[Therapeutic strategies for muscular dystrophy by myostatin inhibition].

Myostatin is a member of the TGF-beta superfamily that is expressed predominantly in skeletal muscle and functions as a negative regulator of skeletal muscle mass. Myostatin inhibition, therefore, has tremendous potential for increasing muscle mass clinically to treat patients with muscle wasting diseases. Systemic administration of a myostatin neutralizing antibody in mdx mice (a model of Duchenne muscular dystrophy) resulted in an increase in skeletal muscle mass and strength. A human anti-myostatin monoclonal antibody, MYO-029 is under clinical trials in patients with muscular dystrophy in the USA and Europe. Additional approaches to myostatin inhibition have been shown to have beneficial effects in vivo. Blockade of myostatin activity with the myostatin prodomain resulted in increases in muscle mass, enhanced muscle function, and histological improvement of the dystrophic muscle in mdx mice and mutant caveolin-3 transgenic mice (a model of LGMD1C). Treatment with an extracellular ligand-binding domain of the myostatin receptor, ActRIIB, resulted in prominent muscle mass increases in LGMD1C model mice. These findings indicate that myostatin inhibition could lead to effective therapeutics to treat muscular dystrophy. However, therapeutic indication against various types of muscular dystrophy as well as safety of the treatment should be established for the future clinical application.