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Clinical Trials/NCT04199923
NCT04199923
Active, not recruiting
Not Applicable

Harnessing Muscle-specific Atrophy Susceptibility to Disentangle the Mechanisms of Disuse Atrophy in Human Skeletal Muscle Atrophy (iMOB)

University of Nottingham1 site in 1 country36 target enrollmentApril 1, 2019

Overview

Phase
Not Applicable
Intervention
Not specified
Conditions
Muscular Atrophy
Sponsor
University of Nottingham
Enrollment
36
Locations
1
Primary Endpoint
Changes in muscle volume (cm3)
Status
Active, not recruiting
Last Updated
last year

Overview

Brief Summary

Loss of muscle can be caused by a variety of stimuli and results in reduced mobility and strength and also impacts whole body health. Whilst it is known that muscles waste the process by which this occurs is not well understood. Furthermore, whilst some muscles waste quickly others seem resistant to the effects of disuse.

This study aims to evaluate how quickly changes in muscles start to occur, and investigate the processes which underlie muscle atrophy. By studying muscles which waste quickly and those which are resistant to atrophy this study aims to identify the different processes which lead to muscle loss. This study will also evaluate the differences in muscle changes between young and old people.

Detailed Description

Skeletal muscles host \~40% of all protein in the body. Muscles are not only crucial for locomotion but also represent the body's largest metabolically active tissue, glucose disposal site and fuel reservoir for other organs in pathological conditions (i.e., supply of amino acids to the liver for gluconeogenesis). Muscle atrophy is characterized by a reduction in cross sectional area (CSA) and length and occurs in many common illnesses (e.g. cancers (1), renal/heart failure, sepsis, genetic diseases, neurodegenerative disorders etc). It is also prevalent in situations of reduced neural input such as leg casting after fractures (2), bed-rest, spinal cord injury (3), space flight and chronic physical inactivity. Atrophy results in a loss of muscle power and strength (which is related to increased morbidity and mortality (4)) and reduced capacities for whole-body glucose storage and metabolism which causes insulin resistance. Strategies to oppose atrophy are limited but include mechanical loading (5) and the synergistic anabolic effects of nutrients. Although muscle atrophy is of great clinical importance, relatively little mechanistic research has been done in humans. Thus, the aim of this study is to assess the link between the variation in muscle physiological responses to disuse atrophy with variation in protein turnover and molecular-networks. This will not only provide new hypotheses for physiological regulation of human muscle and generate 'intervention targets' derived from clinically relevant human studies, it will also improve understanding of whether the response to disuse is altered with age and determine if mechanistic differences in atrophy resistant and atrophy sensitive muscles might explain inter-muscular variation in susceptibility to atrophy. This study aims to define the molecular and metabolic mechanisms causing disuse atrophy in both young and older individuals and explore how and why some muscles are protected against it. The study will also assess temporal aspects of disuse atrophy (in younger individuals only) to explore the mechanistic basis for the more rapid atrophy observed in the early days of disuse.

Registry
clinicaltrials.gov
Start Date
April 1, 2019
End Date
October 1, 2026
Last Updated
last year
Study Type
Interventional
Study Design
Single Group
Sex
Male

Investigators

Responsible Party
Principal Investigator
Principal Investigator

Bethan Phillips

Professor of Translational Physiology

University of Nottingham

Eligibility Criteria

Inclusion Criteria

  • Group 1 and 2: Male, Age 18-40, BMI 18-35
  • Group 3: Male, Age 65-80, BMI 18-35

Exclusion Criteria

  • BMI \> 35 / \<18
  • Personal or Family History of Venous Thromboembolism
  • Significant medical comorbidities

Outcomes

Primary Outcomes

Changes in muscle volume (cm3)

Time Frame: 14 days in group 1. 5 days in groups 2 and 3

MRI assessment of muscle volume in Tibialis Anterior (TA) and Medial Gastrocnemius (MG) in immobilised vs non-immobilised leg, pre and post immobilisation

Changes in muscle fibre length (cm)

Time Frame: 14 days in group 1. 5 days in groups 2 and 3

Ultrasound assessment of muscle fibre length in tibialis anterior (TA) and Medial Gastrocnemius (MG) in immobilised vs non-immobilised pre and post immobilisation

Muscle Protein Synthesis (MPS) rate (%/hr)

Time Frame: Over 8 hours following immobilisation period

IV tracer (Individual muscle MPS in TA+MG muscles in immobilised vs non immobilised legs)

Changes in muscle fibre pennation angle (degrees)

Time Frame: 14 days in group 1. 5 days in groups 2 and 3

Ultrasound assessment of muscle fibre pennation angle in tibialis anterior (TA) and Medial Gastrocnemius (MG) in immobilised vs non-immobilised pre and post immobilisation

Muscle Protein Breakdown (MPB) rate (%/hr)

Time Frame: Over 8 hours following immobilisation period

IV Pulse tracers (IV tracers to give muscle specific MPB measures of TA+MG muscles in immobilised vs non-immobilised legs)

Changes in muscle cross surface area (cm2)

Time Frame: 14 days in group 1. 5 days in groups 2 and 3

Ultrasound assessment of muscle cross surface area, in tibialis anterior (TA) and Medial Gastrocnemius (MG) in immobilised vs non-immobilised pre and post immobilisation

Changes in muscle thickness (cm)

Time Frame: 14 days in group 1. 5 days in groups 2 and 3

Ultrasound scan (USS) assessment of muscle thickness in Tibialis Anterior (TA) and Medial Gastrocnemius (MG) in immobilised vs non-immobilised leg, pre and post immobilisation

Secondary Outcomes

  • Anabolic Signalling(14 days in group 1. 5 days in groups 2 and 3)
  • Histology(14 days in group 1. 5 days in groups 2 and 3)
  • Muscle blood flow(over 5 minutes (following immobilisation period))
  • Leg blood flow(Over 5 minutes (following immobilisation period))
  • Intramuscular electromyography (iEMG)(14 days in group 1. 5 days in groups 2 and 3)
  • RNA sequencing(14 days in group 1. 5 days in groups 2 and 3)
  • Catabolic Signaling(14 days in group 1. 5 days in groups 2 and 3)
  • Mitochondrial respiration(14 days in group 1. 5 days in groups 2 and 3)
  • Muscle power(14 days in group 1. 5 days in groups 2 and 3)
  • Cardio pulmonary fitness(14 days in group 1. 5 days in groups 2 and 3)

Study Sites (1)

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