Journal Article

Prednisolone Attenuates Improvement of Cardiac and Skeletal Contractile Function and Histopathology by Lisinopril and Spironolactone in the mdx Mouse Model of Duchenne Muscular Dystrophy

Schultz, Eric J., Tran, Tam, Raman, Subha V., Schill, Kevin E., Rafael-Fortney, Jill A., Murray, Jason D., Janssen, Paul M. L., Rastogi, Neha

2014

Overview

Duchenne muscular dystrophy (DMD) is an inherited disease that causes striated muscle weakness. Recently, we showed therapeutic effects of the combination of lisinopril (L), an angiotensin converting enzyme (ACE) inhibitor, and spironolactone (S), an aldosterone antagonist, in mice lacking dystrophin and haploinsufficient for utrophin (utrn(+/-);mdx, het mice); both cardiac and skeletal muscle function and histology were improved when these mice were treated early with LS. It was unknown to what extent LS treatment is effective in the most commonly used DMD murine model, the mdx mouse. In addition, current standard-of-care treatment for DMD is limited to corticosteroids. Therefore, potentially useful alternative or additive drugs need to be both compared directly to corticosteroids and tested in presence of corticosteroids. We evaluated the effectiveness of this LS combination in the mdx mouse model both compared with corticosteroid treatment (prednisolone, P) or in combination (LSP). We tested the additional combinatorial treatment containing the angiotensin II receptor blocker losartan (T), which is widely used to halt and treat the developing cardiac dysfunction in DMD patients as an alternative to an ACE inhibitor. Peak myocardial strain rate, assessed by magnetic resonance imaging, showed a negative impact of P, whereas in both diaphragm and extensor digitorum longus (EDL) muscle contractile function was not significantly impaired by P. Histologically, P generally increased cardiac damage, estimated by percentage area infiltrated by IgG as well as by collagen staining. In general, groups that only differed in the presence or absence of P (i.e. mdx vs. P, LS vs. LSP, and TS vs. TSP) demonstrated a significant detrimental impact of P on many assessed parameters, with the most profound impact on cardiac pathology.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Age / Aldosterone / Angiotensin / Angiotensin converting enzyme / Angiotensin II / Angiotensins / Animal models / Animals / Antiandrogens / Biochemistry / Biology / Cardiotonic agents / Cardiotonic Agents - antagonists & inhibitors / Cardiotonic Agents - pharmacology / Collagen / Combinatorial analysis / Corticoids / Corticosteroids / Diaphragm / Diaphragm (anatomy) / Disease Models, Animal / Diuretics - antagonists & inhibitors / Diuretics - pharmacology / Drugs / Duchenne muscular dystrophy / Duchenne's muscular dystrophy / Dystrophin / Dystrophin - deficiency / Dystrophin - genetics / Dystrophy / Female / Gene Expression / Glucocorticoids / Glucocorticoids - adverse effects / Health aspects / Heart / Heart diseases / Histochemistry / Histology / Histopathology / Humans / Immunoglobulin G / Inhibitors / Laboratory animals / Lisinopril / Lisinopril - antagonists & inhibitors / Lisinopril - pharmacology / Losartan - pharmacology / Magnetic resonance / Magnetic resonance imaging / Male / Medicine / Mice / Mice, Inbred mdx / Muscle contraction / Muscle Contraction - drug effects / Muscle Weakness - drug therapy / Muscle Weakness - genetics / Muscle Weakness - physiopathology / Muscle, Skeletal - drug effects / Muscles / Muscular dystrophy / Muscular Dystrophy, Animal - drug therapy / Muscular Dystrophy, Animal - genetics / Muscular Dystrophy, Animal - physiopathology / Muscular Dystrophy, Duchenne / Musculoskeletal system / Myocardium - metabolism / Myocardium - pathology / Peptidyl-dipeptidase A / Physiology / Prednisolone / Prednisolone - adverse effects / Rodents / Skeletal muscle / Spironolactone / Spironolactone - antagonists & inhibitors / Spironolactone - pharmacology / Steroids / Steroids (Organic compounds) / Strain rate / Substance abuse treatment / Utrophin / Utrophin - deficiency / Utrophin - genetics