Tissue-based assays provide insight for understanding therapeutic response for Duchenne muscular dystrophy (DMD) therapies within the context of intact muscle. This necessitates that at least two biomarkers are evaluated simultaneously in the same tissue section, one for fibre identification and one for biomarker quantification. While fluorescent multiplex assays are feasible, they present many technical challenges for analytical validation. Chromogenic assays are not subject to the same technical limitations and are commonly used in the clinical space to provide robust data, enabling confident interpretation of therapeutic effect.

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