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Proteomics-based evaluation of AAV dystrophin gene therapy outcomes in mdx skeletal muscle

2025/11/27 by Erynn E. Johnson, Theodore R. Reyes, Jeffrey S. Chamberlain +2 · 1 voice
Biochemistry, Genetics and Molecular Biology · Medicine · #Muscle Physiology and Disorders #CRISPR and Genetic Engineering #GDF15 and Related Biomarkers

paper · doi:10.1172/jci.insight.197759

openalex publication_date 2025/11/27 · openalex created_date 2025/11/28 · openalex updated_date 2026/06/11

Abstract

Duchenne muscular dystrophy (DMD) is a fatal genetic muscle-wasting disease characterized by loss of dystrophin protein. Therapeutic attempts to restore a functional copy of dystrophin to striated muscle are under active development, and many utilize adeno-associated viral (AAV) vectors. However, the limited cargo capacity of AAVs precludes delivery of full-length dystrophin, a 427 kDa protein, to target tissues. Recently, we developed a method to express large dystrophin constructs using the protein trans-splicing mechanism mediated by split inteins and myotropic AAV vectors. The efficacy of this approach to restore muscle function in mdx4cv mice was previously assessed using histology, dystrophin immunolabeling, and Western blotting. Here, we expand our molecular characterization of dystrophin constructs with variable lengths using a mass spectrometry-based proteomics approach, providing insight into unique protein expression profiles in skeletal muscles of wild-type, dystrophic mdx4cv, and AAV-treated mdx4cv mice. Our data reveal several affected cellular processes in mdx4cv skeletal muscles with changes in the expression profiles of key proteins to muscle homeostasis, whereas successful expression of dystrophin constructs results in an intermediate to complete restoration. This study highlights several biomarkers that could be used in future preclinical or clinical studies to evaluate the effectiveness of therapeutic strategies.

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