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Vascular dysfunction has been suggested as an underlying pathogenic mechanism in DMD. However, this has not been thoroughly studied in a large animal model. Here we investigated structural and functional changes in the vascular smooth muscle and endothelium of the canine DMD model. The expression of dystrophin and endothelial nitric oxide synthase (eNOS), neuronal NOS (nNOS), and the structure and function of the femoral artery from 15 normal and 16 affected adult dogs were evaluated. Full\u2010length dystrophin was detected in the endothelium and smooth muscle in normal but not affected dog arteries. Normal arteries lacked nNOS but expressed eNOS in the endothelium. NOS activity and eNOS expression were reduced in the endothelium of dystrophic dogs. Dystrophin deficiency resulted in structural remodeling of the artery. In affected dogs, the maximum tension induced by vasoconstrictor phenylephrine and endothelin\u20101 was significantly reduced. In addition, acetylcholine\u2010mediated vasorelaxation was significantly impaired, whereas exogenous nitric oxide\u2010induced vasorelaxation was significantly enhanced. Our results suggest that dystrophin plays a crucial role in maintaining the structure and function of vascular endothelium and smooth muscle in large mammals. Vascular defects may contribute to DMD pathogenesis. \u00a9 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley &amp; Sons, Ltd.<\/jats:p>","DOI":"10.1002\/path.5704","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T08:34:20Z","timestamp":1621240460000},"page":"589-605","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Dystrophin deficiency impairs vascular structure and function in the canine model of\n                    <scp>Duchenne<\/scp>\n                    muscular dystrophy"],"prefix":"10.1002","volume":"254","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4724-2133","authenticated-orcid":false,"given":"Kasun","family":"Kodippili","sequence":"first","affiliation":[{"name":"Department of Molecular Microbiology and Immunology University of Missouri  Columbia MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela K","family":"Thorne","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences College of Veterinary Medicine, University of Missouri  Columbia MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Harold","family":"Laughlin","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences College of Veterinary Medicine, University of Missouri  Columbia MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4109-1132","authenticated-orcid":false,"given":"Dongsheng","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Molecular Microbiology and Immunology University of Missouri  Columbia MO USA"},{"name":"Department of Biomedical Sciences College of Veterinary Medicine, University of Missouri  Columbia MO USA"},{"name":"Department of Neurology School of Medicine, University of Missouri  Columbia MO USA"},{"name":"Department of Biomedical, Biological &amp; Chemical Engineering College of Engineering, University of Missouri  Columbia MO 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