Potential adaptive signaling pathways in the diaphragm of mdx mice treated with micro-dystrophin combined with voluntary running

Hamm et al., 2021 reported that voluntary wheel running (R) was complementary to micro-dystrophin gene therapy (GT) in mdx mice, a model of Duchenne muscular dystrophy (DMD). After 21 weeks of running, time to fatigue on a treadmill for the mdxRGT mice was increased 1.8-fold compared to mdxGT mice (no run) and ~5-fold compared to mdx mice (no micro-dystrophin, no run). Fatigue times for mdxRGT were similar to wild type runners (WTR), while mdxGT and WT (no run) were also similar. The diaphragm is an important muscle for endurance exercise. Remarkably, diaphragm power in mdxRGT was depressed compared to mdxGT, suggesting a negative impact of running on GT. To explore mechanisms to explain this decrease, transcriptome profiles for each of the study groups were assessed. RNASeq data revealed differentially expressed genes (DEGs) from groupwise comparisons. Transcripts identified using the Jackson Labs' Gene Expression Database and extensive literature review were organized into a master signaling pathway composed of two sub-pathways: muscle regeneration and fast-slow fiber type shift. Both sub-pathways were hypothesized to explain the improved treadmill performance despite decreased diaphragm power in mdxRGT as potential adaptive mechanisms. Analysis revealed that GT alone (mdxGT) rescued transcriptome expression to WT values in the mdx phenotype more than GT and running combined (mdxRGT). This outcome indicates that, at the 26-week timepoint of sacrifice, the signaling of the transcripts in the muscle regeneration and fast-slow fiber type shift sub-pathways was likely not responsible for the observed improved running performance of mdxRGT compared to mdx.