Matrix metalloproteinases are hallmark early biomarkers and therapeutic targets in FSHD

JCI Insight
|September 18, 2025
PubMed

Insights

Matrix metalloproteinases (MMPs) drive muscle degeneration in facioscapulohumeral muscular dystrophy (FSHD). Inhibiting MMPs reduced fibrosis and inflammation, suggesting MMP inhibitors as a potential therapy for FSHD.

Area of Science:

  • Muscle Biology
  • Molecular Medicine
  • Biochemistry

Background:

  • Matrix metalloproteinases (MMPs) are crucial for muscle homeostasis, but their dysregulation contributes to degenerative diseases.
  • Facioscapulohumeral muscular dystrophy (FSHD) is characterized by progressive muscle degeneration, with the role of MMPs not fully elucidated.

Purpose of the Study:

  • To investigate the role of MMPs in FSHD pathogenesis.
  • To identify the cellular sources of MMPs in dystrophic muscle.
  • To evaluate the therapeutic potential of MMP inhibition in FSHD.

Main Methods:

  • Analysis of RNA-Seq data from FSHD patient biopsies and an iDUX4pA FSHD mouse model.
  • Single-cell RNA-Seq to identify MMP-producing cells.
  • Treatment of the FSHD mouse model with the pan-MMP inhibitor batimastat.

Main Results:

  • MMP expression correlated with disease severity in FSHD patients and increased during DUX4-induced degeneration in mice.
  • Fibroadipogenic progenitors (FAPs) and macrophages were identified as major MMP sources (MMP2, MMP14, MMP19) in dystrophic muscle.
  • Batimastat treatment reduced inflammation, fibrosis, and FAP/macrophage infiltration, while improving muscle structure.

Conclusions:

  • MMPs play a significant role in driving muscle degeneration in FSHD.
  • MMPs serve as functional biomarkers for FSHD progression.
  • MMP inhibitors represent a promising DUX4-independent therapeutic strategy for FSHD, targeting fibroadipogenesis and promoting muscle regeneration.