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Review
. 2025 Oct 1;38(5):504-512.
doi: 10.1097/WCO.0000000000001382. Epub 2025 Jun 5.

Recent progress in the molecular understanding and treatments of facioscapulohumeral muscular dystrophy

Roy Augustinus  1 , Nicole Voet  2 , Jessica C de Greef  1 , Nicol C Voermans  3   4
Affiliations
Review

Recent progress in the molecular understanding and treatments of facioscapulohumeral muscular dystrophy

Roy Augustinus et al. Curr Opin Neurol. .

Abstract

Purpose of review: Facioscapulohumeral muscular dystrophy (FSHD) is a progressive inherited myopathy, for which there is currently no cure available. This review focuses on the recent progress in the molecular understanding and treatments of FSHD.

Recent findings: Recent studies on the molecular understanding of FSHD highlight its multifaceted complexity and suggest new targets for therapeutic intervention. Preclinical models, such as the 3D skeletal muscle, provide an easier way to study molecular pathways and serve as a platform for drug screenings. New insights on training and the new international guideline contribute to optimal symptomatic treatment. In parallel, research is advancing with generic and targeted molecular therapies aiming to inhibit DUX4 activity or its downstream effects.

Summary: FSHD is caused by abnormal expression of the DUX4 gene. Our understanding of the molecular mechanisms underlying DUX4 and DUX4 target gene expression remains incomplete. However, advancements continue to clarify the roles of key proteins and genes, which might be of interest for future therapeutic therapies. Current therapies, treatments, and clinical trials for FSHD focus on molecular approaches, gene therapy, and symptom management. These developments indicate a growing focus on precision treatments and functional assessments, paving the way for improved FSHD management.

Keywords: facioscapulohumeral muscular dystrophy; molecular understanding; therapeutic approaches.

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References

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    1. Šikrová D, Testa AM, Willemsen I, et al. SMCHD1 and LRIF1 converge at the FSHD-associated D4Z4 repeat and LRIF1 promoter yet display different modes of action. Commun Biol 2023; 6:677.
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