Myostatin inhibition with orally administered Lactobacillus casei expressing a modified human myostatin protein: functional benefits and translational potential in advanced Duchenne muscular dystrophy

This study demonstrates that myostatin inhibition with orally administered <i>L. casei</i> expressing a modified human myostatin protein confers functional benefits even in advanced DMD, while highlighting its therapeutic limitations without concomitant dystrophin restoration. As a cost-effective, non-invasive, and immunologically distinct platform, this system holds translational potential not only for DMD but also for broader applications in sarcopenia and metabolic disorders.