These results are very interesting, but to assess their significance and to establish whether or not the ELISA system for Titin-N fragment will be useful for pathological and clinical diagnosis of muscle dystrophy, it will be necessary to complete a large-scale, comprehensive cohort study of DMD patients between the age of disease on-set (around 3 years) and death (around 30 years), including measurements of not only urinary Titin-N concentrations, but also CK-M and other biomarkers for DMD, such as muscle specific miRNAs, as well as muscle biomarker proteins. The gene discussed is CKM; the disease is Duchenne muscular dystrophy.