Neuromuscular disorders encompass a heterogeneous group of conditions that impair the function of muscles, motor neurons, peripheral nerves, and neuromuscular junctions. Being the most common and most severe type of muscular dystrophy, Duchenne muscular dystrophy (DMD), is caused by mutations in the X-linked dystrophin gene. Loss of dystrophin protein leads to recurrent myofiber damage, chronic inflammation, progressive fibrosis, and dysfunction of muscle stem cells. Over the last few years, there has been considerable development of diagnosis and therapeutics for DMD, but current treatments do not cure the disease. Here, we review the current status of DMD pathogenesis and therapy, focusing on mutational spectrum, diagnosis tools, clinical trials, and therapeutic approaches including dystrophin restoration, gene therapy, and myogenic cell transplantation. Furthermore, we present the clinical potential of advanced strategies combining gene editing, cell-based therapy with tissue engineering for the treatment of muscular dystrophy.

译文

神经肌肉疾病包括一组异类疾病,这些疾病会损害肌肉,运动神经元,周围神经和神经肌肉接头的功能。杜兴氏肌营养不良症(DMD)是最常见,最严重的肌营养不良症,是由X连锁肌营养不良蛋白基因的突变引起的。肌营养不良蛋白的丢失会导致肌纤维复发,慢性炎症,进行性纤维化和肌肉干细胞功能障碍。在过去的几年中,DMD的诊断和治疗方法有了长足的发展,但是目前的治疗方法不能治愈该疾病。在这里,我们将回顾DMD发病机理和治疗方法的当前状态,重点关注突变谱,诊断工具,临床试验以及包括肌营养不良蛋白修复,基因治疗和成肌细胞移植在内的治疗方法。此外,我们介绍了结合基因编辑,基于细胞的治疗与组织工程技术治疗肌肉营养不良的先进策略的临床潜力。

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