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Muscles in Liver Diseases (UNIVERSE)

15. februar 2021 opdateret af: Assistance Publique - Hôpitaux de Paris

Cirrhosis is the 11th leading cause of death in the world. The progression to cirrhosis occurs as a result of chronic hepatic injury, related to excessive alcohol consumption, non-alcoholic steatohepatitis, chronic viral infection. Cirrhosis is accompanied by symptoms that profoundly affect the quality of life of patients.

Sarcopenia, or decrease in muscle capacity through loss of muscle mass, is associated with liver disease. Patients with liver disease and sarcopenia have increased morbidity, and higher pre- and post-liver transplant mortality than patients without sarcopenia. The mechanism responsible for the development of sarcopenia in liver disease remains largely misunderstood, as do the mechanisms by which sarcopenia appears to promote complications of liver disease.

This study, carried out on a prospective cohort of patients with liver disease, aims at understanding the pathophysiological mechanisms involved in sarcopenia and its consequences.

Studieoversigt

Detaljeret beskrivelse

Cirrhosis is the 11th leading cause of death in the world. The progression to cirrhosis occurs as a result of chronic hepatic injury, related to excessive alcohol consumption, non-alcoholic steatohepatitis, and chronic viral infection. Cirrhosis is accompanied by symptoms that profoundly affect the quality of life of patients.

Sarcopenia, or decrease in muscle capacity through loss of muscle mass, is associated with liver disease. Patients with liver disease and sarcopenia have increased morbidity, and higher pre- and post-liver transplant mortality than patients without sarcopenia. The mechanism responsible for the development of sarcopenia in liver disease remains largely misunderstood, as do the mechanisms by which sarcopenia appears to promote complications of liver disease.

This study, carried out on a prospective cohort of patients with stable liver disease, aims at understanding the pathophysiological mechanisms involved in sarcopenia and its consequences.

After checking the inclusion criteria, all eligible patients treated at Beaujon Hospital (Clichy) will be invited to participate in the study. After inclusion, clinical and laboratory features (hepatic assessment) will be collected and the blood samples will be taken.

During the surgery, a muscle biopsy will be performed on the incision area. No follow-up is planned.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

260

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Patients over the age of 18 having a scheduled abdominal surgery at Beaujon Hospital
  • Patient affiliated to a social security scheme
  • Informed patient having signed a consent to participate

Exclusion Criteria:

Primary muscle disease (myopathy, dermatopolymyositis, vasculitis with muscle involvement)

  • Amyotrophic drugs: long-term corticosteroid therapy
  • Immunosuppressive treatments
  • Chronic inflammatory disease (example: Crohn's disease)
  • Disease known to cause sarcopenia such as -but not limited to- active extrahepatic neoplasia, polycystic hepatorenal disease
  • Gastrointestinal haemorrhage in the 15 days prior to inclusion
  • Acute alcoholic hepatitis in the month before inclusion
  • Infection during treatment
  • Pregnant or breastfeeding woman
  • Protected populations: people under guardianship or under guardianship
  • Patient not affiliated to a social security scheme
  • Patient under AME
  • Patient not having signed consent

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Grundvidenskab
  • Tildeling: Ikke-randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Andet: patients without liver disease,
taking blood samples and biopsy of muscular wall
3 citrated tubes and 3 EDTA tubes
a muscle biopsy will be performed on the incision area
Andet: patient with chronic liver disease without cirrhosis,
taking blood samples and biopsy of muscular wall
3 citrated tubes and 3 EDTA tubes
a muscle biopsy will be performed on the incision area
Andet: patients with compensated cirrhosis,
taking blood samples and biopsy of muscular wall
3 citrated tubes and 3 EDTA tubes
a muscle biopsy will be performed on the incision area
Andet: patient with severe cirrhosis
taking blood samples and biopsy of muscular wall
3 citrated tubes and 3 EDTA tubes
a muscle biopsy will be performed on the incision area

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
describe the muscle changes that occur during liver disease.
Tidsramme: 1 month after the of inclusion
Assessment of the histology of the muscle removed during abdominal surgery by measuring the diameter of muscle fibers
1 month after the of inclusion
describe the muscle changes that occur during liver disease.
Tidsramme: 1 month after the of inclusion
Assessment of the histology of the muscle removed during abdominal surgery, by evaluating the vascularity with measurements of CD31 count and αSMA count
1 month after the of inclusion
describe the muscle changes that occur during liver disease.
Tidsramme: 1 month after the of inclusion
Assessment of the histology of the muscle removed during abdominal surgery by evaluating the muscle stem cells with measurements of Pax7, MyoD and Myogenin
1 month after the of inclusion
describe the muscle changes that occur during liver disease.
Tidsramme: 1 month after the of inclusion
Assessment of the histology of the muscle removed during abdominal surgery by evaluating gene expression with transcriptomics
1 month after the of inclusion

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Identify circulating mediators that could be responsible for sarcopenia: released by the liver and acting on the muscle.
Tidsramme: 1 month after the of inclusion

Circulating concentration of mediators / cells suspected of being responsible for sarcopenia:

  • extracellular vesicles released by the liver
  • lymphocyte phenotype potentially modified by sinusoidal endothelial cells of the liver
  • protein array
1 month after the of inclusion
Identify circulating mediators that could be responsible for complications of liver disease: released by the muscle and acting on the different organs
Tidsramme: 1 month after the of inclusion

Circulating concentration of mediators / cells suspected of being released by muscle and contributing to organ dysfunction in liver disease:

  • extracellular vesicles
  • myokines
1 month after the of inclusion

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Forventet)

15. februar 2021

Primær færdiggørelse (Forventet)

31. maj 2026

Studieafslutning (Forventet)

31. maj 2026

Datoer for studieregistrering

Først indsendt

7. januar 2021

Først indsendt, der opfyldte QC-kriterier

15. februar 2021

Først opslået (Faktiske)

17. februar 2021

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

17. februar 2021

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

15. februar 2021

Sidst verificeret

1. december 2020

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • APHP201215

Plan for individuelle deltagerdata (IPD)

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