{
  "abstract": "Duchenne muscular dystrophy (DMD) is a severe X-linked myopathy characterised by progressive skeletal and cardiac muscle degeneration, loss of ambulation, respiratory failure and premature mortality. Although corticosteroids and gene therapies have improved disease management, they are limited by significant side effects, mutation specificity and delivery challenges, underscoring the need for an alternative or an adjunctive strategy. Emerging evidence identifies autophagy dysregulation as a critical secondary pathological mechanism in DMD, contributing to impaired clearance of damaged organelles and toxic protein aggregates, exacerbating muscle atrophy and fibrosis.This review aims to acknowledge current insights into autophagy regulation in healthy muscle and its disruption in DMD, explore its crosstalk with key pathological pathways such as nuclear factor kappa B signalling, mitochondrial dysfunction and endoplasmic reticulum stress and critically evaluate emerging therapeutic strategies targeting autophagy.Autophagy, a fundamental cellular recycling process, is suppressed in DMD by hyperactivation of the Akt-mTOR pathway and dysregulated calcium homeostasis. This leads to mitochondrial dysfunction, oxidative stress and activation of inflammatory cascades. Recent preclinical studies highlight the therapeutic potential of pharmacological and dietary autophagy modulators, including rapamycin, 5-aminoimidazole-4-carboxamide ribonucleotide, low protein diets, SRT2104 and Givinostat, which improve autophagic flux, restore mitochondrial integrity and attenuate fibrosis. Lifestyle interventions and combinatorial approaches further underscore the importance of integrating multimodal strategies.Further research should focus on longitudinal studies to optimise therapeutic timing, validate dynamic biomarkers (LC-II, p62, miRNAs) and leverage artificial intelligence with multiomics integration for precision therapies. Targeting autophagy and its interconnected pathways holds promise for transforming DMD management and improving patient outcomes.",
  "authors": [
    {
      "affiliations": [
        "Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST supported center and ICMR Collaborating Center of Excellence – ICMR-CCoE), Department of Biochemistry (DST-FIST supported department), JSS Medical College, JSS Academy of Higher Education and Research (JSS AHER), Mysuru, Karnataka, India"
      ],
      "name": "Lakshmi Krishna"
    },
    {
      "affiliations": [
        "Department of Medical Genetics, JSS Academy of Higher Education and Research, Mysuru, India"
      ],
      "name": "Ananyashree Srivathsa"
    },
    {
      "affiliations": [
        "Department of Medical Genetics, JSS Academy of Higher Education and Research, Mysuru, India"
      ],
      "name": "Rhea Anand"
    },
    {
      "affiliations": [
        "Department of Medical Genetics, JSS Academy of Higher Education and Research, Mysuru, India"
      ],
      "name": "Anagha Rao"
    },
    {
      "affiliations": [
        "Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST supported center and ICMR Collaborating Center of Excellence – ICMR-CCoE), Department of Biochemistry (DST-FIST supported department), JSS Medical College, JSS Academy of Higher Education and Research (JSS AHER), Mysuru, Karnataka, India"
      ],
      "name": "Medha Karnik"
    },
    {
      "affiliations": [
        "Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST supported center and ICMR Collaborating Center of Excellence – ICMR-CCoE), Department of Biochemistry (DST-FIST supported department), JSS Medical College, JSS Academy of Higher Education and Research (JSS AHER), Mysuru, Karnataka, India"
      ],
      "name": "Prashant Vishwanath"
    },
    {
      "affiliations": [
        "Department of Biotechnology & Bioinformatics, JSS School of Life Science, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India"
      ],
      "name": "Chandan Dharmashekar"
    },
    {
      "affiliations": [
        "Department of Pharmaceutical Chemistry, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India"
      ],
      "name": "Yogish Kumar Honnavalli"
    },
    {
      "affiliations": [
        "Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST supported center and ICMR Collaborating Center of Excellence – ICMR-CCoE), Department of Biochemistry (DST-FIST supported department), JSS Medical College, JSS Academy of Higher Education and Research (JSS AHER), Mysuru, Karnataka, India",
        "Department of Medical Genetics, JSS Academy of Higher Education and Research, Mysuru, India"
      ],
      "name": "Akila Prashant"
    }
  ],
  "title": "Targeting autophagy in Duchenne muscular dystrophy: mechanistic insights and emerging therapeutic strategies",
  "uid": "0d623f0f-d245-5002-9625-b5719019f563"
}