Sarcopenia Clinical Trial
Official title:
Nutritional and Contractile Regulation of Muscle Growth (Cycle 2)
Muscle wasting, which involves the loss of muscle tissue, is common in many conditions, such as cancer, AIDS, trauma, kidney failure, bone fracture, and sepsis. It is also prevalent among the elderly and in people who experience periods of physical inactivity and weightlessness. Muscle wasting can lead to overall weakness, immobility, physical dependence, and a greater risk of death when exposed to infection, surgery, or trauma. There is a need to develop scientifically based treatments that prevent muscle wasting. As one step towards such a goal, this study will examine the physiological and cellular mechanisms that regulate skeletal muscle growth.
Skeletal muscle comprises about 40% of one's body weight and contains about 50% to 75% of
all the proteins in the human body. The turnover of protein is a regular process in the
human body. In healthy adults, the interplay between muscle protein synthesis and muscle
protein breakdown results in no net growth or loss of muscle mass. But when the scale tips
towards muscle protein breakdown, muscle wasting can occur. This can result in negative
consequences, because not only does muscle fill the obvious role of converting chemical
energy into mechanical energy for moving and maintaining posture, but muscle is also
involved in the following less apparent roles: regulating metabolism; removing potentially
toxic substances from blood circulation; producing fuel for other tissues; storing energy
and nitrogen, both of which are important for fueling the brain and immune system; and
facilitating wound healing during malnutrition, starvation, injury, and disease. Therefore,
muscle is important not only for physical independence but also for mere survival of the
human body. In fact, a mere 30% loss of the body's proteins results in impaired respiration
and circulation and can eventually lead to death. The purpose of this study is to examine
the physiological and cellular mechanisms that regulate skeletal muscle growth. Results from
the study may help to develop future treatments for maintaining and possibly increasing
muscle mass as a way to improve function, reduce disease complications, and increase
survival.
This study will enroll healthy participants who will be randomly assigned to one of several
treatment arms within one of three separate experiments. Overall, the three experiments will
examine the following: (1) whether the mammalian target of rapamycin (mTOR) signaling
pathway--a group of molecules that work together to control a specific cellular function--is
responsible for stimulating muscle protein synthesis after resistance exercise and/or
ingestion of an amino acid supplement; (2) whether restricting blood flow with a blood
pressure cuff during low-intensity resistance exercise ultimately leads to muscle protein
synthesis; and (3) whether aging is associated with reduced physiological and cellular
mechanisms that are related to muscle protein synthesis and whether such a reduction can be
overcome by post-exercise ingestion of an amino acid supplement or blood flow restriction
during low-intensity resistance exercise.
Depending on which treatment arm participants are assigned to, they may receive amino acid
supplementation, the drug rapamycin, the drug sodium nitroprusside, and/or placebo. They may
also undergo high-intensity resistance exercise, low-intensity resistance exercise, or
low-intensity resistance exercise along with blood flow restriction. All participants will
attend a single 8-hour study visit and a follow-up visit 1 week later. During the study
visit, participants will undergo the following: measurements of vital signs, height, and
weight; blood and urine sampling; a dual energy x-ray absorptiometry (DEXA) scan; and an
infusion study that will include additional blood sampling, muscle biopsies, and assigned
interventions. The follow-up visit will include evaluation of any incisions that were made
during the infusion study.
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