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In DMD, myocytes cell membrane is destabilized and causes disorganization of cytoskeleton, which leads to increased concentration of free Ca2+ in cytosol

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Mechanical trauma from a damaged endothelium, complement fixation and activation on the cell surface, and infectious agents may cause direct membrane degradation and cell destruction

This reduces the synthesis of types I and III procollagen, thereby damaging the formation of new collagen while also degrading it