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NCT Number: NCT04199923

Mechanisms of Disuse Atrophy in Human Skeletal Muscle (iMOB)

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.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

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Key information

Age range

18 year–80 year

Sex eligibility

Male

Study type

Interventional

Phase

Not applicable

Primary location

Graduate Entry Medical School

Derby, Derbyshire, DE22 3DT, United Kingdom

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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
  • Female
  • Personal or Family History of Venous Thromboembolism
  • Significant medical comorbidities

Treatment and study plan

Single leg immobilisation

Behavioral

Immobilisation with single leg suspension immobilisation

Primary outcomes

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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)

  7. 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)

Secondary outcomes

  1. Muscle blood flow

    Time frame: over 5 minutes (following immobilisation period)

    contrast enhanced ultrasound (CEUS) assessment of muscle blood flow in immobilised vs non-immobilised legs (TA+MG muscle specific)

  2. Leg blood flow

    Time frame: Over 5 minutes (following immobilisation period)

    Doppler assessment of leg blood flow through common femoral artery in fed and fasted states in both immobilised and non-immobilised leg

  3. Anabolic Signalling

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

    Measurement of anabolic signalling pathways by western blot (comparison between immobilised vs non immobilised TA + MG muscles)

  4. Catabolic Signaling

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

    Measurement of proteasome and lysosomal and related catabolic signalling pathways by western blot (comparison between immobilised vs non immobilised TA + MG muscles)

  5. RNA sequencing

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

    complete RNA sequencing of immobilised vs non immobilised TA + MG muscles to determine gene set enrichment and pathway analysis

  6. Histology

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

    Morphological assessment of muscle fibres by histological techniques (comparing immobilised vs non immobilised TA + MG muscles)

  7. Mitochondrial respiration

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

    Measurement of mitochondrial respiration to assess different complex activity in immobilised vs non-immobilised TA + MG muscles

  8. Intramuscular electromyography (iEMG)

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

    Electrically induced maximum force development and fatigability in TA + MG muscles pre and post immobilisation

  9. Muscle power

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

    Assessment of changes in muscle power secondary to immobilisation through 1 rep max (kg) pre and post immobilisation

  10. Cardio pulmonary fitness

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

    Cardiopulmonary Exercise Testing (CPET) to assess changes in aerobic fitness (V02 max, anaerobic threshold and Watt Max) following immobilisation

Sponsors and collaborators

Lead sponsor

University of Nottingham

Other

Collaborators

  • Biotechnology and Biological Sciences Research Council

Registry information

Official study title

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

Acronym: iMOB

Important dates

Study start
2019
Primary completion
2026
Study completion
2026
First posted
Dec 16, 2019
Registry last updated
May 2, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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