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Despite progress in understanding the molecular mechanisms associated with DMD, myocardial insufficiency persists as the primary cause of mortality, and existing therapeutic strategies remain limited. This study investigates the hypothesis that a dysregulation of the biological communication between infiltrating macrophages (MPs) and neurocardiac junctions exists in dystrophic cardiac tissue. In a mouse model of DMD (\n                    <jats:italic>mdx<\/jats:italic>\n                    ), this phenomenon is influenced by the over\u2010release of chondroitin sulfate proteoglycan\u20104 (CSPG4), a key inhibitor of nerve sprouting and a modulator of the neural function, by MPs infiltrating the cardiac tissue and associated with dilated cardiomyopathy, a hallmark of DMD. Givinostat, the histone deacetylase inhibitor under current development as a clinical treatment for DMD, is effective at both restoring a physiological microenvironment at the neuro\u2010cardiac junction and cardiac function in\n                    <jats:italic>mdx<\/jats:italic>\n                    mice in addition to a reduction in cardiac fibrosis, MP\u2010mediated inflammation, and tissue CSPG4 content. This study provides novel insight into the pathophysiology of DMD in the heart, identifying potential new biological targets. \u00a9 2024 The Author(s).\n                    <jats:italic>The Journal of Pathology<\/jats:italic>\n                    published by John Wiley &amp; Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.\n                  <\/jats:p>","DOI":"10.1002\/path.6362","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T03:26:03Z","timestamp":1731295563000},"page":"1-13","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Macrophages producing chondroitin sulfate proteoglycan\u20104 induce neuro\u2010cardiac junction impairment in Duchenne muscular 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