This requires better molecular characterization of giant muscle proteins such as titin, nebulin, desmin, and microtubules. High powered digital imaging techniques with great spatial and temporal resolution in functioning muscle fibers should continue to be developed and applied to studies of local sub-cellular signals and molecular interactions during muscle fiber function. This includes the entire cascade of events linking excitation with contractile response at the filament level. A great challenge is to translate the remarkable findings of basic science into useful therapies. It is important to promote gene delivery to muscle and control its expression.
Muscle is often the site of immunization, and thus is likely a good site for antigen presentation.
At the same time, it appears that substances can be delivered by adeno-associated virus vectors and highly overexpressed in myofibers, without any immune response. The dramatic contradictory data concerning muscle as a site of immune reaction are very poorly understood. The discoveries and technologies that are allowing us to understand muscle functions and conquer disease have also changed the way research is carried out. A plan for the future would be incomplete if it did not address resources needed. Muscle is a homogeneous tissue at cellular and biochemical levels, yet shows dramatic adaptation to genetic and physiological stimuli.