In the past, we have shown an increase in TNF-α levels in skeletal muscle; however, it is unclear whether epigenetics controls the expression of immune response genes directly such as the molecules and cell types, namely the TNF-α, IL1, iNOS, Nox4, NPT, M1 macrophages, MMP9, and CD4+ and CD8+ cells during DMD disease pathogenesis [16]. Here, NOX4 is linked to Duchenne muscular dystrophy.