In dystrophinopathies, loss of dystrophin leads to dysfunction of the mitochondria, resulting in, among other things, increased inflammation, decreased activation of satellite cells and worsened clinical phenotype. Epicatechin is an antioxidant from the flavonoid family that mimics the effects of aerobic exercise and may therefore induce mitochondria biogenesis.
A pilot study in people with heart failure or type 2 diabetes for 8 weeks showed that epicatechin helped restore markers of mitochondria biogenesis, muscle growth and muscle regeneration.
An open-label trial of epicatechin was conducted in 7 ambulant adults with Becker’s myopathy, aged 18 to 60 years. Taken twice a day for 8 weeks, epicatechin increased the expression:
- regulators of mitochondria biogenesis (such as LKB1, AMPK, PGC-1α);
- muscle growth regulators (by decreasing myostatin, a natural growth inhibitor, and by increasing follistatin, a myostatin inhibitor);
- proteins involved in the regeneration of skeletal muscles (myogenin, Muf5, MyoD, MEF2a);
- proteins involved in maintaining the integrity of skeletal muscle (including dysferlin and utrophin).
Epicatechin also produced improvements similar to those seen after a short aerobic exercise program (8 to 12 weeks) such as decreased heart rate, VO2 / Kg and plasma lactate levels.
To confirm these results, a longer-term (12-month) epicatechin trial in 20 participants with Becker’s myopathy is under preparation in the United States.
