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Muscles in Liver Diseases (UNIVERSE)

15. februar 2021 oppdatert av: 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.

Studieoversikt

Detaljert 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.

Studietype

Intervensjonell

Registrering (Forventet)

260

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Grunnvitenskap
  • Tildeling: Ikke-randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Annen: 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
Annen: 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
Annen: 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
Annen: 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

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
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
Tiltaksbeskrivelse
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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Studierekorddatoer

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Studer hoveddatoer

Studiestart (Forventet)

15. februar 2021

Primær fullføring (Forventet)

31. mai 2026

Studiet fullført (Forventet)

31. mai 2026

Datoer for studieregistrering

Først innsendt

7. januar 2021

Først innsendt som oppfylte QC-kriteriene

15. februar 2021

Først lagt ut (Faktiske)

17. februar 2021

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

17. februar 2021

Siste oppdatering sendt inn som oppfylte QC-kriteriene

15. februar 2021

Sist bekreftet

1. desember 2020

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • APHP201215

Plan for individuelle deltakerdata (IPD)

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Ubestemt

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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