Lymphatic dysfunction is linked to disease pathogenesis in Duchenne muscular dystrophy animal models

B Bhuvaneshwaran Subramanian (Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University) S Shedreanna Johnson (Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University) A Akshaya Narayanan (Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University) W Wei Wang B Bonnie L. Seaberg (Department of Neuroscience and Experimental Therapeutics, Naresh K. Vashisht College of Medicine, Texas A&M University) J Jillian Ball (Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University) I Ilse M. Paredes Mares (Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University) A Ahana Majumder (Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University) A Alexandria Aceves (Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University) S Sarah E. Frazier (Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University) A Alexis Rutledge (Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University) J John F. Griffin (Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University) S Soumiya Pal (Department of Medical Pharmacology and Physiology, University of Missouri) S Scott Zawieja (Department of Medical Pharmacology and Physiology, University of Missouri) M Michael J. Davis J Joseph M. Rutkowski (Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University) P Peter P. Nghiem (Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University) M Mendell Rimer (Department of Neuroscience and Experimental Therapeutics, Naresh K. Vashisht College of Medicine, Texas A&M University) M Mariappan Muthuchamy (Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University)

Abstract

Duchenne muscular dystrophy (DMD) is a severe muscle-wasting disorder characterized by progressive muscle weakness and inflammation caused by mutations in the DMD gene. Chronic inflammation in DMD exacerbates the complications associated with disease progression. Since the lymphatic system plays a crucial role in regulating and resolving inflammation, our primary goal was to investigate whether lymphatics were dysregulated in skeletal muscle of DMD animals. We used the D2.mdx murine and golden retriever muscular dystrophy (GRMD) canine models, as well as mouse and rat lymphatic muscle cells (LMCs) to determine the role of dystrophin in lymphatic structure and function in skeletal muscles. Single-cell RNA sequencing data from control LMCs showed dystrophin expression, and protein results demonstrated that the 427-, 140-, and 71-kDa dystrophin isoforms were detectable in the LMCs from control mice, whereas the 427 kDa isoform was undetectable in LMCs derived from D2.mdx mice. Microlymphangiography and magnetic resonance lymphangiogram results showed a significant decrease in lymph transport in D2. mdx mice and GRMD dogs, respectively. Isolated flank lymphatic vessels from D2. mdx mice exhibited an increase in tonic contraction and a significant decrease in the phasic contractile frequency and amplitude, supporting lymphatic vessel dysfunction. The gene expression profile and immunofluorescence analyses of dystrophic muscle revealed inflammatory lymphangiogenesis in dystrophic muscle. Skeletal muscle tissues that showed improvement in function after adeno-associated virus-microdystrophin treatment also showed significant improvement in inflammatory lymphangiogenesis in GRMD dogs. Thus, these results show a linkage between lymphatic function and DMD pathogenesis that merits further investigation in DMD patients.

Article Details

Volume / Issue Vol. 122, Issue 38
Published September 23, 2025
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (19)

B

Bhuvaneshwaran Subramanian

Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University

S

Shedreanna Johnson

Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University

A

Akshaya Narayanan

Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University

W

Wei Wang

B

Bonnie L. Seaberg

Department of Neuroscience and Experimental Therapeutics, Naresh K. Vashisht College of Medicine, Texas A&M University

J

Jillian Ball

Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University

I

Ilse M. Paredes Mares

Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University

A

Ahana Majumder

Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University

A

Alexandria Aceves

Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University

S

Sarah E. Frazier

Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University

A

Alexis Rutledge

Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University

J

John F. Griffin

Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University

S

Soumiya Pal

Department of Medical Pharmacology and Physiology, University of Missouri

S

Scott Zawieja

Department of Medical Pharmacology and Physiology, University of Missouri

M

Michael J. Davis

J

Joseph M. Rutkowski

Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University

P

Peter P. Nghiem

Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University

M

Mendell Rimer

Department of Neuroscience and Experimental Therapeutics, Naresh K. Vashisht College of Medicine, Texas A&M University

M

Mariappan Muthuchamy

Department of Medical Physiology, Naresh K. Vashisht College of Medicine, Texas A&M University