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Muscles in Liver Diseases (UNIVERSE)

15 februari 2021 bijgewerkt door: 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.

Studie Overzicht

Gedetailleerde beschrijving

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.

Studietype

Ingrijpend

Inschrijving (Verwacht)

260

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Fundamentele wetenschap
  • Toewijzing: Niet-gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Ander: 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
Ander: 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
Ander: 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
Ander: 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

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
describe the muscle changes that occur during liver disease.
Tijdsspanne: 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.
Tijdsspanne: 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.
Tijdsspanne: 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.
Tijdsspanne: 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

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Identify circulating mediators that could be responsible for sarcopenia: released by the liver and acting on the muscle.
Tijdsspanne: 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
Tijdsspanne: 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

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Verwacht)

15 februari 2021

Primaire voltooiing (Verwacht)

31 mei 2026

Studie voltooiing (Verwacht)

31 mei 2026

Studieregistratiedata

Eerst ingediend

7 januari 2021

Eerst ingediend dat voldeed aan de QC-criteria

15 februari 2021

Eerst geplaatst (Werkelijk)

17 februari 2021

Updates van studierecords

Laatste update geplaatst (Werkelijk)

17 februari 2021

Laatste update ingediend die voldeed aan QC-criteria

15 februari 2021

Laatst geverifieerd

1 december 2020

Meer informatie

Termen gerelateerd aan deze studie

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • APHP201215

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

Onbeslist

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Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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