Epicatechin induces mitochondrial biogenesis and markers of muscle regeneration in adults with Becker muscular dystrophy.

Introduction We conducted an open-label study to examine the effects of the flavonoid (-)-epicatechin, in 7 ambulatory adult patients with Becker muscular dystrophy (BMD). Methods Seven participants received (-)-epicatechin 50 mg twice per day for 8 weeks. Pre- and post-procedures included biceps brachii biopsy to assess muscle structure and growth relevant endpoints by Western blots, mitochondria volume and cristae abundance by electron microscopy, graded exercise testing, and muscle strength and function tests. Results Western blots showed significantly increased levels of enzymes modulating cellular bioenergetics (LKB1 and AMPK). PGC-1α, a transcriptional coactivator of genes involved in mitochondrial biogenesis and cristae-associated mitofilin levels increased as well as cristae abundance. Muscle and plasma follistatin increased significantly while myostatin decreased. Markers of skeletal muscle regeneration myogenin, Myf5, MyoD and MEF2a and structure associated proteins including, dysferlin, utrophin, and intracellular creatine kinase also increased. Exercise testing demonstrated decreased heart rate, VO2 /Kg, and plasma lactate levels at defined workloads. Tissue saturation index improved in resting and post-exercise states. Discussion (-)-Epicatechin, an exercise mimetic, appears to have short-term positive effects on tissue biomarkers indicative of mitochondrial biogenesis and muscle regeneration, and produced improvements in graded exercise testing parameters in patients with BMD.