ITGA4 and Duchenne muscular dystrophy: CD49d, the alpha chain subunit of integrin very late antigen 4 (VLA-4) is expressed widely on immune cells in this cascade and can bind osteopontin [7].In patients with DMD, the number of CD49d high expressing T lymphocytes is inversely proportional to ambulation speed, with highest concentration seen in non-ambulant patients [8].