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Completed

NCT Number: NCT04448626

Micro-environment Involvement in Muscle Alteration Induced

Chronic Obstructive Pulmonary Disease (COPD) is characterized by persistent airway obstruction and inflammatory response of the lungs and bronchi. Episodes of exacerbations contribute to increase the severity and prognosis of the disease. Muscle dysfunction (loss of strengh and muscle mass) is one of comorbidities affecting 30% to 60% of patients and playing a key role in their prognosis. During exacerbation, some studies have suggested an association between muscle dysfunction and modifications of inflammatory circulating factors such as CRP, TNF-alpha, IL- 6, IL8, but no exhaustive study has identified precisely one (or more) biomarker(s) that can induce this muscle wasting during the exacerbation of COPD. Our hypothesis is that the serum of exacerbated COPD patients represents a deleterious microenvironment for the muscle cells which would amplify the mechanisms of atrophy linked to hospitalization. Our team has already developed a cell culture model to study the effects of the plasma microenvironment on atrophy of cultured myotubes. The investigators have shown that the serum of COPD patients can induce muscle atrophy.

The objectives of this study are : 1/ to evaluate the effects of circulating pro-inflammatory factors on atrophy and the myogenic capacities of muscle cells; and 2/ to identify one (or more) circulating biomarker (s) that may be responsible for the muscle damage induced by the microenvironment of hospitalized patients for exacerbation of COPD. First, myotubes and myoblasts of healthy subjects will be cultivated with 9 exacerbation copd patient serum or 9 copd patient serum or 9 healthy subject serum. Myotube diameters, atrophy, inflammatory and oxidative stress markers and alteration of the myogenic capacity of satellite cells will be compared between three groups. Second, the differential expression of circulating proinflammatory molecules will be compared in the serum of the three groups. Identifying circulating factors associated with muscle weakness is a necessary step to better understand the mechanisms and consider a personalized therapeutic approach that can improve the functional and clinical prognosis of disease.

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Key information

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

1/ for COPD patients hospitalized for exacerbation:

  • Hospitalization for COPD exacerbation 2/ for COPD patients
  • COPD patients GOLD II à IV
  • Not having followed respiratory réhabilitation stay for at least one year 3/ for Healthy subjects
  • healthy and sedentary (Voorips score <9)

Exclusion criteria

  • for COPD patients hospitalized for exacerbation:
  • concomitant acute cardiac évent
  • trachéal intubation with mechanical ventilation
  • chronic respiratory disease other than COPD
  • locomotor, neurologic or psychiatric comorbidities
  • for COPD patients
  • Exacerbation with récent hospitalization (<4 weeks)
  • Neurologic comorbidity
  • for Healthy subjects - long term drug treatment with proven central effects

Treatment and study plan

Primary outcomes

  1. Effects evaluation of circulating pro-inflammatory factors on atrophy

    Time frame: 6 months

    Atrophy marker evaluation in cultured muscle cells (myotubes)

    • cultured myotube diameter exposed to the three serum groups (immunofluorescence)
    • atrophy (ubiquitin proteasome system, proteolytic autophagy pathway), inflammatory (TNF-alpha, IL-6, IL-8…) and oxidative stress (ROS, lipid peroxidation) markers expressed by cells exposed to the three serum groups (PCR et WesternBlot)
  2. Effects evaluation of circulating pro-inflammatory factors on the myogenic capacities of muscle cells

    Time frame: 6 months

    Myogenic capacities of cultured muscle cells (myoblastes)

    • inflammatory (TNF-alpha, IL-6, IL-8…) and oxidative stress (ROS, lipid peroxidation) markers expressed by cells exposed to the three serum groups (PCR et WesternBlot)
    • regeneration markers (Notch and myogenesis signaling pathways) expressed by cells exposed to the three serum groups (PCR et WesternBlot)

Secondary outcomes

  1. Identification of one (or more) circulating biomarker (s)

    Time frame: 3 months

    Identification of one (or more) circulating biomarker (s) that may be responsible for the muscle alteration induced by the microenvironment of patient in exacerbation of COPD

Sponsors and collaborators

Lead sponsor

University Hospital, Montpellier

Other

Collaborators

  • APARD Fonds de dotation

Registry information

Official study title

Micro-environment Involvement in Muscle Alteration Induced by Copd Exacerbation

Acronym: MicAMI-BPCO

Important dates

Study start
2020
Primary completion
2020
Study completion
2020
First posted
Jun 26, 2020
Registry last updated
Jun 26, 2020

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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