M S-medecine Sciences最新文献

Myopathies are a heterogeneous group of diseases characterized by progressive muscle weakness and degeneration. While muscle diseases have a major impact on patients' quality of life, a growing number of pre-clinical and clinical studies suggest that adapted physical exercise is beneficial in alleviating some symptoms and improving some functional parameters. This brief review of the literature discusses the current state of research about the effects of exercise in humans with various muscle diseases, exploring its impact on molecular mechanisms, muscle strength, endurance, function and the quality of life.

Arthrogryposis multiplex congenita (AMC) is a group of diseases with joint limitations at two or more distinct joint levels at birth. Joint limitations are not progressive, but the functional consequences have a lifelong impact on patients. In this article we will present the results of our study aimed at evaluating the correlation between muscle fat infiltration on MRI and activity deficiencies and limitations in children with AMC. Our study is one of the first in a pediatric population to establish the link between muscle imaging and functional aspects of AMC.

This study, which focuses on the follow-up of respiratory failure in neuromuscular patients, highlights the need to improve the supply of care and to compensate for gaps in care. Advanced practice nurses (APNs) as part of a multidisciplinary approach, could be the missing link. Improving the management of neuromuscular disorders is a key concern for the Filnemus neuromuscular rare disease network, the reference centers and the AFM-Téléthon. This is also where the need for an APN specialized in neuromuscular disorders is being discussed, and which could meet needs that are not covered, or are insufficiently covered, in the healthcare pathway.

Duchenne muscular dystrophy (DMD) is a severe degenerative genetic muscle disease affecting mainly young boys, characterized by a significant alteration or absence of dystrophin expression. Significant strides have been made in comprehending and treating DMD, particularly with the recent approval of the first gene therapy using a recombinant adeno-associated vector (rAAV) to deliver a shortened form of dystrophin (microdystrophin). Nevertheless, major challenges remain in improving therapeutic outcomes. The use of rAAV vectors is hindered by major limitations, notably the risks of immunotoxicity and hepatotoxicity, linked to high-dose administration. Additionally, microdystrophin exhibits inherent functional limitations and immunological risks. This article examines these challenges and explores the avenues for enhancing gene therapy for DMD.

Through their myogenic activity, adult muscle stem cells (MuSCs) are crucial for the regeneration of striated skeletal muscle. Once activated, they proliferate, differentiate and then fuse to repair or form new muscle fibers (myofibers). Their progression through myogenesis requires a complex regulation involving multiple players such as metabolism, in particular via AMPK. This protein kinase regulates the self-renewal and myonuclear accretion of MuSCs after acute skeletal muscle injury or skeletal muscle contraction. However, in a context of dystrophy such as Duchenne muscular dystrophy (DMD), the regenerative capacity of MuSCs is reduced, presumably due to an increase of the proliferation that is detrimental to differentiation. We are interested here in the potential of metabolism to regulate the myogenic activity of MuSCs in DMD via AMPK.

PAX3 plays a crucial role in embryonic myogenesis, controlling the specification, migration, proliferation, and differentiation of muscle progenitor cells to ensure normal skeletal muscle development in the embryo. However, PAX3 potential role in a context of muscle homeostasis and regeneration remains poorly investigated. The adult muscle stem cells, known as satellite cells (SCs) exhibit heterogeneity in Pax3 expression in various muscles throughout the body and display a bimodal response to environmental stress exposure. To explore the role of PAX3 in the context of tissue damage, we performed regeneration studies, which unveiled a functional heterogeneity of the SCs populations depending on Pax3 expression. Together, this project aims to decipher cell-type specific dysregulations linked to tissue damage and identify PAX3 downstream gene regulatory networks that can lead to specific SC behavior, thus potentially providing novel strategies for muscle disease preventive therapies.

High-throughput sequencing has introduced the concept of "actionable genes". These genes are linked to diseases for which specific treatments or care exist. Accurate genetic diagnosis is therefore crucial for initiating interventions that can prevent or delay the progression of rare diseases. High-throughput sequencing has considerably increased the capacities of genetic analyses, but it has also led to an increase in requests for analyses, lengthening the time taken to obtain results. It is becoming necessary to prioritize analyses, especially when "actionable genes" are suspected to be implicated. In the case of myopathies, a French national study has identified 63 actionable genes, implicated in diseases for which a targeted treatment and/or priority care can be initiated, thereby improving the patient's prognosis. Despite advances, many rare diseases remain without specific treatments, underlining the continuing importance of research and innovation in medical genetics.