Pharmacological interventions that increase myofiber size counter the functional decline of dystrophic muscles 1,2 . We show that deacetylase inhibitors increase the size of myofibers in dystrophin-deficient (MDX) and a-sarcoglycan (a-SG)-deficient mice by inducing the expression of the myostatin antagonist follistatin 3 in satellite cells. Deacetylase inhibitor treatment conferred on dystrophic muscles resistance to contraction-coupled degeneration and alleviated both morphological and functional consequences of the primary genetic defect. These results provide a rationale for using deacetylase inhibitors in the pharmacological therapy of muscular dystrophies.Enlarging fiber size in dystrophic muscles produces beneficial effects in dystrophin-deficient MDX mice, a model of Duchenne muscular dystrophy (DMD) 2,4-6 . Previous studies have shown that three structurally unrelated deacetylase inhibitors-trichostatin A (TSA), valproic acid (VPA) and phenylbutyrate (PhB)-share the ability to promote myoblast fusion into hypernucleated myotubes with an increased size relative to myotubes formed in the absence of drugs 7,8 . To select a compound for long-term treatment of dystrophic mice, we compared the results of pilot experiments in which MDX mice were exposed to TSA (0.6 mg per kg body weight per day), VPA (160 mg/kg per day) or PhB (90 mg/kg per day) by daily intraperitoneal injections. We chose to begin the treatment when the first manifestations of the disease were already evident, as we sought to evaluate the efficacy of deacetylase inhibitors in a situation simulating the clinical stage at which human patients typically receive the diagnosis of muscular dystrophy 9 . Increased histone acetylation, which reflects the bioactivity of deacetylase inhibitors, was detected in muscles and other peripheral organs (for example, brain) a few hours after injection, indicating rapid uptake of the compounds (Supplementary Figure 1 online). We next evaluated the ability of satellite cells from MDX mice exposed to the deacetylase inhibitors for 10 d to differentiate into multinucleated myotubes. After 24 h in differentiation medium, myotubes were present only in cultures of satellite cells isolated from mice exposed to deacetylase inhibitors (Supplementary Figure 2 online). Notably, satellite cells derived from TSA-treated mice formed myotubes with the highest efficiency and showed an increased expression, relative to that in untreated controls, of myosin heavy chain (MyHC)-a marker of terminal differentiation-and of regeneration markers, such as follistatin and embryonic and perinatal MyHC (Supplementary Figure 2). Only satellite cells from TSA-treated mice showed reduced levels of myostatin mRNA relative to those from untreated controls. Treatment of 12-week-old mice with deacetylase inhibitors for an additional three months prevented an increase in serum concentrations of creatine kinase, a biomarker for the severity of the disease (Supplementary Figure 2). The decline of creatine kinase concentrations was more pronounced i...