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Hughes A, Francis T, Marjoram L, Rooney JH, Ellison-Hughes G, Pollock R, Curtis MJ, Cape A, Larsen M, Phillips BE, Atherton PJ, Smith K, Witard OC. The effect of combined β-lactoglobulin supplementation and resistance exercise training prior to limb immobilisation on muscle protein synthesis rates in healthy young adults: study protocol for a randomised controlled trial. Trials 2023; 24:401. [PMID: 37312095 DOI: 10.1186/s13063-023-07329-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/25/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND The decline in skeletal muscle mass experienced following a short-term period (days to weeks) of muscle disuse is mediated by impaired rates of muscle protein synthesis (MPS). Previous RCTs of exercise or nutrition prehabilitation interventions designed to mitigate disuse-induced muscle atrophy have reported limited efficacy. Hence, the aim of this study is to investigate the impact of a complex prehabilitation intervention that combines β-lactoglobulin (a novel milk protein with a high leucine content) supplementation with resistance exercise training on disuse-induced changes in free-living integrated rates of MPS in healthy, young adults. METHODS/DESIGN To address this aim, we will recruit 24 healthy young (18-45 years) males and females to conduct a parallel, double-blind, 2-arm, randomised placebo-controlled trial. The intervention group will combine a 7-day structured resistance exercise training programme with thrice daily dietary supplementation with 23 g of β-lactoglobulin. The placebo group will combine the same training programme with an energy-matched carbohydrate (dextrose) control. The study protocol will last 16 days for each participant. Day 1 will be a familiarisation session and days 2-4 will be the baseline period. Days 5-11 represent the 'prehabilitation period' whereby participants will combine resistance training with their assigned dietary supplementation regimen. Days 12-16 represent the muscle disuse-induced 'immobilisation period' whereby participants will have a single leg immobilised in a brace and continue their assigned dietary supplementation regimen only (i.e. no resistance training). The primary endpoint of this study is the measurement of free-living integrated rates of MPS using deuterium oxide tracer methodology. Measurements of MPS will be calculated at baseline, over the 7-day prehabilitation period and over the 5-day immobilisation period separately. Secondary endpoints include measurements of muscle mass and strength that will be collected on days 4 (baseline), 11 (end of prehabilitation) and 16 (end of immobilisation). DISCUSSION This novel study will establish the impact of a bimodal prehabilitation strategy that combines ß-lactoglobulin supplementation and resistance exercise training in modulating MPS following a short-term period of muscle disuse. If successful, this complex intervention may be translated to clinical practice with application to patients scheduled to undergo, for example, hip or knee replacement surgery. TRIAL REGISTRATION NCT05496452. Registered on August 10, 2022. PROTOCOL VERSION 16-12-2022/1.
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Affiliation(s)
- Alix Hughes
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK
| | - Thomas Francis
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK
| | - Lindsey Marjoram
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK
| | - Jessica H Rooney
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK
| | | | - Ross Pollock
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK
| | - Michael J Curtis
- School of Cardiovascular Medicine & Sciences, King's College London, London, UK
| | - Angela Cape
- Clinical Trials Unit, King's College London, London, UK
| | | | | | | | - Kenneth Smith
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Oliver C Witard
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK.
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Leng Z, Zhu R, Hou W, Feng Y, Yang Y, Han Q, Shan G, Meng F, Du D, Wang S, Fan J, Wang W, Deng L, Shi H, Li H, Hu Z, Zhang F, Gao J, Liu H, Li X, Zhao Y, Yin K, He X, Gao Z, Wang Y, Yang B, Jin R, Stambler I, Lim LW, Su H, Moskalev A, Cano A, Chakrabarti S, Min KJ, Ellison-Hughes G, Caruso C, Jin K, Zhao RC. Transplantation of ACE2 - Mesenchymal Stem Cells Improves the Outcome of Patients with COVID-19 Pneumonia. Aging Dis 2020; 11:216-228. [PMID: 32257537 PMCID: PMC7069465 DOI: 10.14336/ad.2020.0228] [Citation(s) in RCA: 804] [Impact Index Per Article: 201.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 02/28/2020] [Indexed: 01/08/2023] Open
Abstract
A coronavirus (HCoV-19) has caused the novel coronavirus disease (COVID-19) outbreak in Wuhan, China. Preventing and reversing the cytokine storm may be the key to save the patients with severe COVID-19 pneumonia. Mesenchymal stem cells (MSCs) have been shown to possess a comprehensive powerful immunomodulatory function. This study aims to investigate whether MSC transplantation improves the outcome of 7 enrolled patients with COVID-19 pneumonia in Beijing YouAn Hospital, China, from Jan 23, 2020 to Feb 16, 2020. The clinical outcomes, as well as changes of inflammatory and immune function levels and adverse effects of 7 enrolled patients were assessed for 14 days after MSC injection. MSCs could cure or significantly improve the functional outcomes of seven patients without observed adverse effects. The pulmonary function and symptoms of these seven patients were significantly improved in 2 days after MSC transplantation. Among them, two common and one severe patient were recovered and discharged in 10 days after treatment. After treatment, the peripheral lymphocytes were increased, the C-reactive protein decreased, and the overactivated cytokine-secreting immune cells CXCR3+CD4+ T cells, CXCR3+CD8+ T cells, and CXCR3+ NK cells disappeared in 3-6 days. In addition, a group of CD14+CD11c+CD11bmid regulatory DC cell population dramatically increased. Meanwhile, the level of TNF-α was significantly decreased, while IL-10 increased in MSC treatment group compared to the placebo control group. Furthermore, the gene expression profile showed MSCs were ACE2- and TMPRSS2- which indicated MSCs are free from COVID-19 infection. Thus, the intravenous transplantation of MSCs was safe and effective for treatment in patients with COVID-19 pneumonia, especially for the patients in critically severe condition.
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Affiliation(s)
- Zikuan Leng
- 1School of Life Sciences, Shanghai University, Shanghai, China.,5Department of Orthopaedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rongjia Zhu
- 2Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Wei Hou
- 3Beijing YouAn Hospital, Capital Medical University, Beijing, China
| | - Yingmei Feng
- 3Beijing YouAn Hospital, Capital Medical University, Beijing, China
| | - Yanlei Yang
- 4Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qin Han
- 2Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- 2Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Fanyan Meng
- 1School of Life Sciences, Shanghai University, Shanghai, China
| | - Dongshu Du
- 1School of Life Sciences, Shanghai University, Shanghai, China
| | - Shihua Wang
- 2Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Junfen Fan
- 2Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Wenjing Wang
- 3Beijing YouAn Hospital, Capital Medical University, Beijing, China
| | - Luchan Deng
- 2Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Hongbo Shi
- 3Beijing YouAn Hospital, Capital Medical University, Beijing, China
| | - Hongjun Li
- 3Beijing YouAn Hospital, Capital Medical University, Beijing, China
| | - Zhongjie Hu
- 3Beijing YouAn Hospital, Capital Medical University, Beijing, China
| | - Fengchun Zhang
- 4Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinming Gao
- 4Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongjian Liu
- 5Department of Orthopaedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoxia Li
- 6Institute of Stem Cell and Regeneration Medicine, School of Basic Medicine, Qingdao University, Shandong, China
| | - Yangyang Zhao
- 2Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Kan Yin
- 6Institute of Stem Cell and Regeneration Medicine, School of Basic Medicine, Qingdao University, Shandong, China
| | - Xijing He
- 7Department of Orthopaedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhengchao Gao
- 7Department of Orthopaedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yibin Wang
- 7Department of Orthopaedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Bo Yang
- 8Department of Neurosurgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ronghua Jin
- 3Beijing YouAn Hospital, Capital Medical University, Beijing, China
| | - Ilia Stambler
- 9The Executive Committee on Anti-aging and Disease Prevention in the framework of Science and Technology, Pharmacology and Medicine Themes under an Interactive Atlas along the Silk Roads, UNESCO, Paris, France.,10International Society on Aging and Disease, Fort Worth, Texas, USA.,11The Geriatric Medical Center "Shmuel Harofe", Beer Yaakov, affiliated to Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Lee Wei Lim
- 9The Executive Committee on Anti-aging and Disease Prevention in the framework of Science and Technology, Pharmacology and Medicine Themes under an Interactive Atlas along the Silk Roads, UNESCO, Paris, France.,10International Society on Aging and Disease, Fort Worth, Texas, USA.,12School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Huanxing Su
- 9The Executive Committee on Anti-aging and Disease Prevention in the framework of Science and Technology, Pharmacology and Medicine Themes under an Interactive Atlas along the Silk Roads, UNESCO, Paris, France.,10International Society on Aging and Disease, Fort Worth, Texas, USA.,13Institute of Chinese Medical Science, University of Macau, Taipa, Macau, China
| | - Alexey Moskalev
- 9The Executive Committee on Anti-aging and Disease Prevention in the framework of Science and Technology, Pharmacology and Medicine Themes under an Interactive Atlas along the Silk Roads, UNESCO, Paris, France.,10International Society on Aging and Disease, Fort Worth, Texas, USA.,14Institute of Biology, Komi Science Center of Russian Academy of Sciences, Syktyvkar, Russia
| | - Antonio Cano
- 9The Executive Committee on Anti-aging and Disease Prevention in the framework of Science and Technology, Pharmacology and Medicine Themes under an Interactive Atlas along the Silk Roads, UNESCO, Paris, France.,10International Society on Aging and Disease, Fort Worth, Texas, USA.,15Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain
| | | | - Kyung-Jin Min
- 9The Executive Committee on Anti-aging and Disease Prevention in the framework of Science and Technology, Pharmacology and Medicine Themes under an Interactive Atlas along the Silk Roads, UNESCO, Paris, France.,10International Society on Aging and Disease, Fort Worth, Texas, USA.,17Department of Biological Sciences, Inha University, Incheon, South Korea
| | - Georgina Ellison-Hughes
- 9The Executive Committee on Anti-aging and Disease Prevention in the framework of Science and Technology, Pharmacology and Medicine Themes under an Interactive Atlas along the Silk Roads, UNESCO, Paris, France.,10International Society on Aging and Disease, Fort Worth, Texas, USA.,18Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Calogero Caruso
- 9The Executive Committee on Anti-aging and Disease Prevention in the framework of Science and Technology, Pharmacology and Medicine Themes under an Interactive Atlas along the Silk Roads, UNESCO, Paris, France.,10International Society on Aging and Disease, Fort Worth, Texas, USA.,19Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Kunlin Jin
- 9The Executive Committee on Anti-aging and Disease Prevention in the framework of Science and Technology, Pharmacology and Medicine Themes under an Interactive Atlas along the Silk Roads, UNESCO, Paris, France.,10International Society on Aging and Disease, Fort Worth, Texas, USA.,20University of North Texas Health Science Center, Fort Worth, TX76107, USA
| | - Robert Chunhua Zhao
- 1School of Life Sciences, Shanghai University, Shanghai, China.,2Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China.,9The Executive Committee on Anti-aging and Disease Prevention in the framework of Science and Technology, Pharmacology and Medicine Themes under an Interactive Atlas along the Silk Roads, UNESCO, Paris, France.,10International Society on Aging and Disease, Fort Worth, Texas, USA
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