Why the study?
Does human myoblast transplantation improve dystrophin expression and muscle strength in patients with advanced Duchenne muscular dystrophy?
Does human myoblast transplantation improve dystrophin expression and muscle strength in patients with advanced Duchenne muscular dystrophy?
Myoblast transplantation in advanced Duchenne patients can lead to transient dystrophin expression and temporary strength improvements without clinical rejection, though the effects decay over time.
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Should not yet change practice in advanced DMD; hypothesis-generating for myoblast transplantation durability and efficacy.
Myoblasts from immunocompatible donors have been transplanted into the muscles (tibialis anterior, biceps brachii, and/or extensor carpi radialis longus) of 4 Duchenne patients in the advanced stages of the disease. Although no immunosuppressive treatment was used, none of the patients showed any clinical signs of rejection such as fever, redness, and inflammation. One patient transiently produced antibodies against the donor myoblasts as determined by cytofluorometric analysis. This patient and 2 others were shown to form antibodies against their donor's myotubes. Muscle biopsies of the injected tibialis anterior of 4 patients revealed that 80%, 75%, 25%, and 0% of the muscle fibers, respectively, showed some degree of dystrophin immunostaining. The contralateral noninjected muscles of the latter 3 patients did not contain any dystrophin positive fibers, while that of the first patient showed dystrophin expression in 16% of the fibers examined. Myoblasts were also injected into the extensor carpi radialis longus or the biceps brachii of these patients. A few months subsequent to injection, one patient was shown to have a 143% increase of strength during static wrist extension. This result must be interpreted with caution because a double-blind strength-measuring protocol was not used. Furthermore, we have noted that this change slowly decayed over time. The strength of 2 other patients was increased less remarkably (41% and 51%), while the strength of the fourth patient was unchanged.
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Huard et al. (1992) studied this question.
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