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Muscle biology

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Proteomics-based evaluation of AAV dystrophin gene therapy outcomes in mdx skeletal muscle
Erynn E. Johnson, … , James M. Ervasti, Hichem Tasfaout
Erynn E. Johnson, … , James M. Ervasti, Hichem Tasfaout
Published November 27, 2025
Citation Information: JCI Insight. 2025. https://doi.org/10.1172/jci.insight.197759.
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Proteomics-based evaluation of AAV dystrophin gene therapy outcomes in mdx skeletal muscle

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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 novel method to express large dystrophin constructs using the protein trans-splicing (PTS) 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. 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.

Authors

Erynn E. Johnson, Theodore R. Reyes, Jeffrey S. Chamberlain, James M. Ervasti, Hichem Tasfaout

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Myosin inhibition partially rescues the myofibre proteome in X-linked myotubular myopathy
Elise Gerlach Melhedegaard, … , Julien Ochala, Jenni Laitila
Elise Gerlach Melhedegaard, … , Julien Ochala, Jenni Laitila
Published November 4, 2025
Citation Information: JCI Insight. 2025. https://doi.org/10.1172/jci.insight.194868.
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Myosin inhibition partially rescues the myofibre proteome in X-linked myotubular myopathy

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Abstract

X-linked myotubular myopathy (XLMTM) due to MTM1 mutations is a rare and often lethal congenital myopathy. Its downstream molecular and cellular mechanisms are currently incompletely understood. The most abundant protein in muscle, myosin, has been implicated in the pathophysiology of other congenital myopathies. Hence, in the present study, we aimed to define whether myosin is also dysfunctional in XLMTM and whether it thus may constitute a potential drug target. To this end, we used skeletal muscle tissue from human patients and canine/mouse models; we performed Mant-ATP chase experiments coupled with X-ray diffraction analyses and LC/MS-based proteomics studies. In XLMTM humans, we found that myosin molecules are structurally disordered and preferably adopt their ATP-consuming biochemical state. This phosphorylation-related (mal)adaptation was mirrored by a striking remodelling of the myofibre energetic proteome in XLMTM dogs. In line with these, we confirmed an accrued myosin ATP consumption in mice lacking MTM1. Hence, we treated these, with a myosin ATPase inhibitor, mavacamten. After a four-week treatment period, we observed a partial restoration of the myofibre proteome, especially proteins involved in cytoskeletal, sarcomeric and energetic pathways. Altogether, our study highlights myosin inhibition as a new potential drug mechanism for the complex XLMTM muscle phenotype.

Authors

Elise Gerlach Melhedegaard, Fanny Rostedt, Charlotte Gineste, Robert A.E. Seaborne, Hannah F. Dugdale, Vladimir Belhac, Edmar Zanoteli, Michael W. Lawlor, David L. Mack, Carina Wallgren-Pettersson, Anthony L. Hessel, Heinz Jungbluth, Jocelyn Laporte, Yoshihiko Saito, Ichizo Nishino, Julien Ochala, Jenni Laitila

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Spatial-proteomics reveals recombinant human laminin-111 restores adhesion-signaling to laminin-α2 deficient muscle
Hailey J. Hermann, … , Steven A. Moore, Dean J. Burkin
Hailey J. Hermann, … , Steven A. Moore, Dean J. Burkin
Published October 21, 2025
Citation Information: JCI Insight. 2025. https://doi.org/10.1172/jci.insight.194581.
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Spatial-proteomics reveals recombinant human laminin-111 restores adhesion-signaling to laminin-α2 deficient muscle

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Abstract

Laminin-α2-related Congenital Muscular Dystrophy (LAMA2-CMD) is a severe neuromuscular disorder caused by mutations in the LAMA2 gene, leading to loss of heterotrimers laminin-211/221, key components of the skeletal muscle extracellular matrix. Their absence disrupts adhesion between the cytoskeleton and extracellular matrix, resulting in progressive muscle wasting. Laminin-211/221 interacts with adhesion complexes such as the dystrophin/Utrophin glycoprotein complex and the α7β1-integrin. However, the regulatory mechanisms of these laminin-binding complexes and the broader role of laminin’s influence on the formation of the macromolecular network in skeletal muscle remain unclear. We previously demonstrated that mouse laminin-111 delivered in the dyW⁻/⁻ mouse model of LAMA2-CMD prevented disease progression, improved strength, and extended survival. We hypothesize that laminin-111, the embryonic laminin isoform, restores key adhesion-signaling networks. Using spatial-proteomics on patient and mouse muscle, we identified loss of essential signaling components: heat shock proteins 27 and 70, c-Jun N-terminal kinase, and glucose transporter 1 in laminin-α2 deficient muscle. Treatment with recombinant human laminin-111 (rhLAM-111) restored protein localization, reduced ROS, and promoted glycolytic, pro-survival signaling. These findings highlight laminin’s role in maintaining muscle homeostasis and metabolism and support the therapeutic potential of rhLAM-111 for treating LAMA2-CMD by restoring adhesion and intracellular signaling in dystrophic muscle.

Authors

Hailey J. Hermann, Ryan D. Wuebbles, Marisela Dagda, Axel Munoz, Lauren L. Parker, Paula C. C Guzman, Lola T. Byrne, Steven A. Moore, Dean J. Burkin

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A role for the transcriptional coregulator RIP140 in the control of muscle endurance fitness
Elizabeth Pruzinsky, … , Tejvir S. Khurana, Daniel P. Kelly
Elizabeth Pruzinsky, … , Tejvir S. Khurana, Daniel P. Kelly
Published October 21, 2025
Citation Information: JCI Insight. 2025. https://doi.org/10.1172/jci.insight.192376.
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A role for the transcriptional coregulator RIP140 in the control of muscle endurance fitness

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Abstract

Poor skeletal muscle fitness contributes to many chronic disease states including obesity, heart failure, primary muscle disorders, and age-related sarcopenia. Receptor Interacting Protein 140 (RIP140) is a striated muscle-enriched nuclear receptor coregulator known to suppress mitochondrial oxidative capacity. To investigate the role of RIP140 in skeletal muscle, striated muscle-specific RIP140-deficient (strNrip1-/-) mice were generated and characterized. strNrip1-/- mice displayed an enhanced endurance performance phenotype. RNA-sequence (RNA-seq) analysis of glycolytic fast-twitch muscle from strNrip1-/- mice identified a broad array of differentially upregulated metabolic and structural muscle genes known to be induced by endurance training, including pathways involved in mitochondrial biogenesis and respiration, fatty acid oxidation, slow muscle fiber type, and angiogenesis. In addition, muscle RIP140-deficiency induced expansive neuromuscular junction (NMJ) remodeling. Integration of RNA sequence results with CUT&RUN analysis of strNrip1-/- myotubes identified Wnt16 as a candidate effector for the NMJ biogenesis in RIP140-deficient skeletal myotubes. We conclude that RIP140 serves as a physiological “rheostat” for a broad coordinated network of metabolic and structural genes involved in skeletal muscle fitness.

Authors

Elizabeth Pruzinsky, Kirill Batmanov, Denis M. Medeiros, Sarah M. Sulon, Brian P. Sullivan, Tomoya Sakamoto, Teresa C. Leone, Tejvir S. Khurana, Daniel P. Kelly

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Lack of myotubularin phosphatase activity is the main cause of X-linked Myotubular Myopathy
Foteini Moschovaki-Filippidou, … , Bernard Payrastre, Jocelyn Laporte
Foteini Moschovaki-Filippidou, … , Bernard Payrastre, Jocelyn Laporte
Published October 14, 2025
Citation Information: JCI Insight. 2025. https://doi.org/10.1172/jci.insight.189286.
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Lack of myotubularin phosphatase activity is the main cause of X-linked Myotubular Myopathy

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Abstract

The MTM1 gene encodes myotubularin (MTM1), a phosphatidylinositol 3-phosphate (PI(3)P) lipid phosphatase. Loss-of-function mutations in MTM1 cause X-linked myotubular myopathy (XLMTM), a severe congenital myopathy with no available cure and a poorly understood pathomechanism. The importance of MTM1 enzymatic activity and its PI(3)P substrate in physiology under normal conditions and in XLMTM is unclear. We generated the Mtm1 KI C375S mice in which the endogenous MTM1 was converted to a phosphatase-dead protein. Mutant mice survived a median of 12 weeks and demonstrated progressively impaired motor skills. Observed muscle hypotrophy and reduced force production compared to their WT littermates (~3.9-fold reduction in absolute maximal force) were responsible for these severe phenotypes. A significantly higher level of PI(3)P was found in the muscle of Mtm1 KI C375S mice. Muscle histology and molecular characterization revealed XLMTM hallmarks, with alteration of the mTOR and autophagy pathways correlating with muscle hypotrophy, and abnormal myofiber intracellular organization correlating with impaired muscle force. Overall, this study reveals the importance of MTM1 phosphatase activity and related PI(3)P substrate for postnatal muscle maintenance, and highlights the significance of MTM1 phosphatase activity in the development of X-linked myotubular myopathy.

Authors

Foteini Moschovaki-Filippidou, Christine Kretz, David Reiss, Gaetan Chicanne, Bernard Payrastre, Jocelyn Laporte

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Matrix metalloproteinases are hallmark early biomarkers and therapeutic targets in FSHD
Usuk Jung, … , Michael Kyba, Darko Bosnakovski
Usuk Jung, … , Michael Kyba, Darko Bosnakovski
Published September 18, 2025
Citation Information: JCI Insight. 2025. https://doi.org/10.1172/jci.insight.195104.
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Matrix metalloproteinases are hallmark early biomarkers and therapeutic targets in FSHD

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Abstract

Matrix remodeling by metalloproteinases (MMPs) is essential for maintaining muscle homeostasis; however, their dysregulation can drive degenerative processes. By interrogating biopsy RNA-seq data, we show that MMP expression correlates with disease severity in facioscapulohumeral muscular dystrophy (FSHD). In the iDUX4pA FSHD mouse model, MMP levels also progressively increase in response to DUX4-induced muscle degeneration. Single-cell RNA-seq further identifies fibroadipogenic progenitors (FAPs) and macrophages as the primary sources of MMPs, particularly MMP2, MMP14, and MMP19, in dystrophic muscle. Treatment with the pan-MMP inhibitor Batimastat alleviates inflammation and fibrosis, improves muscle structure, and decreases the number of FAPs and infiltrating macrophages. These findings underscore the role of MMPs in driving muscle degeneration in FSHD, highlight MMPs as functional biomarkers of disease, and support MMP inhibitors as a DUX4-independent therapeutic approach to limit fibroadipogenesis and promote muscle regeneration.

Authors

Usuk Jung, Erdong Wei, Haseeb Ahsan, Ana Mitanoska, Kenric Chen, Michael Kyba, Darko Bosnakovski

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Rapid cyclic stretching of cultured human visceral smooth muscle cells promotes a synthetic, proinflammatory phenotype
Sharon M. Wolfson, … , Robert O. Heuckeroth, Sohaib K. Hashmi
Sharon M. Wolfson, … , Robert O. Heuckeroth, Sohaib K. Hashmi
Published September 16, 2025
Citation Information: JCI Insight. 2025. https://doi.org/10.1172/jci.insight.188669.
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Rapid cyclic stretching of cultured human visceral smooth muscle cells promotes a synthetic, proinflammatory phenotype

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Abstract

Bowel smooth muscle experiences mechanical stress constantly during normal function, and pathologic mechanical stressors in disease states. We tested the hypothesis that pathologic mechanical stress could alter transcription to induce smooth muscle phenotypic class switching. To test this hypothesis, primary human intestinal smooth muscle cells (HISMCs), seeded on electrospun aligned poly-ε-caprolactone nano-fibrous scaffolds, were subjected to pathologic, high frequency (1 Hz) uniaxial 3% cyclic stretch (loaded) or kept unloaded in culture for 6 hours. RNA sequencing, qRT-PCR, and quantitative immunohistochemistry defined loading-induced changes in gene expression. NicheNet predicted how differentially expressed genes might impact HISMCs and other bowel cells. These studies showed loading induced differential expression of 4537 HISMC genes. Loaded HISMCs had a less contractile phenotype, with increased expression of synthetic SMC genes, proinflammatory cytokines, and altered expression of axon guidance molecules, growth factors, and morphogens. Many differentially expressed genes encode secreted ligands that could act cell-autonomously on smooth muscle and on other cells in the bowel wall. These data show HISMCs undergo remarkably rapid phenotypic plasticity in response to mechanical stress that may convert contractile HISMCs into proliferative, fibroblast-like cells or proinflammatory cells. These mechanical stress-induced changes in HISMC gene expression may be relevant for human bowel disease.

Authors

Sharon M. Wolfson, Katherine Beigel, Sierra E. Anderson, Brooke Deal, Molly Weiner, Se-Hwan Lee, Deanne M. Taylor, Su Chin Heo, Robert O. Heuckeroth, Sohaib K. Hashmi

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Macrophage metabolic rewiring rejuvenates muscle raman signatures and cellular remodeling during regrowth in aged mice
Zachary J. Fennel, … , Anhong Zhou, Micah J. Drummond
Zachary J. Fennel, … , Anhong Zhou, Micah J. Drummond
Published September 9, 2025
Citation Information: JCI Insight. 2025. https://doi.org/10.1172/jci.insight.194303.
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Macrophage metabolic rewiring rejuvenates muscle raman signatures and cellular remodeling during regrowth in aged mice

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Abstract

Impaired muscle regrowth in aging is underpinned by reduced pro-inflammatory macrophage function and subsequently impaired muscle cellular remodeling. Macrophage phenotype is metabolically controlled through TCA intermediate accumulation and activation of HIF1A. We hypothesized that transient hypoxia following disuse in old mice would enhance macrophage metabolic inflammatory function thereby improving muscle cellular remodeling and recovery. Old (20 months) and young adult mice (4 months) were exposed to acute (24h) normobaric hypoxia immediately following 14-days of hindlimb unloading and assessed during early re-ambulation (4- and 7-days) compared to age-matched controls. Treated aged mice had improved pro-inflammatory macrophage profiles, muscle cellular remodeling, and functional muscle recovery to the levels of young control mice. Likewise, young adult mice had enhanced muscle remodeling and functional recovery when treated with acute hypoxia. Treatment in aged mice restored the muscle molecular fingerprint and biochemical spectral patterns (Raman Spectroscopy) observed in young mice and strongly correlated to improved collagen remodeling. Finally, intramuscular delivery of hypoxia-treated macrophages recapitulated the muscle remodeling and recovery effects of whole-body hypoxic exposure in old mice. These results emphasize the role of pro-inflammatory macrophages during muscle regrowth in aging and highlight immunometabolic approaches as a route to improve muscle cellular dynamics and regrowth.

Authors

Zachary J. Fennel, Negar Kosari, Paul-Emile Bourrant, Elena M. Yee, Robert J. Castro, Anu S. Kurian, Jonathan Palmer, Morgan Christensen, Katsuhiko Funai, Ryan M. O'Connell, Anhong Zhou, Micah J. Drummond

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Differential pathology and susceptibility to MBNL loss across muscles in myotonic dystrophy mouse models
Mackenzie L. Davenport, … , Jodi L. Bubenik, Maurice S. Swanson
Mackenzie L. Davenport, … , Jodi L. Bubenik, Maurice S. Swanson
Published August 14, 2025
Citation Information: JCI Insight. 2025. https://doi.org/10.1172/jci.insight.195836.
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Differential pathology and susceptibility to MBNL loss across muscles in myotonic dystrophy mouse models

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Abstract

There are two subtypes of myotonic dystrophy, DM1 and DM2, each caused by repeat expansion mutations. The leading pathogenic mechanism is RNA mediated toxicity whereby (C)CUG expansions sequester the muscleblind-like (MBNL) family of RNA binding proteins. However, key differences exist in muscle involvement patterns and histopathology between DM1 and DM2. The cause of these disparities both in how the muscles are affected within each disease and between the two diseases is unknown, and it is unclear if current DM mouse models recapitulate these differences or develop differential muscle susceptibility. Here, we examined the expression of disease-relevant genes across healthy human muscles from a transcriptomic atlas and collected a series of muscles from Mbnl knockout mice to evaluate characteristic histologic and molecular features of DM pathology. Our results indicate that MBNL loss discordantly affects muscles, likely through a splicing independent mechanism, and results in a fiber atrophy profile more like DM1 than DM2. These findings point to a predominant role for MBNL loss in muscle pattern involvement in DM1, provide further evidence for additional DM2 pathomechanisms, and have important implications for muscle choice when performing analyses in new mouse models and evaluating therapeutic modalities and biomarkers.

Authors

Mackenzie L. Davenport, Amaya Fong, Gloria Montoya-Vazquez, Maria Fernanda Alves de Moura, Jodi L. Bubenik, Maurice S. Swanson

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STAC3 binding to CaV1.1 II-III loop is nonessential but critically supports skeletal muscle excitation-contraction coupling
Wietske E. Tuinte, … , Adele D’Amico, Marta Campiglio
Wietske E. Tuinte, … , Adele D’Amico, Marta Campiglio
Published August 8, 2025
Citation Information: JCI Insight. 2025;10(15):e191053. https://doi.org/10.1172/jci.insight.191053.
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STAC3 binding to CaV1.1 II-III loop is nonessential but critically supports skeletal muscle excitation-contraction coupling

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Abstract

Skeletal muscle excitation-contraction (EC) coupling depends on the direct coupling between CaV1.1 on the sarcolemma and ryanodine receptor (RyR1) on the sarcoplasmic reticulum. A key regulator of this process is STAC3, a protein essential for both the functional expression of CaV1.1 and its conformational coupling with RyR1. Mutations in Stac3 cause STAC3 disorder, a congenital myopathy characterized by muscle weakness. STAC3 interacts with CaV1.1 in 2 key regions: the II-III loop and the proximal C-terminus. While the II-III loop has been previously found to be essential for skeletal muscle EC coupling, here we demonstrated that the interaction between STAC3 and the proximal C-terminus is necessary and sufficient for CaV1.1 functional expression and minimal EC coupling. In contrast, the interaction with the II-III loop is not essential for EC coupling, though it plays a facilitating role in enhancing the process. Supporting this finding, we identified a patient with STAC3 disorder carrying a mutation that deletes the domain of STAC3 involved in the II-III loop interaction. Collectively, our results established that STAC3 binding to CaV1.1 C-terminus is essential for its functional expression, whereas STAC3 interaction with the II-III loop serves to enhance the conformational coupling with RyR1.

Authors

Wietske E. Tuinte, Enikő Török, Petronel Tuluc, Fabiana Fattori, Adele D’Amico, Marta Campiglio

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