Fig. 1 (IMAGE) Osaka University Caption Mechanisms of molecular pathology and erythromycin treatment in myotonic dystrophy type 1 In myotonic dystrophy type 1, aberrant RNA transcribed from the mutant DMPK gene leads to the aggregation of splicing regulators. The resulting depletion in intracellular splicing regulators disrupts splicing control mechanisms, and splicing abnormalities occur in various genes. These splicing abnormalities are believed to cause diverse symptoms throughout the body, including myotonia, progressive muscle weakness, arrhythmias, and impaired glucose tolerance. In myotonic dystrophy type 1, erythromycin prevents the aggregation of splicing regulators by binding to the abnormal RNAs, thereby restoring splicing regulatory function and improving symptoms. Credit 2023 Nakamori et al., Erythromycin for myotonic dystrophy type 1: a multicentre, randomised, double-blind, placebo-controlled, phase 2 trial., eClinicalMedicine Usage Restrictions Credit must be given to the creator. Only noncommercial uses of the work are permitted. No derivatives or adaptations of the work are permitted. License CC BY-NC-ND Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.