need to treat the underlying genetic defect. Several novel therapies are outlined here, and the unprecedented success of phosphorodiamidate morpholino oligomers (PMOs) in preclinical and clinical studies is overviewed.
School of Human Sciences, The University of Western Australia, Crawley, WA 6009, Australia. vicky.johnstone@uwa.edu.au.
Victoria P A
VP
Johnstone
School of Human Sciences, The University of Western Australia, Crawley, WA 6009, Australia. helena.viola@uwa.edu.au.
Helena M
HM
Viola
School of Human Sciences, The University of Western Australia, Crawley, WA 6009, Australia. livia.hool@uwa.edu.au.|Victor Chang Cardiac Research Institute, Sydney, NSW 2010, Australia. livia.hool@uwa.edu.au.
Livia C
LC
Hool
L-type calcium channel; calcium; cardiomyopathy; cytoskeleton; duchenne muscular dystrophy; mitochondria; molecular therapeutics