Mastrostefano Francesca, Garofalo Martina, Nuzzo Tommaso, Bruno Claudio, Errico Francesco, Usiello Alessandro, De Stefano Maria Egle
Department of Biology and Biotechnologies "Charles Darwin", Sapienza University of Rome, Rome, Italy.
Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Università Degli Studi Della Campania "Luigi Vanvitelli", Caserta, Italy.
J Neurochem. 2025 Sep;169(9):e70223. doi: 10.1111/jnc.70223.
Patients with Duchenne muscular dystrophy (DMD) may experience neurobehavioral and cognitive concerns, including psychiatric symptoms, due to the absence of full-length dystrophin (Dp427), frequently accompanied by deficiencies in shorter isoforms. The lack of dystrophin affects neurophysiological processes from the uterine phase, impacting neural circuitry in brain regions such as the prefrontal cortex, hippocampus, and cerebellum. This leads to reduced inhibitory GABAergic transmission and altered hippocampal glutamatergic signaling. The resulting imbalance between inhibitory and excitatory inputs contributes to the neurodevelopmental and cognitive deficits observed in DMD. Recent studies have reported correlations between serum levels of D-aspartate and D-serine, endogenous ligands of glutamatergic receptors, and conditions such as schizophrenia, spinal muscular atrophy, and aging. Furthermore, in a recent clinical study, we reported a general dysregulation of D-/L-amino acids known to modulate glutamatergic neurotransmission in the serum of DMD patients, with significant correlations between muscle wasting, motor impairment, and alterations in L-glutamate levels and the L-glutamine/L-glutamate ratio. To delve deeper into this matter, we conducted an extensive neurochemical analysis using high-pressure liquid chromatography to measure the levels of the same D-/L-amino acids across various brain regions, the spinal cord, and serum of the mdx mouse model of DMD. Our results revealed a significant reduction in prenatal D-aspartate levels and postnatal levels of specific L-amino acids in the hippocampus of dystrophic mice compared to wild type. In adult mdx mice, we also observed a near-significant decrease in hippocampal D-serine levels and a significant reduction in spinal cord D-aspartate levels. This study provides the first evidence potentially linking D-/L-amino acid dysmetabolism in the hippocampus to the described neurophysiological alterations. Although further investigations are essential to validate this hypothesis, the mechanisms proposed here offer insight into how amino acid imbalances may contribute to the DMD-associated neurological and cognitive deficits, thus supporting the rationale for developing future targeted therapeutic strategies.
杜兴氏肌肉营养不良症(DMD)患者可能会出现神经行为和认知方面的问题,包括精神症状,这是由于缺乏全长抗肌萎缩蛋白(Dp427)所致,同时常常伴有较短亚型的缺乏。抗肌萎缩蛋白的缺失从子宫期就影响神经生理过程,影响前额叶皮质、海马体和小脑等脑区的神经回路。这导致抑制性γ-氨基丁酸能传递减少,海马体谷氨酸能信号改变。抑制性和兴奋性输入之间的失衡导致了DMD中观察到的神经发育和认知缺陷。最近的研究报道了谷氨酸能受体的内源性配体D-天冬氨酸和D-丝氨酸的血清水平与精神分裂症、脊髓性肌萎缩症和衰老等病症之间的相关性。此外,在最近的一项临床研究中,我们报道了已知调节谷氨酸能神经传递的D-/L-氨基酸在DMD患者血清中的普遍失调,肌肉萎缩、运动障碍以及L-谷氨酸水平和L-谷氨酰胺/L-谷氨酸比值的改变之间存在显著相关性。为了更深入地探讨这个问题,我们使用高压液相色谱法进行了广泛的神经化学分析,以测量DMD的mdx小鼠模型的各个脑区、脊髓和血清中相同D-/L-氨基酸的水平。我们的结果显示,与野生型相比,营养不良小鼠海马体中产前D-天冬氨酸水平和产后特定L-氨基酸水平显著降低。在成年mdx小鼠中,我们还观察到海马体D-丝氨酸水平近乎显著下降,脊髓D-天冬氨酸水平显著降低。这项研究提供了首个可能将海马体中D-/L-氨基酸代谢紊乱与上述神经生理改变联系起来的证据。尽管进一步的研究对于验证这一假设至关重要,但这里提出的机制为氨基酸失衡如何导致与DMD相关的神经和认知缺陷提供了见解,从而支持了制定未来靶向治疗策略的理论依据。