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.
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.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
36
Immobilisation with single leg suspension immobilisation
Graduate Entry Medical School
Derby, Derbyshire, United Kingdom
Changes in muscle volume (cm3)
MRI assessment of muscle volume in Tibialis Anterior (TA) and Medial Gastrocnemius (MG) in immobilised vs non-immobilised leg, pre and post immobilisation
Time frame: 14 days in group 1. 5 days in groups 2 and 3
Changes in muscle thickness (cm)
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
Time frame: 14 days in group 1. 5 days in groups 2 and 3
Changes in muscle cross surface area (cm2)
Ultrasound assessment of muscle cross surface area, in tibialis anterior (TA) and Medial Gastrocnemius (MG) in immobilised vs non-immobilised pre and post immobilisation
Time frame: 14 days in group 1. 5 days in groups 2 and 3
Changes in muscle fibre length (cm)
Ultrasound assessment of muscle fibre length in tibialis anterior (TA) and Medial Gastrocnemius (MG) in immobilised vs non-immobilised pre and post immobilisation
Time frame: 14 days in group 1. 5 days in groups 2 and 3
Changes in muscle fibre pennation angle (degrees)
Ultrasound assessment of muscle fibre pennation angle in tibialis anterior (TA) and Medial Gastrocnemius (MG) in immobilised vs non-immobilised pre and post immobilisation
Time frame: 14 days in group 1. 5 days in groups 2 and 3
Muscle Protein Synthesis (MPS) rate (%/hr)
IV tracer (Individual muscle MPS in TA+MG muscles in immobilised vs non immobilised legs)
Time frame: Over 8 hours following immobilisation period
Muscle Protein Breakdown (MPB) rate (%/hr)
IV Pulse tracers (IV tracers to give muscle specific MPB measures of TA+MG muscles in immobilised vs non-immobilised legs)
Time frame: Over 8 hours following immobilisation period
Muscle blood flow
contrast enhanced ultrasound (CEUS) assessment of muscle blood flow in immobilised vs non-immobilised legs (TA+MG muscle specific)
Time frame: over 5 minutes (following immobilisation period)
Leg blood flow
Doppler assessment of leg blood flow through common femoral artery in fed and fasted states in both immobilised and non-immobilised leg
Time frame: Over 5 minutes (following immobilisation period)
Anabolic Signalling
Measurement of anabolic signalling pathways by western blot (comparison between immobilised vs non immobilised TA + MG muscles)
Time frame: 14 days in group 1. 5 days in groups 2 and 3
Catabolic Signaling
Measurement of proteasome and lysosomal and related catabolic signalling pathways by western blot (comparison between immobilised vs non immobilised TA + MG muscles)
Time frame: 14 days in group 1. 5 days in groups 2 and 3
RNA sequencing
complete RNA sequencing of immobilised vs non immobilised TA + MG muscles to determine gene set enrichment and pathway analysis
Time frame: 14 days in group 1. 5 days in groups 2 and 3
Histology
Morphological assessment of muscle fibres by histological techniques (comparing immobilised vs non immobilised TA + MG muscles)
Time frame: 14 days in group 1. 5 days in groups 2 and 3
Mitochondrial respiration
Measurement of mitochondrial respiration to assess different complex activity in immobilised vs non-immobilised TA + MG muscles
Time frame: 14 days in group 1. 5 days in groups 2 and 3
Intramuscular electromyography (iEMG)
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Electrically induced maximum force development and fatigability in TA + MG muscles pre and post immobilisation
Time frame: 14 days in group 1. 5 days in groups 2 and 3
Muscle power
Assessment of changes in muscle power secondary to immobilisation through 1 rep max (kg) pre and post immobilisation
Time frame: 14 days in group 1. 5 days in groups 2 and 3
Cardio pulmonary fitness
Cardiopulmonary Exercise Testing (CPET) to assess changes in aerobic fitness (V02 max, anaerobic threshold and Watt Max) following immobilisation
Time frame: 14 days in group 1. 5 days in groups 2 and 3